Breast Cryoablation: Revolutionizing Breast Cancer Treatment

Introduction

Hi everyone. My name is Rob Ward. I'm an assistant professor of Diagnostic Imaging at the Warren Albert Medical School of Brown University. And today I'm going to be talking to you about breast cryoablation.

I have one disclosure that I was a consultant for Logic once in the last 12 months.

Objectives

  • Introduction to breast cryoablation
  • How to start a cryoablation service line
  • Review clinical cases
  • Performing the procedure
  • Imaging follow-up
  • Current clinical trials
  • Future applications
  • Summary

Topics

1. Introduction to Breast Cryoablation

Cryoablation involves killing tissue with extreme cold, used to treat breast cancers and fibroadenomas. It's an office-based, minimally invasive procedure that's well-tolerated and virtually painless.

Key Points:

  • Ultrasound-guided with real-time visualization
  • Requires local anesthesia only
  • Quick recovery time
  • Longstanding history in other organs like liver, kidney, and lung

2. Starting a Cryoablation Service Line

Understanding the culture and structure of the organization is crucial. Aligning incentives with stakeholders and sharing success is key.

Key Points:

  • Communicate the plan effectively
  • Include all internal stakeholders
  • Engage people early
  • Ensure proper education and training

3. Performing the Procedure

The procedure involves placing a cryoprobe through the lesion, initiating freeze and thaw cycles, and ensuring the ice ball engulfs the lesion.

Key Points:

  • Excellent ultrasound-guided technique required
  • Initial proctoring needed for new practitioners
  • Use of local anesthesia
  • Monitoring patient throughout the procedure

4. Imaging Follow-Up

Follow-up care includes post-procedure visits and diagnostic imaging to confirm lesion resolution.

Key Points:

  • First post-procedure visit 1-2 weeks after
  • Diagnostic mammogram and ultrasound at 6 months
  • Yearly follow-up imaging

5. Current Clinical Trials and Future Applications

Clinical trials like z1072 and ice 3 are crucial for validating the efficacy of cryoablation. Future applications may expand the technique's use.

Key Points:

  • z1072 trial showed >90% success for cancers <2 cm
  • ice 3 trial showed 2% in-breast tumor recurrence rate
  • Cryoablation is cost-effective and well-tolerated
  • Potential future applications in other types of breast lesions

Conclusion

Breast cryoablation is an exciting and promising minimally invasive technique for treating breast cancers and fibroadenomas. It offers excellent cosmetic results and a safe, effective alternative to traditional surgery. Future research will continue to refine and expand its applications in breast cancer care.

Thank you for your attention, and I'm happy to answer any questions you may have.