Single-Centre Experience with Percutaneous Cryoablation of Breast Cancer in 23 Consecutive Non-surgical Patients.
AIM
To present our single-centre prospective experience on the use of cryoablation (CA) applied to treat primary breast cancer (BC) in a cohort of patients unsuitable for surgical treatment.


MATERIALS AND METHODS
Twenty-three consecutive post-menopausal female patients (median age 85 years; range 56-96) underwent percutaneous CA of unifocal, biopsy-proven BC, under ultrasound/computed tomography (US/CT) guidance. Clinical and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) follow-ups were systematically scheduled at 3, 12, 18 and 24 months. Local tumour control was assessed by comparing baseline and follow-up DCE-MRI.


RESULTS
Twenty-three BC (median size 14 mm) were treated under local anaesthesia (78.3 %) or local anaesthesia and conscious sedation (21.7 %). Median number of cryo-probes applied per session was 2.0. A "dual-freezing" protocol was applied for the first ten patients and a more aggressive "triple-freezing" protocol for the remaining 13. Median follow-up was 14.6 months. Five patients recurred during follow-up and two were successfully re-treated with CA. Five patients presented immediate CA-related complications: four hematomas evolved uneventfully at 3-month follow-up and one skin burn resulted in skin inflammation and skin retraction at 3 and 12 months, respectively.


CONCLUSIONS
Percutaneous CA is safe and well tolerated for non-resected elderly BC patients. Procedures can be proposed under local anaesthesia only. Given the insulation properties of the breast gland, aggressive CA protocols are required. Prospective studies are needed to better understand the potential role of CA in the local treatment of early BC.
['Cazzato|Roberto Luigi|RL|', 'de Lara|Christine Tunon|CT|', 'Buy|Xavier|X|', 'Ferron|Stéphane|S|', 'Hurtevent|Gabrielle|G|', 'Fournier|Marion|M|', 'Debled|Marc|M|', 'Palussière|Jean|J|']
D000368:Aged D000369:Aged, 80 and over D001940:Breast D001943:Breast Neoplasms D003287:Contrast Media D003452:Cryosurgery D005260:Female D005500:Follow-Up Studies D006801:Humans D007089:Image Enhancement D008279:Magnetic Resonance Imaging D008875:Middle Aged D011183:Postoperative Complications D011446:Prospective Studies D015641:Radiography, Interventional D014057:Tomography, X-Ray Computed D016896:Treatment Outcome D018084:Ultrasonography, Interventional
Cryoablation Breast cancer Percutaneous ablation