Cryotherapy for Breast Cancer: A Feasibility Study without Excision
Identifieur interne : 003649 ( Ncbi/Merge ); précédent : 003648; suivant : 003650Cryotherapy for Breast Cancer: A Feasibility Study without Excision
Auteurs : Peter J. Littrup ; Bassel Jallad ; Priti Chandiwala-Mody ; Monica D Gostini ; Barbara A. Adam ; David BouwmanSource :
- Journal of vascular and interventional radiology : JVIR [ 1051-0443 ] ; 2009.
Abstract
To assess the feasibility of percutaneous multiprobe breast cryoablation (BC) for diverse presentations of cancers that remained in situ after BC.
After breast magnetic resonance (MR) imaging and thorough consultation, patients underwent BC after giving informed consent. This study was approved by the institutional review board. In 12 BC sessions, 22 breast cancer foci (stages I–IV) were treated in 11 patients who refused surgery by using multiple 2.4-mm cryoprobes. Five patients had recurrent disease and six had new diagnoses. With use of only local anesthesia, six patients were treated with ultrasonographic (US) guidance and five were treated with both computed tomographic (CT) and US guidance. Saline injections and warming bags were used to protect the skin. Procedure success was defined as 1 cm visible ice beyond all tumor margins. MR imaging and/or clinical follow-up were available for up to 72 months after BC.
US produced sufficient ice visualization for small tumors, whereas CT helped confirm overall ice extent. The mean pretreatment breast tumor diameter was 1.7 cm ± 1.2 (range, 0.5–5.8 cm), and an average of 3.1 cryoprobes produced 100% procedural success with mean ice diameters of 5.1 cm ± 2.2 (range, 2.0–10.0 cm). No significant complications, retraction, or scarring were noted. Biopsies at the margins of the cryoablation site immediately after BC and at follow-up were all negative. No local recurrences have been noted at an average imaging follow-up of 18 months.
In conjunction with thorough pre- and postablation MR imaging, CT/US-guided multiprobe BC safely achieved 1 cm visible ice beyond tumor margins with minimal discomfort, good cosmesis, and no short-term local tumor recurrences.
Url:
DOI: 10.1016/j.jvir.2009.06.029
PubMed: 19800542
PubMed Central: 3865783
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PMC:3865783Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Cryotherapy for Breast Cancer: A Feasibility Study without
Excision</title>
<author><name sortKey="Littrup, Peter J" sort="Littrup, Peter J" uniqKey="Littrup P" first="Peter J." last="Littrup">Peter J. Littrup</name>
</author>
<author><name sortKey="Jallad, Bassel" sort="Jallad, Bassel" uniqKey="Jallad B" first="Bassel" last="Jallad">Bassel Jallad</name>
</author>
<author><name sortKey="Chandiwala Mody, Priti" sort="Chandiwala Mody, Priti" uniqKey="Chandiwala Mody P" first="Priti" last="Chandiwala-Mody">Priti Chandiwala-Mody</name>
</author>
<author><name sortKey="D Gostini, Monica" sort="D Gostini, Monica" uniqKey="D Gostini M" first="Monica" last="D Gostini">Monica D Gostini</name>
</author>
<author><name sortKey="Adam, Barbara A" sort="Adam, Barbara A" uniqKey="Adam B" first="Barbara A." last="Adam">Barbara A. Adam</name>
</author>
<author><name sortKey="Bouwman, David" sort="Bouwman, David" uniqKey="Bouwman D" first="David" last="Bouwman">David Bouwman</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Cryotherapy for Breast Cancer: A Feasibility Study without
Excision</title>
<author><name sortKey="Littrup, Peter J" sort="Littrup, Peter J" uniqKey="Littrup P" first="Peter J." last="Littrup">Peter J. Littrup</name>
</author>
<author><name sortKey="Jallad, Bassel" sort="Jallad, Bassel" uniqKey="Jallad B" first="Bassel" last="Jallad">Bassel Jallad</name>
</author>
<author><name sortKey="Chandiwala Mody, Priti" sort="Chandiwala Mody, Priti" uniqKey="Chandiwala Mody P" first="Priti" last="Chandiwala-Mody">Priti Chandiwala-Mody</name>
</author>
<author><name sortKey="D Gostini, Monica" sort="D Gostini, Monica" uniqKey="D Gostini M" first="Monica" last="D Gostini">Monica D Gostini</name>
