A freezing technique called cryoablation can destroy benign tumors. Could it do more?
By Nancy McVicar
Finding a lump in the breast is scary, even though most are not cancerous.
Even some benign tumors can cause pain and worry, though, so some doctors are now using a freezing technique to destroy common benign tumors, if necessary; and the same technique may eventually be used to destroy some cancerous tumors in the breast.
“There are on-going studies here in the United States, but it is for more small, more favorable tumors. It is not the standard of care [for breast cancer],” says Dr. Margaret Gilot, a breast surgeon at Cleveland Clinic Florida. “It’s all under a research protocol. I think the long-term goal – the way most treatments are going now – everyone wants to do things as minimally invasive as possible.”
Gilot is currently using the freezing technique, called cryoablation, to destroy the most common type of breast lump, non-malignant fibroadenomas, if they require removal.
The benign tumors typically occur in women younger than 30, but they can occur in older women as well. Fibroadenomas are typically the size of a marble, firm or rubbery feeling, and move easily under the skin when touched.
“First we have to diagnose it. Typically, if it’s someone younger than 30, we may just do an ultrasound. Sometimes we can tell just by looking,” Gilot says, “but sometimes we do a needle biopsy” – to take a sample of the cells to make sure they are benign.
It is not uncommon for patients to have multiple fibroadenomas in one breast or both breasts.
“If someone has several, they do not all have to be biopsied,” she says.
If the tumor is benign, there is the option of doing nothing, Gilot says, “but if they are causing pain and anxiety, traditionally we would have taken them into the operating room. Now we have this new procedure that is minimally invasive. It requires a local anesthetic, a tiny incision, and the patient is awake and talking to us,” Gilot says.
She uses a system called IceSense3 made by IceCure Medical, Inc., in which a thin hollow needle is guided into the tissue to be destroyed. Extremely cold temperatures created by liquid nitrogen are used to freeze the fibroadenoma. The company says the procedure, which takes 10 to 15 minutes, is comfortable and painless because the cold acts with the local anesthesia to numb the area.
The body absorbs the destroyed cells over time, which varies depending on the size of the mass and other factors.
Gilot says cryoablation has been approved for this use by the U.S. Food and Drug Administration since 2001 and by 2010 more than 2,000 of the procedures had been successfully performed.
“Not every place is doing it,” she says. “We started doing it here one or two years ago.”
But not all insurance companies cover the procedure even though it is recommended by the American College of Breast Surgeons when the patient meets the criteria.
No stitches are needed, and patients can return to their normal routine soon after the procedure, she says.
“Maybe just some Tylenol afterwards. And the cosmetic results are very good.”