Las Vegas--Non-surgical cryoablation of breast cancer – destruction of diseased tissue by exposure to freezing temperatures – shows promise as an alternative to surgery for selected women with early stage invasive ductal cancer (IDC), according to a new phase II clinical trial presented this week at the American Society of Breast Surgeons (ASBrS) Annual Meeting.   The study found that 100% of patients’ tumors less than 1 cm in size treated with cryoablation had no residual invasive cancer on pathological examination of the targeted lesion. The success rate for cancers of any size was 80.5%.  For 69% of patients, cryoablation was successful when defined as no residual IDC or ductal cancer in situ (DCIS), a precursor to cancer.

 

“With cryoablation, a woman need not even enter the operating room for treatment, and the procedure can be as brief as 20 minutes,” comments Rache Simmons, MD, Chief of Breast Surgery at New York Presbyterian/Weill Cornell Medical Center and lead author of the study.  “Compared to surgery, cryoablation is far less invasive and provides better cosmetic results, shorter procedure time and faster recovery.”

 

The technique is well-established for treatment of non-cancerous breast fibroadenomas and has been routinely used for other cancers for some time.  Earlier studies also suggested that cryoablation is an effective non-surgical treatment for breast cancer in a certain early stage patients. 

 

The new study examined 86 patients with 87 breast cancers from 19 treatment centers.  For the procedure, a cryoprobe was inserted under ultrasound guidance through the skin into the targeted lesion.  Patients underwent ablation using a freeze-thaw-freeze cycle lasting approximately 6-10-6 or 8-10-8 minutes, respectively.  Following ablation, the treated tumor was surgically removed for pathological evaluation to determine the procedure’s success.  “We found that the smaller the cancer, the greater the rate of complete cryoablation,” says Dr. Simmons.

 

A secondary study objective was to evaluate the accuracy of MRI in visualizing residual IDC or DCIS imaging following cryoablation to determine whether the patient was cancer-free.  In the study, MRI findings were consistent with subsequent pathology reports for 85.9% of patients with negative findings for IDC and 75% of patients with negative reports for both IDC and DCIS—suggesting an important role for MRI in evaluating cryoablation results.