Cryoablation

Most breast tumors are benign, meaning non-cancerous, and most benign breast tumors are fibroadenomas.  Although a fibroadenoma is not life-threatening, treatment may be desired because this tumor can cause physical deformity, discomfort, or emotional distress. Traditional open excisional biopsy is often recommended, but a procedure like cryoablation may be a better alternative. It is a minimally invasive procedure that can be performed in the office under local anesthesia.

Cryoablation for treating fibroadenoma was approved by the Food and Drug Administration (FDA) in 2001 and in 2008, the American Society of Breast Surgeons issued a consensus statement on the use of cryoablation for treatment of fibroadenomas. Thousands of fibroadenomas have been successfully and safely treated with this method.

What is cryoablation?

Cryoablation is the use of extreme cold to destroy a breast tumor without surgery. Very cold temperatures are applied to the breast tumor through a small metal probe placed through the skin. The freezing destroys the breast tumors. The dead cells are then removed from the breast through natural processes.

It has been approved for the treatment of fibroadenomas no larger than 4 cm (about 1.5 inches). Fibroadenomas are benign tumors frequently seen in young women. Although they do not progress to cancer, they can be bothersome and cause discomfort.

The procedure

Before cryoablation is performed, the patient is evaluated by a Providence Saint John’s breast surgeon to confirm that they indeed have a fibroadenoma. Evaluation consists of an examination, breast ultrasound and core needle biopsy. Once the fibroadenoma is confirmed, the cryoablation procedure is scheduled.

Cryoablation is done at the Margie Petersen Breast Center and does not require general anesthesia. The fibroadenoma is localized using ultrasonographic imaging. After injection of a local anesthetic, ultrasound monitoring is used to guide insertion of a 2-mm metal cryoprobe into the center of the fibroadenoma.

The tip of the probe is then cooled to very low temperatures, essentially turning the tumor into a small ball of ice. Freezing of the tumor is carefully monitored by ultrasound to ensure that minimal normal tissue is affected. After about 15 minutes, the cryoprobe is removed and a small dressing is placed over its insertion site. Immediately after the procedure, a patient may resume normal activities such as driving and going to work. Over the next few months, the tumor disappears as the frozen (destroyed) cells are gradually cleared by the body’s natural mechanisms.

Studies have shown that there is minimal discomfort during or after cryoablation. Most patients take only 1 or 2 acetaminophen (Tylenol®) tablets after cryoablation.

The advantages of cryoablation 

There are several advantages to cryoablation as compared with surgery. First, cryoablation requires a much smaller skin incision. Since the extreme cold used in cryoablation does not cause pain, cryoablation does not require general anesthesia. It’s also much faster than surgery, and since no breast tissue is removed, cryoablation results in an excellent cosmetic result. Additionally, there are no reports of scarring or other artifacts that would interfere with the interpretation of routine mammograms or other breast imaging.

An added benefit – Some insurance companies cover fibroadenoma cryoablation. We will work with your insurance company to determine coverage and approval prior to the procedure.