Successful cryoablation of breast cancer

Swintelski, Cara; Plaza, Michael J.

doi:10.1111/tbj.12996

Cited by 5 publications

(6 citation statements)

References 8 publications

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“…While the use of cryoablation continues to grow for the treatment of breast cancer, 6,7,[11][12][13][14][15]45,48 there remains a void in the literature surrounding the basic response of breast cancer cells to freezing. Although the exact clinical techniques needed for the complete cryoablation in vivo are difficult to characterize, it is now known that successful cryoablation is dependent on several factors including the cancer phenotype, the number of freezethaw cycles, the rate of cooling and thawing, the final tissue temperature, and the duration of the freezing episode.…”

Section: Discussionmentioning

confidence: 99%

“…25,30,[54][55][56][57][58] Several reports detailing the successful application of cryoablation to treat breast cancer have appeared in the literature. 6,7,[11][12][13][14][15]59 In a pilot 27-patient study, Sabel et al 59 reported successful ablation of localized breast tumors <1.5 cm in diameter in 100% of the patients. More recently, Simmons et al extended this work in a Phase II clinical study (ACOSOG Z1072) targeting unifocal invasive ductal carcinoma ⩽2.0 cm and reported 100% ablation of tumor <1.0 cm in diameter and 77.4% in tumor ⩾ 1.0 cm.…”

Section: Discussionmentioning

confidence: 99%

“…A 10-minute thaw interval was tested given that this is the standard used clinically in prostate and other cancer cryoablation. 7,[11][12][13][39][40][41][42][43][44][45] To this end, a 5-minute freeze/10-minute passive thaw/5-minute freeze protocol (5/p10/5) was employed, followed by a final 10-minute passive thaw and return to culture at normothermic temperatures. As with the other conditions, minimal cell death was observed following exposure to −5°C ( Figure 3).…”

Section: Impact Of Increasing Thaw Interval During a Repeat (Double) mentioning

confidence: 99%

“…Ablation therapy has been used for over 10 years to treat breast cancer. 11-15 For instance, Kinoshita reported that localized tumors with a maximum diameter of 2 cm, preoperatively diagnosed by imaging and histopathology and treated with RFA yielded a 90% complete ablation rate based on histopathologic analysis. 8 Ito et al 9 conducted a retrospective analysis of 386 patients with breast cancer treated with RFA at 10 institutions and concluded “RFA in breast cancer is a safe and promising minimally invasive treatment for tumors ⩽2 cm in diameter.” Cazzato et al 6 reported on the successful application of cryoablation for primary breast cancer in a patient cohort unsuitable for surgical excision.…”

Section: Introductionmentioning

confidence: 99%

“…With a continued rise in diagnosis and advances in biomarkers, the use of thermal ablation for pre-and metastatic breast cancer have experienced an increase in use and efficacy in the past 10 years. [6][7][8][9][10][11][12][13][14][15] Ablative techniques such as cryotherapy have been used for the treatment of solid tumors for over 100 years. 16,17 Thermal therapies include radiofrequency ablation (RFA), high-intensity focused ablation (HiFu), and cryoablation.…”

mentioning

confidence: 99%

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Breast Cancer Cryoablation: Assessment of the Impact of Fundamental Procedural Variables in an In Vitro Human Breast Cancer Model

Snyder

Buskirk

Baust

et al. 2020

Breast Cancer�(Auckl)

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Introduction: Breast cancer is the most prominent form of cancer and the second leading cause of death in women behind lung cancer. The primary modes of treatment today include surgical excision (lumpectomy, mastectomy), radiation, chemoablation, anti-HER2/neu therapy, and/or hormone therapy. The severe side effects associated with these therapies suggest a minimally invasive therapy with fewer quality of life issues would be advantageous for treatment of this pervasive disease. Cryoablation has been used in the treatment of other cancers, including prostate, skin, and cervical, for decades and has been shown to be a successful minimally invasive therapeutic option. To this end, the use of cryotherapy for the treatment of breast cancer has increased over the last several years. Although successful, one of the challenges in cryoablation is management of cancer destruction in the periphery of the ice ball as the tissue within this outer margin may not experience ablative temperatures. In breast cancer, this is of concern due to the lobular nature of the tumors. As such, in this study, we investigated the level of cell death at various temperatures associated with the margin of a cryogenic lesion as well as the impact of repetitive freezing and thawing methods on overall efficacy. Methods: Human breast cancer cells, MCF-7, were exposed to temperatures of −5°C, −10°C, −15°C, −20°C, or −25°C for 5-minute freeze intervals in a single or repeat freeze-thaw cycle. Samples were thawed with either passive or active warming for 5 or 10 minutes. Samples were assessed at 1, 2, and 3 days post-freeze to assess cell survival and recovery. In addition, the modes of cell death associated with freezing were assessed over the initial 24-hour post-thaw recovery period. Results: Exposure of MCF-7 cells to −5°C and −10°C resulted in minimal cell death regardless of the freeze/thaw conditions. Freezing to a temperature of −25°C resulted in complete cell death 1 day post-thaw with no cell recovery in all freeze/thaw scenarios evaluated. Exposure to a single freeze event resulted in a gradual increase in cell death at −15°C and −20°C. Application of a repeat freeze-thaw cycle (dual 5-minute freeze) resulted in an increase in cell death with complete destruction at −20°C and near complete death at −15°C (day 1 survival: single −15°C freeze/thaw = 20%; repeated −15°C freeze/thaw = 4%). Analysis of thaw interval time (5 vs 10 minute) demonstrated that the shorter 5-minute thaw interval between freezes resulted in increased cell destruction. Furthermore, investigation of thaw rate (active vs passive thawing) demonstrated that active thawing resulted in increased cell survival thereby less effective ablation compared with passive thawing (eg, −15°C 5/10/5 procedure survival, passive thaw: 4% vs active thaw: 29%). Conclusions: In summary, these in vitro findings suggest that freezing to temperatures of 25°C results in a high degree of breast cancer cell destruction. Furthermore, the data demonstrate that the application of a repeat freeze procedure with a passive 5-minute or 10-minute thaw interval between freeze cycles increases the minimal lethal temperature to the −15°C to −20°C range. The data also demonstrate that the use of an active thawing procedure between freezes reduces ablation efficacy at temperatures associated with the iceball periphery. These findings may be important to improving future clinical applications of cryoablation for the treatment of breast cancer.

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