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Cryoablation of Breast Fibroadenomas

Non-Surgical Procedure Freezes Fibroadenomas, Gets Great Results

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Updated January 29, 2010

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Visica Cryoablation of Fibroadenoma Part 2

Visica Cryoablation of Fibroadenoma Step 2

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Fibroadenomas, a common benign breast lump, can be removed during a lumpectomy. But you could just tell your pesky fibroadenoma to take a permanent chill. Cryoablation may be used to eliminate those lumps by freezing them with a technology called Visica 2TM Treatment System.

Approved by the FDA in 2001, Visica uses intense cold to destroy the fibroadenoma. You are left with only a tiny scar, no sutures, and no change in breast shape. Cryoablation is done as a 30-minute outpatient procedure with local anesthesia.

Benign But Bothersome Fibroadenomas
That smooth, flexible lump you can feel in your breast may be a fibroadenoma, a harmless breast abnormality. Fibroadenomas can show up clearly on your mammogram, where they resemble cysts, and on ultrasound, as a dark mass with a definite outline. Most fibroadenomas are painless unless they become large or are located near your skin. To get a clear diagnosis of fibroadenoma and to rule out a malignant lump, a breast biopsy must be done.

If you have one or more painful fibroadenomas and are over 40 years old, many doctors recommend having them removed. The standard treatment has been a lumpectomy, but cryoablation may be used for breast fibroadenomas, as well as liver, kidney, prostate, and bone tumors.

Breast Surgeons Use Cryoablation On Fibroadenomas
Several breast surgeons have been using cryoablation to treat fibroadenomas. Dr. Cary Kaufman worked with a team of researchers to determine the long-range safety, effectiveness, and patient satisfaction with cryoblation. They found that 30 months after treatment, most fibroadenomas had shrunk so much that patients could no longer feel them. Cryoblation did not interfere with follow-up mammograms or ultrasound. All of the doctors and 97% of the patients were very satisfied with the results of cryoblation.

Dr. Deanna Attai, a breast surgeon in California, says, "I have been treating patients with fibroadenomas in my practice with cryoablation since 2004 and have been very pleased with the results." She notes that patients like Visica cryoablation because the cosmetic results are superior to a lumpectomy.

Good Candidates for Cryoablation
If your fibroadenoma is 4 cm or smaller, you could be a good candidate for a cryoablation procedure. The fibroadenoma must be clearly seen on your mammogram and ultrasound, with a diagnosis confirmed by a breast biopsy. You must not be pregnant and not breastfeeding. If you have multiple fibroadenomas, those can all be treated during the same procedure.

Cryoablation Kills Fibroadenomas Quickly
Having a cryoablation treatment won't slow you down much at all. This procedure can be done right in your doctor's office. From start to finish, the whole process will take just about 30 minutes. You won't have a big surgical dressing, and you won't be woozy from anesthetic. If you're curious about the procedure itself, here's a full description of cryoablation of a fibroadenoma.

Advantages and Drawbacks of Fibroadenoma Cryoablation
Cryoablation removes no tissue, so the shape of your breast is not distorted. The 3 mm scar will soon heal and fade. And because the insertion cut is so small, your risk of infection is lower than for a standard surgical procedure.

There's no hospital visit, which keeps your cost lower. Recovery is fast -- in fact, you can return to normal activities immediately and participate in sports 3 or 4 days later. You will have some bruising, and may need to take Tylenol for any discomfort you have during recovery.

If you have high blood pressure, hemophilia or a very large fibroadenoma, cryoablation may not be your best option. Check with your doctor to see which procedure will benefit you the most.

Cryoablation of Breast Tumors
The Visica Cryoablation Treatment System is currently in a National Cancer Institute-funded Phase 2 clinical trial for the cryoablation of breast cancer. Cryoablation will kill a malignant tumor as well as a margin of tissue around the tumor. Just as the procedure for fibroadenoma is done in an office setting, a breast tumor could be frozen to death in your doctor's office. This may save you the trauma of surgery and hospital costs.

Cryoablation for cancer seems to have another, unexpected benefit. Dr. Rache Simmons of the Weil Cornell Medical Center explains, "What we have shown in mouse models is that there is something about the cryoablation process that actually acts as an auto-vaccine against your own cancer, and what we think may be happening is that when the cancer freezes, it then releases cancer DNA to our blood stream, and then our immune system can recognize this cancer DNA and mount an auto-vaccine, so to speak, against your own breast cancer." This cryoimmunology effect may produce a customized vaccine that might shrink any secondary tumor sites for the patient.

In her book, "5 Lessons I Didn't Learn from Breast Cancer," Shelley Lewis wrote that she planned to go on with her life during treatment. Ms. Lewis wanted to have "20-minute breast cancer" and get right back to work. Perhaps with cryoablation, we will someday have a 20-minute non-surgical treatment for breast cancer that activates our body's own resources to fight cancer naturally. Then we could just tell cancer to cool it - for good!

Sources:

Kaufman, C.S., Littrup, P.J., Freeman-Gibb, L.A., "Office Based Cryoablation of Breast Fibroadenomas with Long-Term Follow-up," The Breast Journal, 2005, (11), 344-350.

American Society of Breast Surgeons, Official Statement, "Management of Fibroadenomas of the Breast," Revised, 12/8/2005

Cryosurgery in Cancer Treatment: Questions and Answers. National Cancer Institute. Reviewed: 09/10/2003.

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