Cryoablation of breast cancer: a promising new treatment option on the horizon
Breast cancer is a disease wrought with emotion that can leave behind both visible and unseen scars. The physical and mental toll it can take on a woman’s health is immense, which is why women need to have innovative treatment choices to cater to their individual situation.
Advancements in women’s health innovations has been slow. It was only in 1990 that the National Institute of Health consensus panel determined that lumpectomy followed by radiation is as good as mastectomy for early-stage breast cancer. While there have been many advancements in hormone treatments, radiation, and chemotherapies, over 30 years later it remains the “gold standard” of surgical treatment.
Now a promising technology, cryoablation, is emerging to treat early-stage breast cancer or patients who are high risk for surgery, which is being studied as part of the ICE3 Clinical Trial. Cryoablation, or tumor freezing, has been used in the medical field to treat other types of benign and malignant tumors in the kidneys, bone, lung, and liver.
Breast cryoablation is performed in a physician’s office, with only local anesthesia (lidocaine) to the breast – the patient is awake for the procedure. A hollow needle, or cryoprobe, is inserted into the tumor under ultrasound guidance. The tumor is then frozen, thawed, and frozen again. An additional margin of healthy tissue will be frozen.
Patients can return home shortly after the procedure. The tumor becomes necrotic and the body absorbs dead tissue over time. There is little or no change to the cosmetic appearance of the breast. Adjuvant therapy such as oral hormone blocker or radiation is complementary to cryoablation.
Recent studies have been conduced to examine cryoablation’s efficacy in breast cancer. One such study, ACOSOG (or Z1072), was considered to be highly effective for its targeted population in tumors 1cm or less. Interim results of the ongoing ICE3 study treating tumors up to 1.5cm shows promise with 97.94% of patients recurrence free as of April 2021.
The availability of breast cryoablation in the US is still limited. While there is FDA approval to treat benign and malignant tumors, and fibroadenoma (benign breast lesions), there is yet to be a specific FDA indication for treating breast cancer. Should the indication for breast cancer be cleared, there will be more physicians willing to adapt cryoablation into their practice and billing codes for reimbursement.
While more clinical evidence is needed, breast cryoablation has the potential to become a new option, once marketing approval is received by the FDA, and can be incorporated in the future as a standard of care in the treatment of breast cancer for subsets of patients with early-stage disease or high risk to surgery. If you are interested in breast cryoablation, speak to your doctor to see if this is the right treatment option for you.
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