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academies
Archives of General Internal Medicine | Volume 2
&
April 04-05, 2018 | Miami, USA
International Conference on
Internal Medicine & Practice and Primary Care
International Meeting on
Breast Pathology & Cancer Diagnosis
Breast cancer cryoablation - offering patients a choice
Robert C Ward, Ana P Lourenco
and
Martha B Mainiero
Rhode Island Hospital, USA
P
ercutaneous ultrasound (US)-guided cryoablation is a
minimally-invasive technique that kills targeted tissue
with extreme cold. We are enrolling patients in the FROST
clinical trial aimed at determining the rate of successful tumor
cryoablation instead of surgical resection in univocal IDC, less
than 1.5 cm in size, at least 0.5 cm from skin, ER/PR+ HER2-, and
clinically node negative. We are also offering cryoablation as an
alternative to surgical resection in selected patients excluded
from the trial. The procedure is performed in the breast imaging
center using local anaesthesia. Ultrasound is used for needle
placement and intraprocedural monitoring. The Sanarus Visica
2 Treatment system 10-gauge needle is placed through the
center of the tumor. The device uses closed loop circulation
of liquid nitrogen creating an ice ball. The freeze-thaw-freeze
treatment cycle is 6-10-6minutes for tumors less than 1 cm and
8-10-8 minutes for tumors up to 2 cm. Intraprocedural saline
hydro dissection protects the skin. Periodic lifting up of the
ablation probe protects the chest wall with the patient supine.
Four patients have been treated off-trial at our facility between
July and November 2017, age 71-88. These invasive tumors
were of any histology, up to 1.8 cm in size, and at least 0.2 cm
from skin. All tumors were encompassed by a greater than 1
cm margin of ice on all visible sides, ensuring the tumor was
encompassed by the -30 degree C lethal isotherm. All patients
tolerated the procedure well with local anaesthesia. There have
been no complications. Patients have been able to leave the
facility within 20minutes of procedure completion, and resume
all normal activities within 24 hours. US-guided cryoablation of
breast cancer is a well-tolerated, minimally-invasive treatment
modality for selected patients. Long term follow up is needed
to demonstrate efficacy.
Speaker Biography
Robert C Ward received his MD from the George Washington University in Washington,
DC, in 2010. He then completed an internship in Internal Medicine, residency in
Diagnostic Radiology, and fellowship in Women’s Imaging through the Alpert Medical
School of Brown University affiliated hospitals, including Rhode Island Hospital and
Women and Infants Hospital. He specializes in breast imaging and intervention,
including ultrasound-guided breast cryoablation. His research interests also include
the immune response to cryoablation.
e:
rward@lifespan.org