Breast fibroadenomas – a type of benign breast lump – can be killed with the intense cold of cryoablation treatment. The Visica2TM Treatment System received FDA clearance in 2001 for treatment of soft tissue lesions such as fibroadenomas. Instead of removing a fibroadenoma with a traditional lumpectomy, cryoablation simply freezes the lump to death so that healthy tissue can take its place. Fibroadenoma cryoablation is done in one office visit, takes less than 30 minutes, and results in a tiny scar. Here's what to expect during a cryoablation of a breast fibroadenoma.
Considering Cryoablation For A Fibroadenoma
Visica cryoablation for fibroadenomas is commercially available in most American states. This procedure is done in your doctor's office and does not require general anesthesia, which keeps your costs low and avoids a visit to the hospital.
You need to have a clear diagnosis of fibroadenoma, confirmed by a breast biopsy, to rule out other conditions. The fibroadenoma must be 4 centimeters or smaller, and multiple fibroadenomas can be treated during the same office visit.
If you have high blood pressure, hemophilia, or a fibroadenoma larger than 4 centimeters, cryoablation may not be your best option.
Getting Ready For Your Fibroadenoma Cryoablation
A cryoablation of a breast fibroadenoma can be done in your doctor's office. General anesthesia won't be needed. The procedure is done with local anesthesia, so you will be awake but should feel no pain during the procedure. Your breast will not be compressed (as for a mammogram or sterotactic biopsy).
You will undress from the waist up and lie comfortably on an exam table for the procedure.
Locating The Fibroadenoma With Ultrasound
Your surgeon will use an ultrasound transducer to locate your fibroadenoma. The fibroadenoma must be clearly seen on ultrasound, so the cryoprobe that will be used for your treatment can be accurately positioned in the center of the lump.
Once the fibroadenoma has been pinpointed, local anesthesia will be injected to numb your breast. Some time will be allowed for the anesthesia to do its work.
Positioning The Cryoprobe
A 3 millimeter cut will be made in your breast skin to make way for the cryoprobe. This tiny cut will usually be made on the underside of your breast, so the scar won't be seen.
Guided by ultrasound, your doctor will insert the cryoprobe into the center of your fibroadenoma. Using a perpendicular angle of view, your doctor will double-check the position of the probe and the fibroadenoma to ensure accurate treatment. If your fibroadenoma is near your skin, some saline solution will be injected between the treatment area and your skin to insulate it from the extreme cold that will be used.
Having Your Fibroadenoma Cryoablation
With the cryoprobe in place and the ultrasound transducer positioned above the fibroadenoma, your doctor will start the cryoablation process. The Visica system will be programmed to create a custom-sized area of frozen tissue that matches your fibroadenoma. Two freeze-thaw cycles will take place, subjecting the entire fibroadenoma to a uniformly-distributed temperature of -40° C or lower.
After the fibroadenoma has been treated, the probe is removed, and a small bandage is placed over the skin. If other fibroadenomas are being treated, the same procedure can be repeated for each lump. Depending on the size of the fibroadenoma, the process takes about 15-30 minutes total.
Speedy Recovery, Minor Pain, Small Scars
You will be able to drive yourself back to work or home after the cryoablation treatment. Don't do any lifting or strenuous activity for about 24 hours. Avoid sports and heavy tasks for the next 3-4 days.
It is normal to have some bruising, some tenderness, and in rare cases, some pain at the incision site. You can take ibuprofen to alleviate any discomfort.
As you heal, you'll be able to feel a firm area where the fibroadenoma was located – but that will fade. Because the cryoablation broke the cells and destroyed the blood supply to the fibroadenoma, it will not be able to regrow. Instead, it will be replaced by healthy tissue.
You will have a follow-up appointment and then you will resume your annual schedule of mammograms.
Healing After Cryoablation
Patients who have had cryoablation instead of lumpectomy for a fibroadenoma say they would recommend the procedure. Dr. Cary Kaufman wrote that both patients and physicians were satisfied with cosmetic results of cryoablation – the breast never changes shape, has almost no scar, and improves in texture.
Dr. Kaufman and his colleagues followed the progress of cryoablation patients for three years. Here's what they found:
- 69% of cryoablated fibroadenomas ≤ 2 cm could not be felt after 6 months
- 84% of cryoablated fibroadenomas could not be felt or were softer, or less prominent at 12 months
- 97% of patients and 100% of physicians were satisfied with the results after 2.6 years
- 100% of cryoablated fibroadenomas have not regrown
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 (ASBS), Official Statement, “Management of Fibroadenomas of the Breast,” Revised, December 8, 2005.
Cryosurgery in Cancer Treatment: Questions and Answers. National Cancer Institute. Reviewed: 09/10/2003.