“Breast Cancer Recurrence After Cryoablation” will be presented during the Closing Plenary Session on Wednesday, March 27, at 10:30 a.m. MT.
Watch the segment about this research from ABC News.
Jolie Jean, MD
Breast cancer patients who are unable or unwilling to undergo surgery may find a safe and viable treatment in cryoablation, according to data from a new, single-institution review.
Yolanda Bryce, MD
The standard of care for breast cancer is surgery, with or without radiation, and with or without systemic therapies such as hormonal therapy, chemotherapy or immunotherapy. However, some patients can’t undergo surgery because of co-morbidities such as heart disease or concurrent chemotherapy for another cancer.
Typically, cryoablation is used on breast cancer patients with smaller tumors who have low-risk pathology. However, Yolanda Bryce, MD, of Memorial Sloan Kettering Cancer Center, sees a high number of patients who are not surgical candidates but are still seeking treatment options.
“Compared to some of the surgical techniques, cryoablation is a more novel treatment, or a novel intervention. We are determining whether it’s efficient and useful for some of these more complex, high-grade breast cancers,” said Jolie Jean, MD, lead author of “Breast Cancer Recurrence After Cryoablation,” one of the SIR 2024 Abstracts of the Year.
Because the patients Dr. Bryce treats at her clinic vary from the standard cryoablation population, Drs. Jean and Bryce reviewed their patient data to determine the efficacy of treatment and tumor recurrence rates.
Dr. Jean pulled data from 60 patients who had a tumor size range larger than 1.4 cm and were treated with multiple probes—unlike patients in many other studies where just one probe is used. Of the 60 patients, 48 had invasive ductal carcinoma and five had invasive lobular carcinoma. According to Dr. Jean, this review is the largest retrospective study to date that looks at cryoablation for this kind of patient and tumor population.
“At around our 15-month follow-up, we found a recurrence rate of 10%,” said Dr. Jean. “So, 10% of patients who had cryoablation had a recurrence within that same breast.”
This is extremely promising for patients who otherwise would have had no surgery, Dr. Jean said. “What we’re doing is giving them a procedure where they’re able to go home the same day. It has great cosmetic outcomes, requires no general anesthesia and has very low adverse event rates.”
It’s a promising option for a population that is otherwise underserved, she said.
Receiving cryoablation for breast cancer does not prevent patients from receiving concurrent or additional therapy, Drs. Jean and Bryce added.
“We actually strongly encourage radiation or systemic therapies,” said Dr. Bryce. “I always offer a referral to radiation and medical oncologists, because I’d like patients to know what to expect and understand that with other treatments, their recurrence rate is likely lower.”
While Drs. Jean and Bryce emphasize that surgery is the best option for these patients, they do feel confident that cryoablation is a solid option for patients who either adamantly refuse surgery or cannot go to surgery as deemed by a breast surgeon.
Though the data is promising, Drs. Jean and Bryce acknowledge the need for more data and a larger population size. Dr. Bryce says she plans to re-review her data every few years to ensure that her efficacy rates stay the same.
“I do want to eventually stratify my data into the patients who did receive radiation and other systemic therapy versus those who didn’t and see if there’s a difference in recurrence in those two populations,” she said.
Dr. Jean also identified the need for a multicenter study. “With any single-center, retrospective study, there’s always going to be innate bias,” she said. “And eventually, hopefully this research can allow us to think more critically on the efficiency and effectiveness of this treatment for patients who are surgical candidates and illuminate what role cryoablation can play in the standard of care.”
Regardless of patient population or treatment, Dr. Bryce encourages all physicians to review their data periodically.
“It’s easy to think that you do good work for your patients, but you can’t know that unless you review your data and outcomes to make sure the service you’re providing is of the highest quality,” she said. “There are always areas to improve, and the only way to find them is to review your work.”
