Initial experience on broadening the use of cryoablation on early breast cancer (Oral presentation)

Abstract

<p>Background: The ICE-3 trial final report in 2024 indicated that cryoablation is a feasible treatment for luminal breast cancers (BC) ≤ 1.5 cm. This study aimed to broaden the eligibility criteria for cryoablation to include T1 BC of all IHC subtypes.<br></p><p>Methods: This single-center, single-armed prospective trial assessed cryoablation for early-stage BC. Inclusion criteria included biopsy-confirmed invasive or in-situ BC ≤ 2 cm. Those with lobular carcinomas and tumors < 5 mm from the skin were excluded. Patients underwent contrast MRI and PET-CT scans to confirm eligibility. Cryoablation was performed by the same surgeons using intra-operative ultrasound guidance, with axillary surgery in the same setting if indicated. A 14 mm circumferential ablative margin was adopted. Procedure duration and iceball size were recorded, and patients were regularly followed for pain and complications. Contrast breast MRI, regional PET-CT scans, and core biopsies were conducted six weeks post-cryoablation to assess tumor viability.</p><p><br></p><p>Result: Among 53 patients, 33 received cryoablation. Out of the 20 excluded patients, 35% of the patients were excluded due to size discrepancy and 25% were excluded due to multifocal lesions detected from MRI screening. The median age was 64, and median tumor size was 11.95 mm. There were 4 (12.1%) DCIS and 29 (87.8%) invasive cancers, including 1 (3.4%) TNBC. The median procedure time was 52 minutes, with all patients undergoing two freeze-thaw cycles. The median final iceball size was 50.6 mm. The median pain score one week post-ablation was 1 out of 10, with no significant complications reported. 82.6% of patients had follow-up imaging 6-week post-cryosurgery and biopsy. Additionally, 71.4% of the patients had completed 1-year postcryosurgery MRI/PET-CT. All displayed no radiological evidence of residual malignancy.<br></p><p>Conclusions: Cryoablation effectively ablated T1 BC, including TNBC. Further studies are needed to confirm its broader applicability. MRI scan is an essential tool to provide better patient selection</p>