No need for surgery? This technology can "freeze" breast tumors to death!

Breast cancer is the most common cancer affecting women's health worldwide and in my country.

In my country, breast cancer diagnosed in Chinese women

The average age is 45-55 years old

In the past, we often heard about "mastectomy"

Many women with breast cancer

The first thought is often

“Will I lose my breasts?”

In fact, with the innovation of surgical treatment concepts and the development of medical technology, the treatment methods for breast cancer are becoming increasingly diverse. Among them, minimally invasive ablation technology for breast cancer treatment is in line with the trend of minimally invasive and precise treatment, and has received more and more widespread attention. Today, let's learn about cryoablation treatment technology . Breast cancer can be treated without surgery!

01What is cryoablation?

Cryoablation, as the name suggests, is a method of destroying tissue by freezing . It is one of the earliest tumor treatment methods attempted by humans.

In the mid-19th century, Dr. James Arnott used a salt solution containing crushed ice to freeze breast cancer, cervical cancer, and skin cancer, which not only improved pain but also caused the tumors to shrink or regress. In 1961, neurosurgeon Dr. Irving Cooper and his colleagues developed a cryosurgery system based on liquid nitrogen cooling of tissues, which became the prototype of the modern cryoablation system.

Source: Irving Cooper

After decades of technological improvements, early simple cryotherapy under direct vision has developed into a new composite cryoablation technology that integrates low-temperature and high-temperature ablation. Treatment pathways include image-guided percutaneous puncture, bronchoscopy, laparoscopy and open surgery. Among them, percutaneous puncture has less trauma, low cost and is repeatable, so it is the most widely used in clinical practice.

02What are the advantages of cryoablation?

Compared with other ablative treatments, the unique advantages of cryoablation are that it is painless , well tolerated by patients [1], and has a low complication rate [2].

Japanese expert Fukuma E[3] [4] successfully used cryoablation in patients with early low-risk breast cancer, i.e. lesion diameter <1.5 cm, ductal carcinoma in situ (DCIS) or luminal A type invasive breast cancer without lymph node metastasis. After cryoablation, adjuvant endocrine therapy and radiotherapy were used. The results showed that the patients had a low local recurrence rate and a definite medium- and long-term survival effect.

In clinical applications and research, it has been found that cryoablation can stimulate a stronger immune response in the body while treating tumors[5]. Studies have shown that cryoablation for breast cancer with lymph node metastasis only ablates the primary breast lesions, and the abnormal metabolism of breast lesions and axillary lymph nodes disappears[6].

03How does cryoablation treat breast cancer?

Cryoablation is a procedure that uses medical imaging technology to accurately place a cryoprobe in the center of a breast lesion. Liquid nitrogen or argon gas is used to freeze tissue , and the freezing temperature is targeted at a specific area, turning the tumor into an ice ball to destroy diseased cells and induce tumor cell damage .

The mechanisms include: ice crystal growth leading to cell dehydration; microthrombosis and tumor tissue ischemia; hypothermia-induced cell apoptosis; and immune stimulation leading to a cascade-like tumor-suppressing effect[7].

Cryoablation therapy mechanism

04Which breast cancer patients can choose cryoablation?

Currently, cryoablation is mainly applicable to early-stage low-risk breast cancer , including ductal carcinoma in situ with a diameter of less than 2 cm, luminal A type (hormone receptor positive, Her-2 receptor negative, Ki67 expression less than 20%) and invasive breast cancer without lymph node metastasis, etc. However, due to the different sizes of ice balls that can be formed by different devices, the sizes of tumors that can be ablated by different devices are slightly different.

In addition, cryoablation is an alternative to traditional breast-conserving surgery, and subsequent treatments such as radiotherapy and endocrine therapy should be carried out as usual. Therefore, patients with contraindications to breast-conserving surgery are also not suitable for cryoablation. Therefore, a breast surgeon should formulate a surgical plan after a comprehensive evaluation based on imaging examinations, pathological classification and staging before surgery.

05To protect your breasts, you can do this

1. Maintain a healthy diet

Studies have shown that if women consume more than 30 grams of fiber per day , their risk of developing breast cancer after menopause will be greatly reduced. Foods rich in fiber include grains, beans and bean products, vegetables and fruits.

It is recommended to eat more nuts or seafood to take in trace element selenium. Trace element selenium can inhibit cell proliferation and induce apoptosis, thereby affecting estrogen receptors.

Do not eat too much high-fat and high-calorie foods , and try to eat less fried foods. Monounsaturated fatty acids have a certain preventive effect on breast cancer, and olive oil is rich in monounsaturated fatty acids.

2. Maintain a positive attitude towards life

In daily life, we must learn to actively regulate our negative emotions . The long-term accumulation of negative emotions can easily turn into physical illness.

3. Maintain good living habits

Maintaining good living habits plays a certain role in preventing breast cancer. It is important to maintain a regular work and rest schedule , avoid staying up late, combine work and rest, avoid overwork, actively participate in exercise, and choose a form of exercise that suits you, such as jogging, walking, etc.[8]

References:

[1] Fleming, MM, AI Holbrook, and MS Newell, Update on Image-Guided Percutaneous Ablation of Breast Cancer. AJR Am J Roentgenol, 2017. 208(2): p. 267-274.

[2] Mauri, G., et al., Technical success, technique efficacy and complications of minimally-invasive imaging-guided percutaneous ablation procedures of breast cancer: A systematic review and meta-analysis. Eur Radiol, 2017. 27(8): p. 3199-3210.

[3] Adachi, T., et al., Fluorodeoxyglucose positron emission tomography/computed tomography findings after percutaneous cryoablation of early breast cancer. Cancer Imaging, 2020. 20(1): p. 49.

[4] Machida, Y., et al., MRI Findings After Cryoablation of Primary Breast Cancer Without Surgical Resection. Acad Radiol, 2019. 26(6): p. 744-751.

[5] Baust, JG, et al., Mechanisms of cryoablation: clinical consequences on malignant tumors. Cryobiology, 2014. 68(1): p. 1-11.

[6] Kumar, AV, SG Patterson, and MJ Plaza, Abscopal Effect following Cryoablation of Breast Cancer. J Vasc Interv Radiol, 2019. 30(3): p. 466-469.

[7]Chu, Katrina F., and Damian E. Dupuy. "Thermal ablation of tumours: biological mechanisms and advances in therapy." Nature Reviews Cancer, 14.3 (2014): 199-208.

[8] Yang Yukun. How to prevent breast cancer[J]. Happy Family, 2020(18):107.

Author: Zhao Jin, Director of Beijing Refrigeration Society, Associate Chief Physician of Breast and Thyroid Surgery, China-Japan Friendship Hospital

Reviewer: Wang Li, Vice President of Beijing Refrigeration Society, Director of Science Popularization Training Working Committee, Professor of Beijing University of Science and Technology