Ultrasound-guided cryoablation is safe, effective, and well tolerated by patients with breast cancer, according to results published December 22 in Clinical Breast Cancer. 

Researchers led by Jacopo Cucchiari, MD, from Careggi University Hospital in Florence, Italy, found that cryoablation led to high complete ablation rates for larger tumors (15 mm or greater), and women reported less anxiety and better quality of life compared with conventional surgery. 

“The procedure allows rapid recovery, without major complications in elderly patients,” Cucchiari and colleagues wrote.

With growing interest in less-invasive treatment strategies for breast cancer, cryoablation has emerged as a potentially favorable option. Prior research suggests cryoablation can effectively treat many small breast tumors while also maintaining a high safety profile. 

These studies focused on early-stage, low-grade invasive ductal carcinoma hormone receptor-positive and HER2-negative cancers, with a tumor size less than 15 mm. The researchers noted a lack of data on the efficacy and safety in patients with other subtypes of low-grade breast cancers. 

The Cucchiari team investigated the safety and efficacy of cryoablation for treating breast cancer tumor subtypes 12 months after treatment. 

The single-center prospective study included 36 women with an average age of 84.5 years with 39 biopsy-proven breast tumors. The women underwent cryoablation between 2021 and 2023. The 39 tumors included the following subtypes: luminal A, luminal B, invasive ductal carcinoma (IDC), and IDC plus ductal carcinoma in situ. Of the total women, 28 underwent contrast-enhanced mammography (CEM) for tumor staging. 

The group reported completed ablation rates of 100% for breast tumors 15 mm or smaller and 84.6% for tumors larger than 15 mm, respectively. And no procedure-related unexpected adverse events occurred in the women, it added. 

The investigators also reported higher complete ablation rates for luminal A (100%) compared with luminal B (88.9%) tumors and for Ki67 ≤ 20% (100%) compared with Ki67 >20% (80%). However, these differences did not achieve statistical significance. 

For measuring pain, patients reported a median decrease of one unit on visual analogue scale (VAS) scoring at six months after cryoablation (p = 0.009). This remained consistent at 12 months post cryoablation (p = 0.003). 

Using multiple questionnaires completed by patients, the researchers found improvements in depression, anxiety, physical functioning, and limitations due to physical and emotional problems. 

The results add to growing evidence supporting cryoablation as a “valuable and effective treatment option for early breast cancer, especially in elderly patients with comorbidities,” the study authors wrote.  

They added that further randomized trials and long-term studies are needed and that the results highlight CEM’s efficacy in evaluating cryoablation by showing concordance enhancement and histology. 

Read the full study here.