An unprecedented study suggests that slow-growing breast cancers can be treated with a highly targeted tumor freezing technique, eliminating the need for invasive surgery.
Tests so far suggest that the technique is effective among women over 60 with a diagnosis of relatively low-risk breast cancer.
“Cryoablation is a minimally invasive solution that safely and quickly destroys breast tumors without the need for surgery,” said study author Dr. Richard Fine, breast surgeon at the West Cancer Center & Research Institute in Germantown, Tenn.
“The procedure exposes the diseased tissue to extreme cold [cryo] to destroy [ablate] “he added.” It is performed in the office while the patient is awake. ”
The new study – involving nearly 200 women – found that when cryoablation was performed on women with low-grade / low-risk breast cancer, almost all patients remained cancer-free three years later.
“The therapy is already well established for the treatment of cancer in the bones, kidneys, prostate and others,” noted Fine.
The average age of patients in the study was 75 years, and all were diagnosed with “invasive ductal carcinoma” breast cancer.
The tumors were relatively small, measuring no more than 1.5 centimeters in size. All patients had “hormone receptor positive” tumors, that is, tumors that were ER +, PR + and / or HER2-.
“In general, tumors that are ER + and / or PR + have slightly slower growth and have a slightly better prognosis than tumors that are negative for the hormone receptor,” said Fine.
All patients in the study underwent cryoablation, which involved the direct insertion of a probe through the skin to the tumor site, under localized anesthesia. In turn, liquid nitrogen was applied to freeze target tumors from the inside out.
The treatment lasted between 20 and 40 minutes, turning the tumors into ice balls.
The procedure removed the need for follow-up surgery, the researchers reported, although nearly 15% of women also underwent radiation, while about 3/4 were later treated with endocrine therapy. One patient underwent chemotherapy.
Patients were examined twice a year, up to five years after treatment.
The result: at an average follow-up point of almost three years after treatment, only 2% – four patients – saw the cancer return. No serious side effects were reported, and almost all patients and attending physicians reported being satisfied with treatment, in 95% and 98%, respectively.
“For benign and cancerous tumors, the benefits over traditional surgery include in-office procedures, [that were] faster, [entailed] almost immediate recovery, better cosmetic results, greater patient comfort, less risk of the procedure and lower cost, “said Fine.
Unlike a conventional mastectomy or mastectomy, he added, cryoablation preserves the volume of the breast and minimizes the risk of infection. And the process usually produces “excellent cosmetic results without scarring”, while allowing patients to resume normal activities quickly.
Fine noted that the European Union approved cryoablation for breast cancer in 2010, with the procedure also approved for use in Australia, South Africa, Thailand, Singapore and Hong Kong.
In the United States, “the treatment is in experimental use,” explained Dr. Shawna Willey, director of breast cancer research at the Inova Schar Cancer Institute at the Inova Fairfax Hospital in Fairfax, Virginia.
“If it continues with similar success, the data will be sent to the FDA [U.S. Food and Drug Administration] to get the first approval for the use of a specific cryoablation device in the treatment of breast cancer for the tumor and the patient parameters studied, “added Willey.
Although not part of the study team, she noted that the Fine “trial is the largest of its kind and can lead to cryoablation being much more widely available as a treatment option for older women with low-risk breast cancer, while it continues to be studied in broader patient populations. “
Still, Willey warned that cryoablation was only tested among carefully selected groups of breast cancer patients. Therefore, its effectiveness, she emphasized, “is not supported by extensive data with long-term follow-up, or by data on a wide range of tumor types in women of all ages.”
Fine and colleagues presented their findings this week at a virtual meeting of the American Society of Breast Surgeons. This research is considered preliminary until it is published in a peer-reviewed journal.
There is more information on how to cryoablate and cancer in Mayo clinic.
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