Cryoablation for Breast Cancer

Cryoablation uses extreme cold to freeze and kill abnormal tissue. It’s well established as a treatment for a variety of conditions, including skin cancer and other skin lesions, liver cancer, prostate cancer, and heart arrhythmias. You may also see it referred to as cryotherapy or cryosurgery. 

Recently, cryoablation has gained increased attention for use with breast cancer. Research has shown it can be a safe and effective alternative to breast cancer surgery in specific situations.  

“Cryoablation is becoming a more established treatment for breast cancer,” says Yolanda Bryce, MD, a breast interventional radiologist and founder of the cryoablation program at Memorial Sloan Kettering Cancer Center in New York City. “But it’s in a little bit of a gray zone right now because, while the FDA looks like they are about to approve it for breast cancer, they haven’t yet.”  

Bryce notes that surgery is still the standard of care for most people with breast cancer. 

“However, through our research,” she says, “we’re getting really close to designating which patient populations are appropriate for cryoablation.”

Currently, cryoablation for breast cancer is offered by some hospitals and radiology and surgical practices in the U.S. 

Just like surgery, cryoablation can be used in combination with other standard treatments like hormonal (also called anti-estrogen) therapy and radiation therapy. 

Cryoablation may be a better option for you than lumpectomy or mastectomy in the following cases. 

Cryoablation may be a good option if you aren’t a candidate for surgery — for example, due to other health conditions like heart failure, age, or because you’re currently receiving chemotherapy for another cancer. 

If you’re age 50 or older and have a small tumor (1.5 centimeters or less) that’s hormone receptor-positive, HER2-negative, and low grade, cryoablation might be a good fit. Typically, the tumor must not be located too close to the surface of the skin (to avoid frostbite). It’s important to note that cryoablation is typically only recommended for people in this situation who are willing to undergo hormonal therapy afterwards.   

Cryoablation might be an option if you have metastatic breast cancer and the metastases are controlled through systematic therapy (such as chemotherapy or targeted therapy), but the primary tumor in the breast is growing. In this situation, you could continue with systemic therapy while undergoing cryoablation, which isn’t always possible with a lumpectomy or mastectomy. 

If you have a breast cancer diagnosis, but don’t fit into these categories, you may be eligible for cryoablation through a clinical trial. For example, clinical trials are exploring the use of cryoablation for conditions like ductal carcinoma in situ (DCIS) and triple-negative breast cancer.

In general, cryoablation may not be as effective as surgery at removing tumor cells and lowering the risk of recurrence. It’s also not as effective for larger tumors in the breast. 

Research shows, however, that cryoablation can be a good alternative if you’re not a candidate for surgery or if you have a small tumor with a low risk of progression. Researchers also think it’s possible that cryoablation might enhance the immune system’s ability to fight breast cancer and lower the risk of it metastasizing. Known as the abscopal effect, some clinical trials are studying whether cryoablation for breast cancer can help trigger this immune response. 

Cryoablation is an FDA-approved treatment for fibroadenomas, a type of solid, non-cancerous lump in the breast. But doctors don’t recommend it as often as surgical excision (cutting the fibroadenoma out).  

Compared to a lumpectomy or mastectomy, cryoablation is a faster and less expensive procedure with a quicker recovery time and fewer potential complications. There is usually minimal scarring or changes to the shape and appearance of the breast.   

The procedure typically takes 30–90 minutes. It’s an outpatient procedure, which means you don’t have to stay overnight at the hospital. 

To start, you’ll receive a local anesthetic to numb the area of the breast near the tumor. You may also receive a mild sedative medicine to help you relax, but you’ll be awake.

During the procedure, the doctor will use ultrasound (or, in rarer cases, a CT scan or MRI) to locate the tumor.

The doctor makes a very small incision in the breast and inserts a cryoprobe — a thin, needle-like device — into the tumor. Liquid nitrogen or argon gas is injected through the cryoprobe, forming an ice ball around the tumor. The ice kills the tumor and a margin of normal tissue around it. Depending on the size of the tumor, the doctor may reposition the cryoprobe more than once or use multiple cryoprobes. 

Finally, the doctor removes the cryoprobe(s) and bandages the incision. Stitches aren’t usually necessary. 

The dead cancer cells are cleared from the body by white blood cells over time. 

For a few days after the procedure, you may experience some bruising, swelling, or tenderness. Scar tissue will remain in the area where there was a tumor, potentially forming a painless lump that will shrink over time (but may never fully go away).       

In the United States, a few cancer centers and doctors in private practice offer cryoablation for breast cancer. 

The procedure is performed by an interventional radiologist, breast radiologist, or breast surgeon.

Depending on your individual situation, you might qualify for receiving cryoablation through a clinical trial. 

Cryoablation can be a good alternative to traditional breast cancer treatments, but it’s not for everyone. If you’ve been diagnosed with breast cancer and are interested in cryoablation, talk with your doctors about whether the procedure makes sense for you.