Kaufman Cary S, Littrup Peter J, Freeman-Gibb Laurie A, Smith J Stanley, Francescatti Darius, Simmons Rache, Stocks Lewis H, Bailey Lisa, Harness Jay K, Bachman Barbara A, Henry C Alan
University of Washington and the Bellingham Breast Center, Bellingham, Washington 98225, USA.
Breast J. 2005 Sep-Oct;11(5):344-50. doi: 10.1111/j.1075-122X.2005.21700.x.
Approximately 10% of women will experience a breast fibroadenoma in their lifetime. Cryoablation is a new treatment that combines the better attributes of the current standards: surveillance and surgery. It is a minimally invasive office-based procedure that is administered without the use of general anesthesia, involving minimal patient discomfort and little to no scarring. This work aimed to establish the long-term (2-3 years) efficacy, safety, and satisfaction of the procedure, as well as the impact of cryoablation on mammogram and ultrasound images. Thirty-seven treated fibroadenomas were available for assessment with an average follow-up period of 2.6 years. Of the original 84% that were palpable prior to treatment, only 16% remained palpable to the patient as of this writing. Of those fibroadenomas that were initially < or = 2.0 cm in size, only 6% remained palpable. A median volume reduction of 99% was observed with ultrasound. Ninety-seven percent of patients and 100% of physicians were satisfied with the long-term treatment results. Mammograms and ultrasounds showed cryoablation produced no artifact that would adversely affect interpretation. Cryoablation for breast fibroadenomas has previously been reported as safe and effective both acutely and at the 1-year follow-up mark, and thus has been implemented as a treatment option. At long-term follow-up, cryoablation as a primary therapy for breast fibroadenomas demonstrates progressive resolution of the treated area, durable safety, and excellent patient and physician satisfaction. The treatment is performed in an office setting rather than an operating room, resulting in a cost-effective and patient-friendly procedure. Cryoablation should be considered a preferred option for those patients desiring definitive therapy for their fibroadenomas without surgical intervention.
约10%的女性一生中会患乳腺纤维腺瘤。冷冻消融是一种新的治疗方法,它结合了当前标准治疗(监测和手术)的优点。这是一种基于门诊的微创手术,无需全身麻醉,患者不适程度最低,几乎不会留下疤痕。这项研究旨在确定该手术的长期(2至3年)疗效、安全性和患者满意度,以及冷冻消融对乳房X光片和超声图像的影响。共有37个接受治疗的纤维腺瘤可供评估,平均随访期为2.6年。在治疗前可触及的最初84%的纤维腺瘤中,截至撰写本文时,只有16%对患者来说仍可触及。在那些最初大小≤2.0厘米的纤维腺瘤中,只有6%仍可触及。超声检查显示体积中位数减少了99%。97%的患者和所有医生对长期治疗结果感到满意。乳房X光片和超声检查显示冷冻消融未产生会对影像解读产生不利影响的伪像。此前已有报道称,冷冻消融治疗乳腺纤维腺瘤在急性期和1年随访时都是安全有效的,因此已作为一种治疗选择应用。在长期随访中,冷冻消融作为乳腺纤维腺瘤的主要治疗方法,显示出治疗区域逐渐消退、安全性持久,患者和医生满意度高。该治疗在门诊进行,而非手术室,是一种经济高效且对患者友好的手术。对于那些希望在不进行手术干预的情况下对纤维腺瘤进行确定性治疗的患者,应考虑将冷冻消融作为首选方案。