Breast Cancer Recurrence After Cryoablation in Patients Who are Poor Surgical Candidates or Who Refuse Surgery.

Abstract

Purpose: To evaluate in-breast recurrence rates after cryoablation in patients with primary breast cancer who were poor surgical candidates or refused surgery.

Materials & methods: Patients with primary breast cancer who were poor surgical candidates or who refused surgery and were treated with cryoablation at a single academic cancer center between October 2018-June 2023 were retrospectively reviewed. Out of the sixty treated patients, 45 had invasive ductal carcinoma (IDC), 6 patients had invasive lobular carcinoma, 2 patients had multicentric ductal carcinoma in situ (DCIS), and 7 patients had other histology. Tumor size ranged from (0.3-9cm), with a mean of 2.7cm. Recurrence was defined as new tumor or regrowth of residual tumor in the ipsilateral breast.

Results: With a mean follow up of 21 months and median follow up of 9.8 months, there was a recurrence rate of 10% (6/60 patients). Patients in the recurrence group had more poorly differentiated disease than those in the non-recurrence group (66.7% vs. 22.2%, p= 0.038). Tumor size did not differ between non-recurrence and recurrence groups (no recurrence group mean 2.7 ± 2.6cm, recurrence group mean 2.5 ± 1.0cm, p = 0.506). Patients who were treated with palliative intent rather than curative intent were significantly older (79.7 ± 12.2 vs. 72.5 ± 11.3, p = 0.032).

Conclusion: Cryoablation can be considered in patients who are poor surgical candidates or who refuse surgery, with a 10% recurrence rate at a mean follow up of 21 months in this retrospective review that included patients with tumors up to 9 cm, unfavorable pathology, and multicentric disease.