Abstract
Introduction
This is a prospective single arm clinical trial on cryosurgery for early breast cancers,
to evaluate the expanded criteria to tumors larger than 1.5 cm and non-luminal breast
cancers.
Methods
Inclusion criteria include Solitary T1 breast cancers of any immunohistotypes. Cryosurgery
was performed using the IceCure ProSense Cryoablation System. Lumpectomy of the cryoablated
tumor was then performed 8 weeks after cryosurgery.
Results
Fifteen patients underwent cryosurgery followed by lumpectomy (BCS). Median age was
53 years old 5 (33.3%) patients had ductal carcinoma in situ (DCIS), while 10 (66.7%)
patients had invasive ductal carcinoma (IDC), of which 5 (50%) patients had luminal
type cancers of which 3 (60%) were luminal A and 2 (40%) luminal B, 3 (30%) patients
had HER2 enriched invasive carcinoma and 2 (20%) patients had triple negative IDC.
Median tumor size was 13mm (Range 8.6-18mm). Seven (46.7%) patients were found to
have residual cancer in the post-cryosurgery lumpectomy specimen. All residual cancers
were found at the periphery of the cryoablated breast tissue. All breast cancers were
otherwise completely ablated centrally as confirmed by routine histopathology, immunochemistry
and TUNEL assay for evaluation of cell viability. None of the tumor factors such as
tumor biology, as well as surgical factors such as ablation time and iceball size,
were associated with risk of residual cancer. None of the 15 patients developed post-operative
complications.
Conclusion
Residual cancer occurs at the periphery of the cryoablation site, careful pre-operative
planning and intra-operative monitoring is crucial to ensure complete cryoablation.
Keywords
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Article info
Publication history
Published online: January 17, 2023
Accepted:
January 15,
2023
Received in revised form:
January 6,
2023
Received:
December 26,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Ava Kwong and Michael Co are Co-first authors of the manuscript with equal contributions
Identification
Copyright
© 2023 Published by Elsevier Inc.
