Percutaneous cryoablation of clinical stage I/II breast cancer in patients without indication for axillary surgery

Objective: To review the efficacy of percutaneous treatment of infiltrating breast cancer (BC) by ultrasound-guided cryoablation in patients with clinical stage I/II without indication for axillary surgery Methods: Patients with clinical stage I/II BC who were treated by ultrasound-guided cryoablation in whom axillary surgery was ruled out were collected from our files. Patients who had a minimum follow-up of 12 months were selected. The ultrasound follow up were: the first between 1-2 months (to assess residual lesions due to incomplete treatment) and subsequently every six months (to assess recurrences). Residual lesions and recurrences were confirmed with CNB and in all cases treatment with new (salvage) cryoablation was considered. The efficacy of the procedure was assessed on local control in the breast.Results: Between March 2019 and September 2022, 84 patients with 92 BC in clinical stage I/II were treated with ultrasound-guided cryoablation without indication for axillary surgery. The inclusion criteria of the retrospective study were met by 43 patients (58-96 years, mean 83, SD +/- 7,64) with 48 BC (between 5-60mm, mean 17, SD +/- 13,75) who were reviewed during a mean period of 20 months (between 12-40 months). There were two patients with incomplete treatment at the first ultrasound and five patients relapsed (between 9-27 months, mean 17). All were treated with salvage cryoablation. Local control at 12 months was 90.5% (probability 0.905 standard error 0.045) and in 95% of patients (41/43) the BC was locally controlled. Six patients died, three due to progression of the BC and three due to other causes. All procedures were well tolerated and there were no serious complications. Conclusion: Ultrasound-guided cryoablation is an effective percutaneous treatment for the local control of BC in patients with clinical stage I/II without indication for axillary surgery.(c) 2023 SESPM. Published by Elsevier Espana, S.L.U. All rights reserved.