Breast cancer: cryoablation offered for the first time in Quebec at CHUM

MONTREAL — Some breast cancer patients now have the option of cryoablation treatment, thanks to a new technique that the University Hospital Center of Montreal is the first to offer in Quebec.

Cryoablation literally involves “freezing” a cancerous tumor using an ultra-fine needle. The procedure, performed under local anesthesia, leaves little to no scars and the patient is usually discharged the same day.

“Over the last few years, we’ve really moved toward treatments that are more personalized and more tailored to each patient, with de-escalation of therapy,” said Dr. Matthew Seidler, chief of breast imaging at CHUM Radiology. department.

“We know that some patients with small tumors could potentially benefit from a less aggressive approach with local treatment. Breast cancer cryoablation is truly an alternative approach to surgery and is a very promising technique.”

Surgical removal of the tumor often remains the best option for breast cancer. But for patients for whom this is not possible – for example, due to other health problems or undergoing other treatments – cryoablation now offers a new therapeutic option.

The method is relatively new, but the data available so far is intriguing to say the least.

Thus, in a study of sixty patients, only 10% of participants relapsed sixteen months after treatment. In another study of 194 patients, only four—or 2.1%—relapsed after three years.

“We know that rapid freezing at -40 degrees Celsius and then thawing cycles leads to a sort of cell death cascade that is very effective,” Dr. Seidler explained.

He said cold not only causes cancer cells to die, but also causes the expression of tumor antigens, which are then recognized by the human body, “and this triggers an inflammatory response in our own immune system. So it’s a different mechanism,” Dr. Seidler said.

Cryoablation works best for small tumors smaller than 1.5 cm, he added, and for tumors that express hormone receptors or are of a lower grade.

But cryoablation, Dr. Seidler emphasizes, has more than just benefits. For example, during surgical ablation, the removed tissue can be carefully analyzed in the pathology department, allowing the disease to be thoroughly characterized. Obviously, this is not possible during cryoablation.

At the moment, according to the specialist, the technique is “very well accepted by patients.”

“(They) go away within a few hours of the procedure,” recalls Dr. Seidler. There is practically no pain, with local anesthesia, as well as with the help of cold, which helps with anesthesia. “You have to choose the right patients, but it’s always good to have different options that you can discuss with them.”