Cryosurgery - Breast


Cryosurgery of benign tumorous lesions (fibromas) and malignant ones (generally adenocarcinomas) of the breast, is performed by inserting thin needles called cryoprobes into the tumour under ultrasound scan monitoring. Ice balls are produced that encapsulate the lesion and cause its necrosis. Then the dead tissue is naturally reabsorbed leaving a small fibrous kernel in its place. Since these are percutaneous procedures, there is no surgical scarring.


The breast is an organ located in the upper part of the thorax and it is mainly made up of a combination of glands and adipose tissue. Various glandular structures, called lobules, radiate from around the nipple. On average there are eighteen of these structures, and they produce breast milk. The lobules are joined to each other and also to the nipple by the lactiferous ducts.


Tumours in the breasts are classified according to whether they are benign, and in this case we call them fibromas, or if they are malignant, in which case we call them adenocarcinomas.

In this case too, neoplasms in the breasts are asymptomatic in the early stages; in fact benign cysts generally cause any pain felt. In every case, prevention plays a fundamental role since palpable tumorous forms are usually indicative of cancer that is beyond stage zero. Constant gynaecological and self examination (such as self-exploration) are most important to identify potential cancer in time. Undergoing check-ups arranged by the reference gynaecologist physician that mainly consist of mammograms and ultrasound scans, is therefore recommended.

If self-examination, or the mammogram or ultrasound scan have made a positive diagnosis a biopsy is taken of the mass identified, in order to perform cytological and micro-histological examinations so as to ascertain its nature and characteristics. Statistics on this topic show five year survival of 98% if the tumour is identified at once, that is at stage 0.


Breast fibromas can be treated surgically by removal or minimally invasive techniques such as cryosurgery.

Adenocarcinomascan be treated surgically or using minimally invasive removal techniques. In the first case a quadrantectomy is usually performed, that is, the partial removal of the breast tissue involved and of a “sentinel lymph node”, or via mastectomy, that is the more or less destructive exeresis (removal) of the breast according to the gravity of the condition;

According to each case (2), (3), (11), minimally invasive techniques can be a valid replacement for surgery (10), since they permit the full cure of the condition and they preserve the aesthetic aspect of the organ. In the case of cryoablation we have a technique that has been in use for several years now in the United States and in other countries, and where the capacity to completely neutralise the tumour tissue from the breast has been observed as being the equivalent of that of the traditional technique (10). Furthermore, it is well regarded for its simple method of execution, the absence of pain, the low level of complications, and for the typical immunological effect of cryoablation (9).

The patient furthermore, can return home on the same day of the operation; in the course of the following weeks and months, the mass involved with the low temperature will be reabsorbed by the body, giving rise to a reduction in size or even the total disappearance of the cancer (1) or of the fibroma (8). Fear is minimised, as is pain (which is almost completely absent), whilst the aesthetic result is considered excellent, to the extent that cryoablation is considered to be one of the most effective treatments of fibroadenomas (8).

Even in metastasised and/or painful forms, it is considered to be an excellent surgical solution. The effectiveness of the operation, which is tolerable in the case of a high degree of concurrent disorders, enables cryosurgery to be used to handle forms of metastasis and the pain connected with themn(4), (5). The combination of cryoablation with hyperthermia in the treatment of cutaneous metastasis also seems to be a winner (7).

An Italian study has recently compared the level of effectiveness of radiofrequency ablation (RFA is another minimally invasive technique for the thermal ablation of tumorous tissue) with cryoablation (CA) and, even if the level of efficiency of removal is equal, CA is preferred precisely because of it palliative effect on pain (5).