</author>
<author><name sortKey="Adam, Barbara A" sort="Adam, Barbara A" uniqKey="Adam B" first="Barbara A." last="Adam">Barbara A. Adam</name>
</author>
<author><name sortKey="Bouwman, David" sort="Bouwman, David" uniqKey="Bouwman D" first="David" last="Bouwman">David Bouwman</name>
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<series><title level="j">Journal of vascular and interventional radiology : JVIR</title>
<idno type="ISSN">1051-0443</idno>
<idno type="eISSN">1535-7732</idno>
<imprint><date when="2009">2009</date>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>PURPOSE</title>
<p id="P1">To assess the feasibility of percutaneous multiprobe breast
cryoablation (BC) for diverse presentations of cancers that remained in situ
after BC.</p>
</sec>
<sec id="S2"><title>MATERIALS AND METHODS</title>
<p id="P2">After breast magnetic resonance (MR) imaging and thorough
consultation, patients underwent BC after giving informed consent. This
study was approved by the institutional review board. In 12 BC sessions, 22
breast cancer foci (stages I–IV) were treated in 11 patients who
refused surgery by using multiple 2.4-mm cryoprobes. Five patients had
recurrent disease and six had new diagnoses. With use of only local
anesthesia, six patients were treated with ultrasonographic (US) guidance
and five were treated with both computed tomographic (CT) and US guidance.
Saline injections and warming bags were used to protect the skin. Procedure
success was defined as 1 cm visible ice beyond all tumor margins. MR imaging
and/or clinical follow-up were available for up to 72 months after BC.</p>
</sec>
<sec id="S3"><title>RESULTS</title>
<p id="P3">US produced sufficient ice visualization for small tumors, whereas CT
helped confirm overall ice extent. The mean pretreatment breast tumor
diameter was 1.7 cm ± 1.2 (range, 0.5–5.8 cm), and an
average of 3.1 cryoprobes produced 100% procedural success with mean
ice diameters of 5.1 cm ± 2.2 (range, 2.0–10.0 cm). No
significant complications, retraction, or scarring were noted. Biopsies at
the margins of the cryoablation site immediately after BC and at follow-up
were all negative. No local recurrences have been noted at an average
imaging follow-up of 18 months.</p>
</sec>
<sec id="S4"><title>CONCLUSIONS</title>
<p id="P4">In conjunction with thorough pre- and postablation MR imaging,
CT/US-guided multiprobe BC safely achieved 1 cm visible ice beyond tumor
margins with minimal discomfort, good cosmesis, and no short-term local
tumor recurrences.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">9203369</journal-id>
<journal-id journal-id-type="pubmed-jr-id">2083</journal-id>
<journal-id journal-id-type="nlm-ta">J Vasc Interv Radiol</journal-id>
<journal-id journal-id-type="iso-abbrev">J Vasc Interv Radiol</journal-id>
<journal-title-group><journal-title>Journal of vascular and interventional radiology : JVIR</journal-title>
</journal-title-group>
<issn pub-type="ppub">1051-0443</issn>
<issn pub-type="epub">1535-7732</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">19800542</article-id>
<article-id pub-id-type="pmc">3865783</article-id>
<article-id pub-id-type="doi">10.1016/j.jvir.2009.06.029</article-id>
<article-id pub-id-type="manuscript">NIHMS521341</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Cryotherapy for Breast Cancer: A Feasibility Study without
Excision</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Littrup</surname>
<given-names>Peter J.</given-names>
</name>
<degrees>MD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Jallad</surname>
<given-names>Bassel</given-names>
</name>
<degrees>MD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Chandiwala-Mody</surname>
<given-names>Priti</given-names>
</name>
<degrees>DO</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>D’Agostini</surname>
<given-names>Monica</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Adam</surname>
<given-names>Barbara A.</given-names>
</name>
<degrees>BSN</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Bouwman</surname>
