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Single-Centre Experience with Percutaneous Cryoablation of Breast Cancer in 23 Consecutive Non-surgical Patients

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Abstract

Aim

To present our single-centre prospective experience on the use of cryoablation (CA) applied to treat primary breast cancer (BC) in a cohort of patients unsuitable for surgical treatment.

Materials and Methods

Twenty-three consecutive post-menopausal female patients (median age 85 years; range 56–96) underwent percutaneous CA of unifocal, biopsy-proven BC, under ultrasound/computed tomography (US/CT) guidance. Clinical and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) follow-ups were systematically scheduled at 3, 12, 18 and 24 months. Local tumour control was assessed by comparing baseline and follow-up DCE-MRI.

Results

Twenty-three BC (median size 14 mm) were treated under local anaesthesia (78.3 %) or local anaesthesia and conscious sedation (21.7 %). Median number of cryo-probes applied per session was 2.0. A “dual-freezing” protocol was applied for the first ten patients and a more aggressive “triple-freezing” protocol for the remaining 13. Median follow-up was 14.6 months. Five patients recurred during follow-up and two were successfully re-treated with CA. Five patients presented immediate CA-related complications: four hematomas evolved uneventfully at 3-month follow-up and one skin burn resulted in skin inflammation and skin retraction at 3 and 12 months, respectively.

Conclusions

Percutaneous CA is safe and well tolerated for non-resected elderly BC patients. Procedures can be proposed under local anaesthesia only. Given the insulation properties of the breast gland, aggressive CA protocols are required. Prospective studies are needed to better understand the potential role of CA in the local treatment of early BC.

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Acknowledgments

Roberto Luigi Cazzato would like to thank CIRSE Foundation for supporting him with an educational grant which was spent to attend a fellowship at the Department of Radiology, Institut Bergonié, Bordeaux, France. Without the support of such grant, the present paper would have not be possible. The authors would like to thank Ravi Nookala for medical editorial assistance.

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Authors and Affiliations

  1. Department of Medical Imaging, Institut Bergonié, Comprehensive Cancer Centre, 229 cours de l’Argonne, 33000, Bordeaux, France

    Roberto Luigi Cazzato, Xavier Buy, Stéphane Ferron, Gabrielle Hurtevent & Jean Palussière

  2. Department of Medical Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, 21 via Álvaro del Portillo, Rome, Italy

    Roberto Luigi Cazzato

  3. Department of Surgery, Institut Bergonié, Comprehensive Cancer Centre, 229 cours de l’Argonne, 33000, Bordeaux, France

    Christine Tunon de Lara & Marion Fournier

  4. Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Centre, 229 cours de l’Argonne, 33000, Bordeaux, France

    Marc Debled

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  1. Roberto Luigi Cazzato
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  2. Christine Tunon de Lara
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  3. Xavier Buy
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  4. Stéphane Ferron
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  7. Marc Debled
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  8. Jean Palussière
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Correspondence to Roberto Luigi Cazzato.

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Conflict of interest

Authors Roberto Luigi Cazzato, Christine Tunon de Lara, Xavier Buy, Stéphane Ferron, Gabrielle Hurtevent, Marion Fournier, Marc Debled and Jean Palussière have no conflict of interest to disclose.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Cazzato, R.L., de Lara, C.T., Buy, X. et al. Single-Centre Experience with Percutaneous Cryoablation of Breast Cancer in 23 Consecutive Non-surgical Patients. Cardiovasc Intervent Radiol 38, 1237–1243 (2015). https://doi.org/10.1007/s00270-015-1181-5

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  • DOI: https://doi.org/10.1007/s00270-015-1181-5

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