New research suggests cryoablation, which uses extreme cold to kill cancer cells, could help treat large breast cancer tumors.
- Breast cancer is the most frequently diagnosed
cancer in the world, with several treatment options available.
- A newer treatment called cryoablation, which
uses extreme cold to kill cancer cells, has traditionally only been used
to treat small breast cancer tumors.
- New research provides evidence that
cryoablation may also be effective in treating large breast cancer tumors.
- The findings could offer an alternative to
surgery for high risk breast cancer patients such as those with
comorbidities.
With about
Depending on the type and stage of breast cancer,
various treatment options are available, including chemotherapy, radiation therapy, surgery, and a newer
treatment called cryoablation — a process that kills cancer
tumors by freezing them.
According to a new study recently
presented at the 2024 Society of Interventional Radiology Annual Scientific
Meeting, most studies involving cryoablation and breast cancer have focused on
treating small breast cancer tumors.
“Cryoablation has been typically used to treat tumors
smaller than 1.5 cm,” Yolanda Bryce, MD, interventional radiologist
at the Memorial Sloan Kettering Cancer Center in New York and co-author of this
study told Medical
News Today.
In this new research, Bryce and her team provide
evidence suggesting cryoablation may also effectively treat large breast cancer
tumors. The findings have not yet been published in a peer-reviewed scientific
journal.
This study involved 60 participants who all underwent
cryoablation because they were not able to or did not want surgery.
“Traditionally, the standard of care for patients with
breast cancer is to have surgery to remove the tumor — especially if the cancer
is localized to the breast,” Bryce explained.
“But
there are many patients who are not candidates for surgery. For instance, they
may be older, have too many comorbidities that prohibit them from having
surgery, or they’re on a blood thinner that they cannot
come off of,” Bryce noted.
“Some comorbidities, such as heart disease or high blood pressure,
can increase the risks associated with traditional surgical options,” she
added.
“Cryoablation gives these patients another option to
treat their cancer.”
According to Bryce, cryoablation is a minimally invasive
treatment that uses imaging guidance such as ultrasound or
a computed tomography (CT) scan to locate
tumors.
“An interventional radiologist will then insert small,
needle-like probes emitting extremely cold temperatures at the location of the
tumor to create an ice ball that surrounds the tumor, killing the cancer
cells,” she continued.
“When
combined with
For this study, the cryoablation procedures were
conducted with local anesthesia or minimal sedation. The procedure included a
free-thaw cycle encompassing five to 10 minutes of freezing, 5 to 8 minutes of
passive thaw, and another five to 10 minutes of freezing at 100% intensity.
Participants were able to go home the same day after treatment.
Breast cancer tumor sizes amongst the study
participants ranged in size from 0.3 to 9 cm with a 2.5 cm average size.
During cryoablation, participants with tumors larger
than 1.4 cm were treated with one probe for each tumor centimeter.
What is the
success rate of cryoablation for breast cancer?
When researchers followed up on study participants
after a median period of 16 months, they found the recurrence rate was only
10%.
“Until now, cryoablation for breast cancer has been a
treatment option for those with smaller tumors,” Bryce said.
“We didn’t know if it could be a feasible option for
patients with larger tumors as well. For patients who have larger tumors but
can’t undergo surgery, they would typically only be able to try radiation, chemotherapy, and hormonal therapy to treat
their tumors. But cryoablation could be more effective than this current
standard of care for patients who are not surgical candidates,” Bryce
continued.
“When treated with only
radiation and hormonal therapy, tumors will eventually return, so the fact that
we saw only a 10% recurrence rate in our study is incredibly promising. We will
be conducting a retrospective study and will continue to watch this cohort of
patients for further analysis. We hope that these results give those with
breast cancer additional options to treat their cancer. The procedure is
available to patients now, and we encourage all patients to discuss with their
doctor which treatment option is best for their unique case.”— Yolanda Bryce,
MD, study co-author
More studies on cryoablation for
large breast tumors needed
After reviewing this study, Janie Grumley, MD, breast
surgical oncologist and director of the Margie Petersen Breast Center at
Providence Saint John’s Center and associate professor of surgery at Saint
John’s Cancer Institute in Santa Monica, CA, told MNT that cryoablation is something doctors and
scientists have been looking at for many years.
In general, Grumley said she does not come across many
patients who are not eligible for surgery.
“There are patients who choose not to have surgery,
but there aren’t a lot of patients who aren’t eligible for surgery — it’s
pretty rare because surgical excision is a very small operation,” she
explained. “If you do a lumpectomy, there’s very little risk to it, and
you can even do it without full general anesthesia.”
Grumley also commented she felt the study was small
with a very short follow-up.
“With
breast cancer, doing a follow-up that is less than 10, 15, 20 years is really
inadequate data,” she explained.
“I think there’s been only one large study, the ICE3 trial — when I say large is 197
patients. In the world of breast cancer, [194] patients is very small, but you
need to see what’s the 10-year follow-up on these patients — what is their
recurrence rate?”
“At
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