my personal edition > radiation oncology > news


  E-Mail this DGDispatch to a colleague

DGDispatch

Cryotherapy Offers Good Local Control of Small Breast Cancer: Presented at RSNA

By Ed Susman

CHICAGO, IL -- November 26, 2007 -- The use of cryotherapy could have a role in treating breast cancer as part of breast conservation therapy and appears to works best in women whose tumours remain smaller than 16 mm in diameter.

"Our results show that cryotherapy is a secure and effective therapy for breast cancer," said Pascal Baltzer, MD, Radiologist, Friedlich Schiller University, Jena, Germany. "In the future, minimal invasive therapy of small breast cancer may play a larger role in breast cancer treatment."

When a tumour cell encounters extreme cold it undergoes mechanical damage, cellular dehydration and ischaemia, resulting in necrosis. That necrosis, Dr. Baltzer said, is enhanced by rapid cooling, followed by thawing and then by another cycle of cooling and warming.

In an oral presentation on November 25 here at the 93rd Scientific Assembly and Annual Meeting of the Radiological Society of North America, Dr. Baltzer presented the results of a study of 52 patients who had biopsy-confirmed breast cancer and underwent cryotherapy prior to breast-conserving surgery.

In the study, all patients were given local anaesthesia then each tumour underwent a cooling cycle of about 7 to 12 minutes followed by a passive heating cycle of 5 minutes, another cooling period, and a final thawing cycle. The team used an Argon-based cryohit system (Galil Medical, Yokneam, Israel) with 2- to 3-mm replaceable needles. During the procedure the size of the ice ball was measured minute by minute.

Of the 52 patients enrolled, 41 had invasive ductal carcinoma, seven had invasive lobular carcinoma, three had tubular carcinoma, and one had ductal carcinoma in situ. The median tumour diameter was 14 mm. One patient was excluded from the evaluation because cryotherapy had to be interrupted due to technical problems.

After patients underwent the cryotherapy procedure, the researchers found no residual cancer in all patients whose baseline tumour size was smaller than 16 mm in diameter, Dr. Baltzer said. However, residual cancer cells were found in 15 patients -- all with tumours that were larger than 16 mm in diameter.

"Local tumour control is the requirement for curative therapy of breast cancer," he said. "In the future, minimal invasive treatment of small breast cancer may reduce operative risks combined with a better cosmetic outcome."

Two complications were noted: Arterial bleeding that was stopped within 30 minutes of hand pressure compression and a seroma that resolved without treatment.

"All patients could be discharged 4 hours after the procedure," Dr. Baltzer said. "No one reported any serious, therapy-requiring pain."

Dr. Baltzer said the use of cryotherapy warrants further study, possibly for smaller tumours or following neoadjuvant chemotherapy.


[Presentation title: Cryotherapy of Early Breast Cancer. Abstract SSA03-01]

E-Mail this DGDispatch to a colleague

To print, use this version