Cryoablation, which is effective therapy for benign breast masses, shows promise as therapy for small cancerous tumors in the size range frequently found on mammography, according to a presentation at the annual meeting of the Radiological Society of North America.

The presentation was based on data for 9 women treated at a single university center as part of a larger trial on cryoablation therapy for breast cancer. In this pilot trial, a thin probe was placed in the center of the tumor under ultrasound guidance; tumors were in the range of 8 mm to 18 mm in size.

All tumors were biopsied before cryoablation, and all tumors were removed by lumpectomy within 23 days of cryoablation. None of the 9 women needed any sedation during the procedure and there were no complications during the 6-week follow-up period. As with cryoablation for fibroadenoma, the procedure took about 30 minutes and was conducted via a tiny incision in the breast that was closed by a small bandage.

Analysis of the lumpectomy specimens showed that 7 of the 9 patients had complete tumor necrosis. These tumors ranged in size from 8 mm to 17 mm, and most were invasive ductal carcinoma. The eighth patient had invasive colloid carcinoma, and the remaining patient had ductal carcinoma in situ.

Of the 2 patients who did not have complete tumor necrosis, 1 woman had complete necrosis of the invasive portion of her tumor, but the lumpectomy identified an adjacent area of ductal carcinoma in situ that had not been found before cryoablation by mammography, initial biopsy, or ultrasound. The tumor of the last patient was the largest in the study group (18 mm in size); it had indistinct margins, and a small remaining area of invasive cancer was identified after cryoablation.

The authors concluded that these initial results provide insight on which patients may be the best candidates for future clinical trials on the procedure based on tumor size and ultrasound appearance. The findings also indicate there is no cosmetic change to the breast after cryoablation.

“While this is an early result, it is encouraging, and it will guide future research on this technique for patients with malignant disease,” said Marilyn Roubidoux, MD. “For instance, the experience with these first 9 patients gives us clues to patient selection. We hope that if further investigation continues to yield good results, this technique may become a viable option for women with early-stage disease.”

The results from the large, multicenter trial are currently in press, and a larger clinical trial is in the design stage.

“We’re still quite a few years from being able to see cryoablation as the final treatment for any malignant cancer,” cautioned Roubidoux. “But in the meantime, it’s showing promise for initial treatment, and perhaps as the sole invasive procedure for patients who cannot tolerate lumpectomy.”