Some tumors are very small and can be removed in the surgeon’s office, without needing to go to the operating room. One technique used by Dr. Margulies uses Radiofrequency technology to cut out and remove the tumor through a small skin incision. This procedure preserves the tumor for analysis and biopsy by a pathologist. We will discuss this in more detail in a future blog post.
Another method is called cryoablation. Cryoablation is a procedure that uses a large needle to place multiple very fine needles to destroy tumor tissue (ablation) with extremely cold (cryo) liquid nitrogen. Physicians have been using cryoablation to destroy benign tumors without surgery for quite some time, but researchers are now studying its effectiveness for treating early-stage malignant breast cancer tumors.
Meant for small tumors—less than 1.5 cm but preferably less than 1 cm—that are not very aggressive, cryoablation is ideal for patients who are not good surgical candidates due to age or other health concerns such as cardiovascular disease. Cryoablation candidates must also have early stage breast cancer that is hormone receptor positive. Patients with triple negative breast cancer or tumors larger than 1.5 cm would not be candidates.
While cryoablation is a promising technique that’s being studied, it has not yet proven to be effective and has not been approved to treat breast cancer. Anyone receiving cryoablation should be part of a clinical trial, preferably a clinical trial supported by an oncology cooperative group.
A clinical trial run by an oncology cooperative group is approved by the National Cancer Institute and is usually performed at designated medical centers. Clinical trials are designed to evaluate and test new treatments for safety and effectiveness, and to make recommendations for improvements. Most recently, a phase II clinical trial of cryoablation—called The Alliance for Clinical Trials in Oncology z1072—was funded by the National Cancer Institute and sponsored by the Alliance for Clinical Trials in Oncology.
The trial used the Visica 2 Treatment System over 5 years with 87 patients and found that patients treated with cryoablation still had tumor remaining 24% of the time. Also, for patients who still had tumor after cryoablation, MRI was not able to predict this result about 19% of the time.
The clinical trial report summarizes, “Because it is so important to be sure that all tumor cells are removed, the results of this study mean that the procedure of cryoablation and examination by MRI must be further improved before it can be considered safe for further study. This method of treating tumors in the breast is not currently recommended.”
The bottom line is that cancer is not something to mess around with, and cryoablation outside of a clinical trial is not yet approved to treat breast cancer. Although the procedure holds a lot of promise, it’s still very early in the exploration stage of how to most safely and effectively use cryoablation. Again, only qualified candidates in a clinical trial should receive cryoablation.
Talk to your oncologist and breast cancer surgeon before pursuing cryoablation at any medical centers that offer it outside of a clinical trial. We are making great progress in the fight against breast cancers and there are likely other courses of treatment that would provide a better long-term outcome.
If you’d like to discuss the most successful surgical treatments for your breast cancer, consult with Dr. Aaron Margulies. Committed to serving breast cancer patients through his solo practice in Breast Surgical Oncology and General Surgery, Dr. Margulies has offices at Tennova Turkey Creek Medical Center in West Knoxville, at Tennova North Knoxville Medical Center in Powell, at Jefferson Memorial Hospital, and in Newport. His extensive research and expertise have distinguished him as a leader in the field. To learn more about Dr. Margulies’ compassionate surgical care approach visit www.aaronmd.com or call (865) 692-1610.
