CHUM is the first in Quebec to offer cryoablation for breast cancer

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Some breast cancer patients are now able to be treated with cryoablation thanks to a new technique offered by the Central Hospitalier de l'Université de Montréal, the first in Quebec.

Cryoablation refers to the “freezing” of a cancer using an ultra-thin needle. The procedure, performed under local anesthesia, leaves virtually no scarring and the patient is usually discharged the same day.

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“Over the past few years, we've really moved toward a de-escalation of therapy that's more personalized and tailored to each patient,” said Dr. Matthew Seidler, chief of breast imaging in CHUM's Department of Radiology.

“We know that some patients with small tumors benefit from a less aggressive approach with local treatment. Cryoablation of breast cancer is really an alternative to surgery, and it's a very promising method.”

Surgical removal of the tumor is often 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 treatment option.

The technique is relatively new, but the data currently available is interesting to say the least.

In a study of 60 patients, only 10 percent had recurrence 16 months after treatment. In another study of 194 patients, only four, or 2.1 percent, had a recurrence after three years.

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“We know that rapid freeze-then-thaw cycles at -40 degrees Celsius lead to a type of cell death cascade that is very efficient,” Seidler explained.

According to him, the cold not only causes cancer cells to die, but also causes the expression of tumor antigens, which are recognized by the human body, “which causes an inflammatory response of our immune system. So it's a different mechanism,” Seidler said.

Cryoablation works best for tumors smaller than 1.5 centimeters, as well as tumors that express hormone receptors or are of low grade, he added.

But cryoablation isn't effective everywhere, he said. For example, the tissue removed during surgical ablation can be analyzed in depth in the pathology department, which allows for a thorough description of the disease. This is clearly not possible with cryoablation.

Currently, the specialist says, this method is “accepted very well by patients”.

“(They) go away a few hours after the procedure. There is practically no pain, with local anesthesia, as well as with cold, which helps with anesthesia. You have to choose the right patients, but it's always good to have different options to discuss with them.”

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