Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe, Unit 1350, Houston, Texas 77030, USA (M.L.H., D.L.L., L.Q.C.S., R.P.C., L.S.).
Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe, Unit 1350, Houston, Texas 77030, USA (M.L.H., D.L.L., L.Q.C.S., R.P.C., L.S.).
Acad Radiol. 2024 Dec;31(12):4759-4771. doi: 10.1016/j.acra.2024.07.017. Epub 2024 Aug 5.
Recent ICE3 trial of breast cryoablation for breast cancer demonstrated 98% success rate, similar to breast-conserving surgery. However, ICE3 and other published studies did not differentiate curative from palliative treatment nor define patient-specific treatment objectives. We sought to define treatment success of curative and palliative breast cryoablation for breast cancer in meeting procedure objectives and patient-specific treatment objectives.
We conducted a retrospective analysis of breast cancer patients who underwent breast cryoablation during 2021-2024. Breast radiologists performed outpatient cryoablation using local anesthesia and argon gas cryoprobes under ultrasound or MRI guidance. Patient demographics, referral indications, tumor characteristics, procedure details, and imaging follow-up findings were analyzed. Cryoablation was categorized as curative or palliative. Treatment success was defined as achievement of both procedure and patient-specific treatment objectives.
Breast cryoablation was performed for 34 lesions in 29 patients with N0M0 (n = 25), N1M0 (n = 2), N2M0 (n = 1), and N0M1 (n = 1) disease. Most tumors were invasive ductal carcinoma (IDC), low to intermediate grade, estrogen receptor (ER) and progesterone receptor (PR) positive and HER2 negative (23 tumors, 68%). Tumor size ranged from 0.4-1.9 (median 0.8) cm for curative cryoablation and 0.6-6.0 (median 1.3) cm for palliative cryoablation. For 27 patients with follow-up imaging, ablation was curative in 14 patients, 14 tumors and palliative in 13 patients, 18 lesions. Imaging follow-up time ranged from 3 to 26 (median 16) months, > 12 months in 22 of 27 patients and 25 of 32 tumors. Complications were limited to 2 cases of skin frost injury, 1 mild and 1 moderate. Treatment success was achieved in 13 of 14 patients with curative and all 13 patients with palliative cryoablation.
Our study defines treatment success for curative and palliative breast cryoablation, demonstrates breast cryoablation achieves not only procedure (technical) but also patient-specific treatment objectives without significant complications, and may serve as guide for integrating breast cryoablation in the treatment of breast cancer patients.
最近的 ICE3 乳房冷冻消融治疗乳腺癌的试验显示，成功率为 98%，与保乳手术相似。然而，ICE3 和其他已发表的研究并未区分根治性和姑息性治疗，也未定义患者特定的治疗目标。我们旨在确定根治性和姑息性乳房冷冻消融治疗乳腺癌在满足手术目标和患者特定治疗目标方面的治疗成功率。
我们对 2021 年至 2024 年间接受乳房冷冻消融治疗的乳腺癌患者进行了回顾性分析。乳腺放射科医生在局部麻醉下使用氩气冷冻探针，在超声或 MRI 引导下进行门诊冷冻消融。分析了患者的人口统计学资料、转诊指征、肿瘤特征、手术细节和影像学随访结果。冷冻消融分为根治性和姑息性。治疗成功定义为同时达到手术和患者特定治疗目标。
29 例 N0M0（n=25）、N1M0（n=2）、N2M0（n=1）和 N0M1（n=1）疾病的患者共 34 个病灶接受了乳房冷冻消融治疗。大多数肿瘤为浸润性导管癌（IDC），中低级别，雌激素受体（ER）和孕激素受体（PR）阳性，HER2 阴性（23 个肿瘤，68%）。肿瘤大小范围为 0.4-1.9cm（中位值 0.8cm）的为根治性冷冻消融，0.6-6.0cm（中位值 1.3cm）的为姑息性冷冻消融。在 27 例有随访影像学的患者中，14 例患者、14 个肿瘤为根治性消融，13 例患者、18 个病灶为姑息性消融。影像学随访时间为 3-26 个月（中位值 16 个月），27 例患者中有 22 例和 32 个肿瘤中有 25 例随访时间>12 个月。并发症仅限于 2 例皮肤冻伤，1 例轻度，1 例中度。14 例根治性冷冻消融和 13 例姑息性冷冻消融的患者均达到了治疗成功。
本研究定义了根治性和姑息性乳房冷冻消融的治疗成功率，表明乳房冷冻消融不仅达到了手术（技术）目标，而且达到了患者特定的治疗目标，且无明显并发症，可能为将乳房冷冻消融纳入乳腺癌患者治疗提供指导。
