Percutaneous local ablation of unifocal subclinical breast cancer: clinical experience and preliminary results of cryotherapy

Eur Radiol. 2011 Nov;21(11):2344-53. doi: 10.1007/s00330-011-2179-2. Epub 2011 Jun 17.

Abstract

Objectives: To assess the ablative effectiveness, the oncological and cosmetic efficacy of image-guided percutaneous cryoablation in the treatment of single breast nodules with subclinical dimensions after identification with ultrasonography (US), mammography, magnetic resonance (MRI) and characterization by vacuum assisted biopsy.

Materials: Fifteen women with a mean age of 73 ± 5 years (range 64-82 years) and lesion diameter of 8 ± 4 mm were undergoing cryotherapy technology with a single probe under US-guidance associated with intra-procedural lymph-node mapping and excision of the sentinel node. All the patients underwent surgical resection (lumpectomy) from 30 to 45 days after the percutaneous ablation.

Results: The iceball size generated by the cryoprobe during the procedure at minus 40°C was 16 × 41 mm. In 14 of the 15 patients was observed a complete necrosis of the cryo-ablated lesion both in post-procedural MRI follow-up and anatomo-pathological evaluation after surgical resection. In one case there was a residual disease in post-procedural MRI and postoperative histological examination, probably justified by an incorrect positioning of the probe.

Conclusion: The percutaneous cryoablation as a "minimally invasive" technique can provide excellent oncological and cosmetic results on selected cases handled by experienced operators by using the tested devices.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biopsy / methods
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / pathology
  • Breast Neoplasms / therapy*
  • Cryosurgery / methods*
  • Cryotherapy / methods*
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods
  • Mammography / methods
  • Medical Oncology / methods
  • Middle Aged
  • Necrosis
  • Ultrasonography / methods