Cryoablation as an Alternative to Surgery for Clinical Trial–Ineligible Patients With Breast Cancer

By: Julia Cipriano, MS
Posted: Tuesday, August 6, 2024

Based on retrospective multi-institutional study results published in AJR (American Journal of Roentgenology), breast cancer cryoablation appears to be a safe alternative to surgery, achieving good outcomes in select individuals with unfavorable patient or tumor characteristics, despite showing a higher frequency of ipsilateral breast tumor recurrence (IBTR) events than previously reported for prospective clinical trials. Karim Oueidat, MD, of Warren Alpert Medical School, Brown University, Providence, Rhode Island, and colleagues noted their findings may be particularly relevant in those who are also poor surgical candidates because of comorbidities.

“Breast cancer cryoablation can be safely applied in a larger patient population than defined by clinical trial inclusion criteria,” the investigators indicated.

The investigators focused on 112 clinical trial–ineligible patients who underwent cryoablation of biopsy-proven unifocal primary breast cancer with locally curative intent, without surgical excision, across seven institutions between January 2000 and August 2021. Cryoablation procedures were deemed technically successful if they were not prematurely terminated, met the intended treatment parameters, and the first imaging follow-up showed no evidence of residual disease.

A total of 6.3% of patients experienced a minor adverse event; no moderate or major toxicities were reported. Nearly all cryoablation procedures (98.2%) achieved technical success. During a median follow-up of 2 years, 20.0% of patients underwent biopsy for suspicious imaging findings in the ipsilateral breast; benign concordant findings and IBTRs were documented in 40.9% and 54.5% of this population, respectively.

A total of 10.9% of patients had IBTRs, of whom 58.3% had a true recurrence, and 41.7% had new primary disease; a quarter of this population had received earlier adjuvant or neoadjuvant therapy. A competing risk model accounting for death revealed cumulative incidences of IBTRs of 5.3%, 12.2%, and 18.2% at 1, 2, and 3 years, respectively.

Disclosure: Dr. Oueidat reported no conflicts of interest. For full disclosures of the other study authors, visit ajronline.org.

American Journal of Roentgenology