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Review
. 2024 Oct;15(5):737-743.
doi: 10.14740/wjon1909. Epub 2024 Sep 16.

Cryotherapy in the Treatment of Early-Stage Breast Cancer

Chelsey C Ciambella  1 , Kazuaki Takabe  1   2   3   4   5   6
Affiliations
Review

Cryotherapy in the Treatment of Early-Stage Breast Cancer

Chelsey C Ciambella et al. World J Oncol. 2024 Oct.

Abstract

Breast cancer is one of the most common malignancies, affecting millions of people worldwide annually. The treatment paradigm for early-stage breast cancer is in flux. The focus is now on opportunities to de-escalation treatment to minimize morbidity and maximize patients' quality of life. Recently, percutaneous minimally invasive ablative techniques have been explored. Early trials in small population of patients demonstrated cryoablation to be effective, safe, and well-tolerated in an outpatient setting. Subsequent surgical resection was performed and the ablation success rate was the highest if the tumor was less than 1.5 cm and with < 25% ductal carcinoma in situ component. ACOSOG Alliance Z1072, a phase II trial with curative intent, demonstrated 100% ablation in all tumors smaller than 1 cm and 92% success in lesions without multifocal disease and less than 2 cm in size. There are ongoing prospective clinical trials to investigate the efficacy of cryoablation without surgical excision for treatment of early-stage breast cancer. FROST (Freezing Instead of Removal Of Small Tumors) started in 2016 is ongoing, ICE3 (Cryoablation of Low Risk Small Breast Cancer) started in 2014 just released 5 years results, and COOL-IT: Cryoablation vs Lumpectomy in T1 Breast Cancers is also ongoing. These prospective trials will expand our knowledge on the safety and value of cryoablation. It is crucial to understand the indications, technical nuances, and distinctive imaging findings for cryoablation as it has potential to revolutionize standard surgical practice.

Keywords: Breast cancer; Cryoablation; Cryobiology; De-escalation.

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Conflict of interest statement

The authors report no conflict of interest relevant to this article.

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Grants and funding

This research was supported by the National Institutes of Health, R37CA248018, R01CA250412, R01CA251545, R01EB029596, the US Department of Defense BCRP, W81XWH-19-1-0674 and W81XWH-19-1-0111 (KT), as well as by the Roswell Park Comprehensive Cancer Center and National Cancer Institute cancer center support grant P30CA016056.

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