Green Health & Wellness This Freezing Technique Could Be the Next Frontier in Breast Cancer Treatment – GWC Mag gwcmagApril 15, 2024062 views A treatment using extreme cold has proven successful in destroying large tumors in people with breast cancer who are ineligible for surgery. The technique, called cryoablation, is already used to freeze and eliminate small cancerous tumors. Because this cryoablation technique has been shown to be effective in treating tumors smaller than 1.5 centimeters (cm) (just over half an inch in diameter), researchers set out to find if it would work on larger tumors as well, examining outcomes in women who had an average tumor size of 2.5 cm (about an inch in diameter). In a presentation at the Interventional Radiology Annual Scientific Meeting in Salt Lake City held March 23–28, scientists revealed that in 60 patients who had received the cryoablation procedure, the cancer recurrence rate was 10 percent at a median follow-up point of 16 months, meaning cancer returned in just six patients. “When treated with only radiation and hormonal therapy, tumors will eventually return. So the fact that we saw only a 10 percent recurrence rate in our study is incredibly promising,” said Yolanda Bryce, MD, a study leader and an interventional radiologist at Memorial Sloan Kettering Cancer Center in New York City, in a press release. [1] Dr. Bryce and her collaborators note that if tumors do return, patients can be treated with cryoablation multiple times to control growth. An Option When Surgery Is Not Advised With cryoablation therapy, a small needle-like probe is inserted into the breast. Using imaging guidance such as ultrasound or computed tomography (CT) scan to pinpoint the tumor, an interventional radiologist then guides the cryoprobe, which forms a small ice ball around the tumor, killing off the cancer cells. When combined with hormonal therapy and radiation, patients can have nearly 100 percent of the tumors eliminated, according to the study authors. While surgery is still considered the gold standard for breast cancer treatment, cryoablation provides an option for patients who may not be candidates for surgery or who refused surgery after consultation with a breast surgeon because of age, cardiac issues, high blood pressure, or because they are currently undergoing chemotherapy for another cancer. [2] “In the past, when treating smaller lesions, we have felt confident that the cryoablation therapy reached the entire ‘kill zone’ of the tumor and a rim of treatment effect outside of malignant tumors,” says Lauren Kopicky, DO, a breast surgical oncologist with the Cleveland Clinic in Ohio. “With a larger tumor, treatment is more complex, navigating multiple probes to achieve complete tumor ablation and adequately achieve freezing of that target volume.” For Dr. Kopicky, who was not involved in the research, the results from this study highlight how cryoablation may truly impact large tumor treatment and tumor control. Cryoablation Is a Relatively Fast and Painless Procedure Research subjects were all poor surgical candidates or refused surgery and underwent cryoablation of primary breast cancer. They were treated from January 2017 to March 2023. For the treatment, subjects received a local anesthesia or minimal sedation. The procedure required a freeze-thaw cycle that started with 5 to 10 minutes of freezing, followed by 5 to 8 minutes of passive thaw, and then 5 to 10 minutes of freezing at 100 percent intensity. Patients were able to go home on the same day after the treatment. Side effects can include breast pain, swelling, skin discoloration, and skin burns. [3] Follow-up imaging was performed three months after the procedure with mammogram and ultrasound, and sometimes contrast-enhanced mammogram or MRI. Bryce and her team intend to track the patient group to collect data on long-term effectiveness and to better understand the impact that additional therapies such as hormone treatment and radiation combined with cryoablation can have on this patient population. FDA Approval Is Still Pending The use of this treatment for cancerous breast tumors is still in the experimental phase. [4] At this time, the American Society of Breast Surgeons says that the U.S. Food and Drug Administration (FDA) has approved cryoablation in relation to breast cancer only for the treatment of fibroadenomas (noncancerous breast tumors that present as a solid, not fluid-filled, lump). [5] The FDA, however, is currently reviewing a minimally invasive cryoablation technology for treating patients with early-stage, low-risk breast cancer. [6] Kopicky expects that cryoablation will be more commonly accepted and used in practice once there is FDA approval. “I think FDA approval will be critical to adopting this technology,” she says. “It’s important for a newly diagnosed cancer patient to consult with their care team, know the recommended standards of treatment, and be informed about what alternative options might be.”