Breast cancer: cryoablation offered as a Quebec first at the CHUM

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Some patients with breast cancer now have the possibility of being treated by cryoablation, thanks to a recently developed technique, which the University of Montreal Hospital Center (CHUM) is the first to offer in Quebec.

Cryoablation literally involves freezing the cancerous tumor using an ultra-fine needle. The procedure, which is performed under local anesthesia, leaves virtually no scars. The patient is usually discharged the same day.

In recent years, we have really moved towards treatments that are more personalized and more adapted to each patient, with a de-escalation of therapy, said Dr. Matthew Seidler, section head of breast imaging in the department of radiology at the CHUM.

We know that some patients with small tumors can potentially benefit from a less aggressive approach, with local treatment. Cryoablation of breast cancer is truly an alternative to the surgical approach and it is a technique that is very promising.

A quote from Dr. Matthew Seidler, section head of breast imaging in the CHUM radiology department

Surgical removal of the tumor frequently remains the best option for breast cancer. But for patients for whom this is not possible – for example, because they have other health problems or are undergoing other treatments – cryoablation now offers a new therapeutic avenue.

The technique is relatively new, but the data available at the moment are intriguing to say the least.

Thus, in a study involving 60 patients, only 10% of participants suffered a relapse 16 months after treatment. In another study which included 194 patients, only four – or 2.1% – had suffered a relapse after three years.

degrees Celsius, then the thawing cycles, result in a kind of cascade of cell death which is very effective”,”text”:”We know that rapid freezing at -40 degrees Celsius, then the thawing cycles, results in a kind of cascade of cell death which is very effective”}}”>We know that rapid freezing at -40 degrees Celsius then thawing cycles results in a sort of cascade of cell death which is very effective, explained Dr. Seidler.

Not only does the cold cause cancer cells to die, he said, but it also causes the expression of tumor antigens which are then recognized by the human body, and this causes an inflammatory response by our own immune system. So that’s another mechanism, said Dr. Seidler.

Cryoablation works best for small tumors that are less than 1.5 centimeters, he added, as well as with tumors that express hormone receptors or are of lower grade.

But cryoablation, emphasizes Dr. Seidler, does not only have advantages. For example, during surgical ablation, the removed tissues can be analyzed in depth by the pathology department, allowing the disease to be carefully characterized. This is obviously not possible during cryoablation.

For the moment, said the specialist, the technique is very well received by patients.

They leave a few hours after the procedure, recalled Dr. Seidler. There is practically no pain, with the local anesthesia and also with the cold which helps with the anesthesia. You have to choose the right patients, but it’s always good to have different options that you can discuss with them.