Cryoablation: The Future of Breast Cancer Treatment Without Surgery

PubMed offers this background:

The use of freezing temperatures for the therapeutic destruction of tissue began in England in 1845-51 when Dr James Arnott described the use of iced salt solutions (about minus 20 degrees C) to freeze advanced cancers in accessible sites, producing reduction in tumor size and amelioration of pain. Improved freezing  techniques were possible early in the 1990s when solidified carbon dioxide came into use and later when liquid nitrogen and nitrous oxide became available.  Nevertheless, cryotherapy was a minor technique, used only for the accessible  lesions of skin and mucosa. With the development of modern cryosurgical  apparatus by Cooper in 1961, a resurgence of interest in cryosurgery was initiated and techniques for diverse clinical conditions, including visceral or abdominal cancer, evolved. After the initial widespread clinical trials matured in the 1970s,  some applications of the technique fell into disuse while others became standard  treatment. Late in the 1980s, further improvements in apparatus and imaging  techniques have permitted increased clinical use in neoplastic disease, including  visceral cancer.

A short history

Cryotherapy has been used for cervical abnormalities in females as standard of care for at least 40 years. Cryotherapy is used to destroy skin tumors, precancerous skin moles, nodules, skin tags, or unsightly freckles. With the improvement of imaging techniques and the development of devices to better control extreme temperatures,  physicians are using cryotherapy as a treatment for patients with breast cancer as well as other forms of cancer including liver (usually metastasized from other  organs), lung, kidney tumors, prostate cancers and pancreatic cancer. Breast cancers  are much easier to freeze since the tumor is sitting in fatty tissues with very few large blood vessels or large nerve tracts to get in the way.

The cryotherapy technique can also be used now to help women with fibroadenoma  breast issues instead of cutting the fibroadenoma out of the breast. Fibroadenomas frequently cause pain and can become quite large. They are usually more of a  problem in the younger women, but most women worry about any lump they are  walking around with. Cryoablation would be a simple approach to these concerns of fibroadenomas. In an article by Dr Peter Littrup et al entitled “Cryotheraphy for  Breast Fibroadenomas” (read article here) in the journal Radiology, August 2004, the conclusion was  “Cryotherapy of fibroadenomas is safe, effective and virtually painless done as an  outpatient procedure as a treatment option with good cosmetics.”

A recent study and article in the Annals of Surgical Oncology shows:

• 100% effective for treating early stage breast cancer
• Z1072 study single arm with a 19 multi-center study done by NCI (National Cancer Institute)
• 100% effective for tumors less than 1cm
• 92%  effective for tumors > than 1cm (there was some erroneous probe placement, thus the 92% rate. There is actually 100% ablation in the ablation zone)
• Lumpectomy effectiveness is only 60-80% in the literature, so cryoablation surpasses this with its cytokine “immune effect” in lymph nodes and satellite lesions.

The centers involved in this study and have used breast cryoablation equipment to date are: MD Anderson, The Cleveland Clinic, University of Arizona Cancer Center, The Medical College at Cornell University, University of South Florida, Penn State, Duke University, Bellingham Breast Center, Bridgeport Hospital,  and the Mayo Clinic for starters. Other centers are listed on the The Annals of Surgical Oncology article for their chief investigators and site location (read the article here).

Over the past ten years, I have been dealing with 42 radiology centers in Oregon,  Washington, California, and Idaho. My favorite radiologist, Dr. Cindy Tortorelli, who is now at EPIC Imaging in Portland, Oregon, previously had been freezing fibroadenomas for over a decade at the Mayo Clinic where she worked in the  women’s breast imaging department. I hope that in the near future, I will be able to contact radiologists and surgeons in an effort to bring cryoablation equipment to the Pacific Northwest. Currently I am sending women who need cryoablation to distant parts of the country to be treated. If your town would like to have this equipment, please contact me.