Breast Cancer Cryoablation Fundamentals Past and Present: Technique Optimization and Imaging Pearls.

ABSTRACT

Surgical treatment for breast cancer has evolved from radical mastectomy to modified radical mastectomy to breast-conserving surgery. As the de-escalation of surgical treatment for breast cancer continues, nonsurgical treatment for early-stage breast cancer with favorable ancillary features (low grade, positivity for hormone receptors) is being explored. Of the nonsurgical treatment options, cryoablation has demonstrated the greatest appeal, proven to be effective, safe, well tolerated, and feasible in an outpatient setting with local anesthetic alone. Results of past and interim results of current trials of cryoablation of stage I low-grade breast cancer with curative intent are promising, with an overall clinical success rate of 98% and recurrence rates consistent with those expected following lumpectomy. Cryoablation is also an alternative palliative treatment for patients who cannot tolerate or who have disease that is refractory to or recurs after standard-of-care breast cancer treatment and may have immunological therapeutic effects, warranting future research. Understanding the indications and optimal technique for breast cancer cryoablation and understanding typical imaging findings after cryoablation are essential to ensure the success of the procedure in carefully selected patients.