A Phase II Trial Exploring the Success of Cryoablation Therapy in the Treatment of Invasive Breast Carcinoma: Results from ACOSOG (Alliance) Z1072

Authors: Simmons R, Ballman K, Cox C, et al.

Source: Ann Surg Oncol (2016) 23:2438-2445

www.ncbi.nlm.nih.gov/pubmed/27221361

Cryoablation therapy is the freezing of tumors by placing a thin probe through the skin into the tumor using image guidance. It is regularly used for hepatic (liver) cancer as well as fibroadenomas (benign breast tumors). This group questioned the usefulness of this technique for breast cancer. They also looked at the ability of magnetic resonance imaging (MRI) to predict the success of killing the breast cancer using cryoablation therapy.

If cryoablation therapy proves effective and safe, this office-based procedure could be used in the future for women with early stage breast cancer.

Eighty-six patients were evaluated in this study. One patient had bilateral breast cancer, so 87 tumors were treated and observed. Each patient had to have a tumor that was visible by MRI. Tumors had to be of ductal origin and no greater than 2cm in size. The average tumor size was 1.1cm and most of them were hormone receptor-positive and HER2-negative.

Each tumor underwent cryoablation. Two to four weeks later, each woman had breast MRI. Definitive surgery (lumpectomy or mastectomy and axillary lymph node surgery) was performed within four weeks of cryoablation. Pathologists examined the breast tissue for the presence of residual disease.

Sixty-six cancers (75.9%) were completely obliterated by cryoablation. There was residual disease in 21 (24.1%) cases. The success rate was 100% for tumors under 1cm in size.

Regarding MRI, it successfully predicted eradication of disease 81.2% of the time. MRI was more accurate with tumors less than 1cm in size compared to tumors 1cm or greater.

These values demonstrate that cryoablation therapy holds promise as another definitive treatment for early stage breast cancer. The investigators intend to continue this study and include questions about proper breast imaging and probe placement for the technique.