  1. Breast pathology after cryotherapy. Histological regression of breast cancer after cryotherapy.
    Gajda MR1,Mireskandari M,Baltzer PA,Pfleiderer SO,Camara O,Runnebaum IB,Kaiser WA,Petersen I.
    Pol J Pathol. 2014 Mar;65(1):20-8.
  2. Percutaneous Image-Guided Cryoablation of Breast Cancer: A Systematic Review.
    Lanza E1,Palussiere J2,Buy X2,Grasso RF3,Beomonte Zobel B3,Poretti D4,Pedicini V4,Balzarini L4,Cazzato RL3.
    J Vasc Interv Radiol. 2015 Nov;26(11):1652-7.e1. doi: 10.1016/j.jvir.2015.07.020. Epub 2015 Sep 3.
  3. A Pilot Study of Ultrasound-Guided Cryoablation of Invasive Ductal Carcinomas up to 15 mm With MRI Follow-Up and Subsequent Surgical Resection.
    Poplack SP1,Levine GM,Henry L,Wells WA,Heinemann FS,Hanna CM,Deneen DR,Tosteson TD,Barth RJ Jr.
    AJR Am J Roentgenol. 2015 May;204(5):1100-8. doi: 10.2214/AJR.13.12325.
  4. Cryoablation of sternal metastases for pain palliation and local tumor control.
    Hegg RM1,Kurup AN2,Schmit GD1,Weisbrod AJ1,Atwell TD1,Olivier KR3,Moynihan TJ4,Callstrom MR1.
    J Vasc Interv Radiol. 2014 Nov;25(11):1665-70. doi: 10.1016/j.jvir.2014.08.011. Epub 2014 Sep 23.
  5. Subclinical Breast Cancer: Minimally Invasive Approaches. Our Experience with Percutaneous Radiofrequency Ablation vs. Cryotherapy.
    Manenti G1,Scarano AL1,Pistolese CA1,Perretta T1,Bonanno E2,Orlandi A2,Simonetti G1.
    Breast Care (Basel). 2013 Oct;8(5):356-60. doi: 10.1159/000355707.
  6. Breast cryoablation in patients with bone metastatic breast cancer.
    Pusceddu C1,Sotgia B2,Amucano G2,Fele RM2,Pilleri S3,Meloni GB3,Melis L2.
    J Vasc Interv Radiol. 2014 Aug;25(8):1225-32. doi: 10.1016/j.jvir.2014.05.001. Epub 2014 Jun 16.
  7. Combination cryosurgery with hyperthermia in the management of skin metastasis from breast cancer: A case report.
    Hachisuka J1,Doi K,Furue M.
    Int J Surg Case Rep. 2012;3(2):68-9. doi: 10.1016/j.ijscr.2011.10.016. Epub 2011 Nov 10.
  8. Cryosurgery for breast fibroadenomas.
    Niu L1,Wu B1,Xu K1.
    Gland Surg. 2012 Aug;1(2):128-31. doi: 10.3978/j.issn.2227-684X.2012.08.02.
  9. Cryosurgery in the treatment of women with breast cancer-a review.
    Tarkowski R1,Rzaca M1.
    Gland Surg. 2014 May;3(2):88-93. doi: 10.3978/j.issn.2227-684X.2014.03.04
  10. Nonsurgical ablation of breast cancer: future options for small breast tumors.
    Sabel MS1.
    Surg Oncol Clin N Am. 2014 Jul;23(3):593-608. doi: 10.1016/j.soc.2014.03.009. Epub 2014 Apr 24.
  11. Recent perspectives of management of breast cancer metastasis - an update.
    Cazzato RL1,2,de Lara CT3,Buy X4,Ferron S5,Hurtevent G6,Fournier M7,Debled M8,Palussière J9.
    Cardiovasc Intervent Radiol. 2015 Oct;38(5):1237-43. doi: 10.1007/s00270-015-1181-5. Epub 2015 Jul 17.
  12. Percutaneous cryoablation of breast tumours in patients with stable metastatic breast cancer: safety, feasibility and efficacy.
    Beji H, Pilleul F, Picard R, Tredan O, Bouhamama A, Peix M, Mavrovi E, Mastier C.
    Br J Radiol. 2018 Feb;91(1083):20170500. doi: 10.1259/bjr.20170500. Epub 2018 Jan 12.
  13. Cryoablation of Primary Breast Cancer in Patients with Metastatic Disease: Considerations Arising from a Single-Centre Data Analysis.
    Pusceddu C, Melis L, Ballicu N, Meloni P, Sanna V, Porcu A, Fancellu A.
    Biomed Res Int. 2017;2017:3839012. doi: 10.1155/2017/3839012. Epub 2017 Oct 19.