Ultrasound-Guided, Percutaneous Cryotherapy of Small (≤15 mm) Breast Cancers

Pfleiderer, Stefan O.R.; Marx, Christiane; Camara, O.; Gajda, Mieczysław; Kaiser, Werner A.

doi:10.1097/01.rli.0000166935.56971.ff

Cited by 83 publications

(63 citation statements)

References 37 publications

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“…The simultaneous use of multiple probes, resulting in exponential summation of necrosis volume represents a questionable procedural complication in this organ application [9] . In literature there are numerous studies on invasive breast cancer cryoablation characterized by different selection criteria and results [9][10][11][12]. The extent of microcalcification visible on mammography often underestimates the true extention of carcinoma in situ and this is further restricted by the selection of patients to be treated.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2011

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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 lymphnode 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 cryoablated 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.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2011

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“…Sentinel lymph node biopsy (SLNB) in immediate surgical excision studies was often performed just prior to the ablative treatment, [14,15,48], five cases of blistering [51], four of coagulative changes to the skin [51], three were cases of ecchymosis [27,46], three cases of nipple retraction, [31] two case of pneumothorax [15,64], two incidences of skin puckering [44], two infections [42,44] and single cases of overreaction [30] and fistula [47] (table 1a). With cryo-ablation 10.9% of patients (20/183) J U S T A C C E P T E D developed a complication, these were skin necrosis (n=5) [61], haematoma (n=5) [22,73], ecchymosis (n=4) [22], skin retraction (n=2) [73], seroma (n=2) [19,20], arterial bleeding (n=1) [20] and skin ulceration (n=1). [73] Several patients also developed skin burns and mastitis (number unreported) [37] (table 1c).…”

Section: Axillary Lymph Nodesmentioning

confidence: 99%

“…Delayed surgical excision was performed within a week of treatment in four studies [19,33,50,72] (most often following laser ablation), within two weeks of treatment in ten studies [8,20,27,34,36,38,55,56,58,59] (most often following HIFU), within three weeks of treatment in eight studies [17,28,39,41,46,47,54,62] (most often following RFA), within four weeks of treatment in four studies [37,40,49,67] and longer than four weeks of…”

Section: J U S T a C C E P T E Dmentioning

confidence: 99%

“…A total of 63 articles matched the selection criteria. The 63 articles included 16 feasibility studies [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28], 12 phase I studies [29][30][31][32][33][34][35][36][37][38][39][40], nine phase II studies [41][42][43][44][45][46][47][48][49], three comparative studies [50][51][52], one retrospective study [53], and four randomised controlled trials [54][55][56]. In 18 studies the type of study was not reported [8,[57][58][59][60][61][62][63][64]…”

Section: Selected Studiesmentioning

confidence: 99%

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Minimally invasive ablative techniques in the treatment of breast cancer: a systematic review and meta-analysis

Peek

Ahmed

Napoli

et al. 2016

International Journal of Hyperthermia

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Purpose: Breast conserving surgery is effective for breast cancer treatment but is associated with morbidity in particular high re-excision rates. We performed a systematic review to assess the current evidence for clinical outcomes with minimally invasive ablative techniques in the non-surgical treatment of breast cancer.Methods: A systematic search of the literature was performed using PubMed and Medline library databases to identify all studies published between 1994 and May 2016. Studies were considered eligible for inclusion if they evaluated the role of ablative techniques in the treatment of breast cancer and included ten patients or more. Studies that failed to fulfil the inclusion criteria were excluded. Results:We identified 63 studies including 1608 patients whose breast tumours were treated with radiofrequency (RFA), high intensity focused ultrasound (HIFU), cryo-, laser or microwave ablation. Fifty studies reported on the number of patients with complete ablation as found on histopathology and the highest rate of complete ablation was achieved with RFA (87.1%, 491/564) and microwave ablation (83.2%, 89/107). Short-term complications were most often reported with microwave ablation (14.6%, 21/144). Recurrence was reported in 24 patients (4.2%, 24/570) and most often with laser ablation (10.7%, 11/103). The shortest treatment times were observed with RFA (15.6±5.6 minutes) and the longest with HIFU (101.5±46.6 minutes).

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“…[1][2][3][4][5][6][7][8][9][10] Procedures such as radiofrequency ablation (RFA) 1,2 and high intensity focused ultrasound (HIFU) 3 destroy tumor cells by heating. In contrast, cryoablation [4][5][6][7][8][9][10] destroys cancer cells by cooling them with a cryoprobe. Both thermal therapies are theoretically acceptable but still undergoing clinical investigation.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided Cryoablation of Invasive Ductal Carcinoma inside the MR Room

et al. 2010

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One disadvantage of ultrasound (US)-guided cryoablation of breast cancer is the di‹cul-ty in visualizing the area behind the ice ball because of acoustic shadowing. We performed US-guided cryoablation with the patient in prone position inside the MR room. The lumpectomy specimen after cryoablation revealed denseˆbrosis without residual viable cancer cells. The combination of needle insertion under US guidance with planning and veriˆca-tion using magnetic resonance imaging may be a feasible and promising treatment protocol.

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Ultrasound-Guided, Percutaneous Cryotherapy of Small (≤15 mm) Breast Cancers

Cited by 83 publications

References 37 publications

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

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

Minimally invasive ablative techniques in the treatment of breast cancer: a systematic review and meta-analysis

Ultrasound-guided Cryoablation of Invasive Ductal Carcinoma inside the MR Room

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