Roberto Luigi Cazzato1,2, Christine Tunon de Lara3, Xavier Buy4, Stéphane Ferron5, Gabrielle Hurtevent6, Marion Fournier7, Marc Debled8, Jean Palussière9. 1. Department of Medical Imaging, Institut Bergonié, Comprehensive Cancer Centre, 229 cours de l'Argonne, 33000, Bordeaux, France. r.cazzato@unicampus.it. 2. Department of Medical Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, 21 via Álvaro del Portillo, Rome, Italy. r.cazzato@unicampus.it. 3. Department of Surgery, Institut Bergonié, Comprehensive Cancer Centre, 229 cours de l'Argonne, 33000, Bordeaux, France. c.tunondelara@bordeaux.unicancer.fr. 4. Department of Medical Imaging, Institut Bergonié, Comprehensive Cancer Centre, 229 cours de l'Argonne, 33000, Bordeaux, France. x.buy@bordeaux.unicancer.fr. 5. Department of Medical Imaging, Institut Bergonié, Comprehensive Cancer Centre, 229 cours de l'Argonne, 33000, Bordeaux, France. s.ferron@bordeaux.unicancer.fr. 6. Department of Medical Imaging, Institut Bergonié, Comprehensive Cancer Centre, 229 cours de l'Argonne, 33000, Bordeaux, France. g.hurtevent@bordeaux.unicancer.fr. 7. Department of Surgery, Institut Bergonié, Comprehensive Cancer Centre, 229 cours de l'Argonne, 33000, Bordeaux, France. m.fournier@bordeaux.unicancer.fr. 8. Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Centre, 229 cours de l'Argonne, 33000, Bordeaux, France. m.debled@bordeaux.unicancer.fr. 9. Department of Medical Imaging, Institut Bergonié, Comprehensive Cancer Centre, 229 cours de l'Argonne, 33000, Bordeaux, France. j.palussiere@bordeaux.unicancer.fr.
Abstract
AIM: To present our single-centre prospective experience on the use of cryoablation (CA) applied to treat primary breast cancer (BC) in a cohort of patients unsuitable for surgical treatment. MATERIALS AND METHODS: Twenty-three consecutive post-menopausal female patients (median age 85 years; range 56-96) underwent percutaneous CA of unifocal, biopsy-proven BC, under ultrasound/computed tomography (US/CT) guidance. Clinical and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) follow-ups were systematically scheduled at 3, 12, 18 and 24 months. Local tumour control was assessed by comparing baseline and follow-up DCE-MRI. RESULTS: Twenty-three BC (median size 14 mm) were treated under local anaesthesia (78.3 %) or local anaesthesia and conscious sedation (21.7 %). Median number of cryo-probes applied per session was 2.0. A "dual-freezing" protocol was applied for the first ten patients and a more aggressive "triple-freezing" protocol for the remaining 13. Median follow-up was 14.6 months. Five patients recurred during follow-up and two were successfully re-treated with CA. Five patients presented immediate CA-related complications: four hematomas evolved uneventfully at 3-month follow-up and one skin burn resulted in skin inflammation and skin retraction at 3 and 12 months, respectively. CONCLUSIONS: Percutaneous CA is safe and well tolerated for non-resected elderly BC patients. Procedures can be proposed under local anaesthesia only. Given the insulation properties of the breast gland, aggressive CA protocols are required. Prospective studies are needed to better understand the potential role of CA in the local treatment of early BC.
AIM: To present our single-centre prospective experience on the use of cryoablation (CA) applied to treat primary breast cancer (BC) in a cohort of patients unsuitable for surgical treatment. MATERIALS AND METHODS: Twenty-three consecutive post-menopausal female patients (median age 85 years; range 56-96) underwent percutaneous CA of unifocal, biopsy-proven BC, under ultrasound/computed tomography (US/CT) guidance. Clinical and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) follow-ups were systematically scheduled at 3, 12, 18 and 24 months. Local tumour control was assessed by comparing baseline and follow-up DCE-MRI. RESULTS: Twenty-three BC (median size 14 mm) were treated under local anaesthesia (78.3 %) or local anaesthesia and conscious sedation (21.7 %). Median number of cryo-probes applied per session was 2.0. A "dual-freezing" protocol was applied for the first ten patients and a more aggressive "triple-freezing" protocol for the remaining 13. Median follow-up was 14.6 months. Five patients recurred during follow-up and two were successfully re-treated with CA. Five patients presented immediate CA-related complications: four hematomas evolved uneventfully at 3-month follow-up and one skin burn resulted in skin inflammation and skin retraction at 3 and 12 months, respectively. CONCLUSIONS: Percutaneous CA is safe and well tolerated for non-resected elderly BC patients. Procedures can be proposed under local anaesthesia only. Given the insulation properties of the breast gland, aggressive CA protocols are required. Prospective studies are needed to better understand the potential role of CA in the local treatment of early BC.
Entities:
Keywords:
Breast cancer; Cryoablation; Percutaneous ablation
Authors: Roberto Luigi Cazzato; Julien Garnon; Nitin Ramamurthy; Guillaume Koch; Georgia Tsoumakidou; Jean Caudrelier; Francesco Arrigoni; Luigi Zugaro; Antonio Barile; Carlo Masciocchi; Afshin Gangi Journal: Med Oncol Date: 2016-11-11 Impact factor: 3.064
Authors: Giovanni Mauri; Luca Nicosia; Gianluca Maria Varano; Paul Shyn; Sergio Sartori; Paola Tombesi; Francesca Di Vece; Franco Orsi; Luigi Solbiati Journal: Ecancermedicalscience Date: 2017-04-18