TITLE:
VAB and MRI Following Percutaneous Ultra-Sound Guided Cryoablation for Primary Early-Stage Breast Cancer: A Pilot Study in Japan
AUTHORS:
Hisanori Kawamoto, Koichiro Tsugawa, Mariko Takishita, Mizuho Tazo, Mari Hara Nakano, Tomoko Tsuruga, Ryoko Oi, Takako Kuroda, Reiko Yoshie, Ayaka Shimo, Tsuguo Iwatani, Arata Shimo, Yasuyuki Kojima, Ai Motoyoshi, Ei Haku, Yukari Yabuki, Akihiko Suto, Yoshihide Kanemaki, Hidefumi Mimura, Ichiro Maeda, Mamoru Fukuda
KEYWORDS:
Breast Cancer, Cryosurgery, Cryoablation, Cryotherapy, Day Surgery
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.12 No.10,
October
26,
2021
ABSTRACT: Objective: This study aimed to evaluate the feasibility, safety, and cosmetic
outcomes of percutaneous cryoablation (PCA) of breast intraductal carcinoma
(IDC) lesions, as well as post-cryoablation magnetic resonance imaging (MRI) as
a follow-up tool for detection of residual malignancies and local recurrences. Methods: Eight female patients
underwent percutaneous ultrasound-guided cryoablation of breast IDC
tumors under local anesthesia without subsequent resection. All patients
received radiation- and endocrine therapies (RT, ET). The patients were
followed using vacuum-assisted biopsy (VAB), mammography (MG), magnetic
resonance imaging (MRI), and Moiré Topography for cosmetic outcomes. VAB was
performed 6 months following cryoablation treatment for cases 1 and 2 (after
starting radiation- and endocrine-therapies) or one month after PCA (cases 3,
4, 5, 6 and 7), prior to RT and ET. One patient declined VAB. Results: Mean
age of the patients was 61.9 years, SD 7.7, ages range 53 - 72 years. Mean
tumor size was 10.3 mm, SD 2.74, ranged 6.8 - 14.5 mm, median follow-up time
was 28 months (range 13 - 34 months). No residual or recurrent malignancies
were detected. One minor adverse event was observed: A skin
redness in the ablated area; MRI at one-month post-cryotherapy showed various
degrees of thermal burns in all patients in the pectoralis major muscle, which
were not symptomatic and were resolved by 6 months following PCA. Decrease of
fat necrosis areas in the vicinity of ablated ex-tumor was traced with MRI
(mean size 54.9 mm, mean decrease after 2 years was 58%) and validated with
VAB. Conclusions: Percutaneous
cryoablation of early-stage low-risk breast cancer tumors smaller than 15 mm
potentially presents a potential substitute for lumpectomy, offering
encouraging short- to mid-term oncology results with good cosmesis outcomes.
Patients would be able to benefit from local anesthesia in an outpatient setting
and a shorter recovery period.