cryoablation of breast fibroadenomas.
Kaufman CS, Bachman B, Littrup PJ, White M, Carolin
KA, Freman-Gibb L, Francescatti D, Stocks LH, Smith JS, Henry CA,
Bailey L, Harness JK, Simmons R.
Department of Surgery, University
of Washington, Bellingham Breast Center, 2940 Squalicum Pkwy., Suite
101, Bellingham, WA 98225, USA. Breastcare@aol.com
BACKGROUND: Fibroadenomas commonly found by palpation
and routine mammography account for approximately 20% of open surgical
breast biopsies. Alternatives to open surgery include tumor removal
using an automated coring device and tumor ablation using heating
or cooling elements. We report our initial experience with cryoablation
of biopsy-proven benign fibroadenomas. METHODS: A table-top cryoablation
system employing a 2.4-mm cryoprobe was used to treat biopsy-proven
benign fibroadenomas up to 4 cm in maximum diameter in a prospective
nonrandomized fashion. The cryoprobe was placed under ultrasound
guidance. Using a treatment algorithm based on fibroadenoma size,
all tumors were subjected to two freeze cycles with an interposing
thaw. Skin appearance and temperature, probe temperature, iceball
size, and patient comfort were closely monitored during the procedure.
Follow-up examinations including ultrasonography and photographs
were scheduled for up to 12 months postablation. RESULTS: Fifty
patients with 57 core biopsy-proven benign fibroadenomas were treated.
Seven early cases were treated in an ambulatory surgery center setting.
The remaining procedures were completely office-based using only
local anesthetic. Tumor diameter varied from 7 mm to 42 mm (mean
21 mm). The iceball engulfed the target lesion in each case. Transient
postoperative side effects were local swelling and ecchymosis. Postoperative
discomfort rarely required medication beyond acetaminophen or ibuprofen.
Lesions showed progressive shrinkage and disappearance over 3 to
12 months. No skin injury was noted and appearance remained excellent.
Patient satisfaction was excellent. CONCLUSIONS: With office-based
use of ultrasound-guided cryoablation for fibroadenomas there was
little or no pain, target lesions were reduced in size or eliminated,
scarring was minimal, cosmesis outstanding, and patient satisfaction
was excellent. Cryoablation offers a useful office-based alternative
to surgical excision of benign fibroadenomas.
PMID: 12433600 [PubMed - indexed for MEDLINE]