<given-names>David</given-names>
</name>
<degrees>MD</degrees>
</contrib>
<aff id="A1">Department of Radiology, Karmanos Cancer Institute, 721 Harper Prof. Bldg Detroit, MI 48201 (P.J.L., B.J., M.D., B.A.A.); and the Departments of Radiology (P.C.M.) and Surgery (D.B.), Wayne State University, Detroit, Michigan</aff>
</contrib-group>
<author-notes><corresp id="FN1">Address correspondence to: P.J.L.;
<email>littrupp@karmanos.org</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>9</day>
<month>11</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="ppub"><month>10</month>
<year>2009</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>17</day>
<month>12</month>
<year>2013</year>
</pub-date>
<volume>20</volume>
<issue>10</issue>
<elocation-id>10.1016/j.jvir.2009.06.029</elocation-id>
<permissions><copyright-statement>© SIR, 2009</copyright-statement>
<copyright-year>2009</copyright-year>
</permissions>
<abstract><sec id="S1"><title>PURPOSE</title>
<p id="P1">To assess the feasibility of percutaneous multiprobe breast
cryoablation (BC) for diverse presentations of cancers that remained in situ
after BC.</p>
</sec>
<sec id="S2"><title>MATERIALS AND METHODS</title>
<p id="P2">After breast magnetic resonance (MR) imaging and thorough
consultation, patients underwent BC after giving informed consent. This
study was approved by the institutional review board. In 12 BC sessions, 22
breast cancer foci (stages I–IV) were treated in 11 patients who
refused surgery by using multiple 2.4-mm cryoprobes. Five patients had
recurrent disease and six had new diagnoses. With use of only local
anesthesia, six patients were treated with ultrasonographic (US) guidance
and five were treated with both computed tomographic (CT) and US guidance.
Saline injections and warming bags were used to protect the skin. Procedure
success was defined as 1 cm visible ice beyond all tumor margins. MR imaging
and/or clinical follow-up were available for up to 72 months after BC.</p>
</sec>
<sec id="S3"><title>RESULTS</title>
<p id="P3">US produced sufficient ice visualization for small tumors, whereas CT
helped confirm overall ice extent. The mean pretreatment breast tumor
diameter was 1.7 cm ± 1.2 (range, 0.5–5.8 cm), and an
average of 3.1 cryoprobes produced 100% procedural success with mean
ice diameters of 5.1 cm ± 2.2 (range, 2.0–10.0 cm). No
significant complications, retraction, or scarring were noted. Biopsies at
the margins of the cryoablation site immediately after BC and at follow-up
were all negative. No local recurrences have been noted at an average
imaging follow-up of 18 months.</p>
</sec>
<sec id="S4"><title>CONCLUSIONS</title>
<p id="P4">In conjunction with thorough pre- and postablation MR imaging,
CT/US-guided multiprobe BC safely achieved 1 cm visible ice beyond tumor
margins with minimal discomfort, good cosmesis, and no short-term local
tumor recurrences.</p>
</sec>
</abstract>
<funding-group><award-group><funding-source country="United States">National Cancer Institute : NCI</funding-source>
<award-id>P30 CA022453 || CA</award-id>
</award-group>
</funding-group>
</article-meta>
</front>
</pmc>
<affiliations><list></list>
<tree><noCountry><name sortKey="Adam, Barbara A" sort="Adam, Barbara A" uniqKey="Adam B" first="Barbara A." last="Adam">Barbara A. Adam</name>
<name sortKey="Bouwman, David" sort="Bouwman, David" uniqKey="Bouwman D" first="David" last="Bouwman">David Bouwman</name>
<name sortKey="Chandiwala Mody, Priti" sort="Chandiwala Mody, Priti" uniqKey="Chandiwala Mody P" first="Priti" last="Chandiwala-Mody">Priti Chandiwala-Mody</name>
<name sortKey="D Gostini, Monica" sort="D Gostini, Monica" uniqKey="D Gostini M" first="Monica" last="D Gostini">Monica D Gostini</name>
<name sortKey="Jallad, Bassel" sort="Jallad, Bassel" uniqKey="Jallad B" first="Bassel" last="Jallad">Bassel Jallad</name>
<name sortKey="Littrup, Peter J" sort="Littrup, Peter J" uniqKey="Littrup P" first="Peter J." last="Littrup">Peter J. Littrup</name>
</noCountry>
</tree>
</affiliations>
</record>
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