Here’s what experts want you to know about the treatment.
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Common breast cancer treatments include a wide range of strategies from chemotherapy to lumpectomies, but the Breast Cancer Research Foundation (BCRF) scientists are working towards more effective options. One of the possibilities is cryoablation for low-risk breast cancer. You may be familiar with the concept, as it’s a treatment used for conditions like skin cancer and irregular heart rhythms. But is it an effective breast cancer treatment option?
Cryoablation is not for everyone. Surgery is often considered the standard of care for patients with breast cancer, but cryoablation may be an effective alternative for certain people with the disease. “I’ve been using cryoablation since we developed our first trial in 2009,” says Dr. Heather McArthur, M.D., M.P.H., a BCRF-supported breast cancer researcher and clinical director of the Breast Cancer Program at UT Southwestern’s Simmons Comprehensive Cancer Center.
A specific form of cryoablation is now approved by the U.S. Food and Drug Administration (FDA) to treat breast cancer under very specific circumstances.
What is cryoablation for breast cancer?
Cryoablation is a minimally invasive procedure that involves inserting a tiny needle into the breast cancer tumor. “An ice ball is created at the tip of the needle under ultrasound,” McArthur explains. The tumor is then frozen and killed.
“This causes inflammation that brings the immune cells into the environment,” McArthur says. “It also physically disrupts tumors, breaking them down into smaller pieces that might be more easily digested by immune cells.”
McArthur is researching a combination treatment in early-stage breast cancer that uses cryoablation with a form of immune therapy known as checkpoint inhibitors. Cancer cells can hide from the body’s immune system, preventing immune cells from activating and killing the tumor. Checkpoint inhibitors help to expose cancer cells, allowing the immune system to recognize and eliminate them.
“It is hoped that by combining immune boosting with tumor freezing the engaged immune cells develop memory to the tumor-specific information, thereby generating a vaccine-like response that ultimately improves breast cancer cure rates,” explains McArthur.
When is cryoablation for breast cancer used?
Cryoablation for breast cancer is FDA-approved for use in certain patients:
- Those who are 70 years old or older
- Patients with biologically low-risk tumors that are 1.5 centimeters or smaller
- Those who have been diagnosed with certain early-stage hormone receptor-positive breast cancer: ER-positive, PR-positive, HER2-negative, Ki-67<15% and/or genomic testing results indicative of low-risk breast cancer, infiltrating ductal carcinoma (excluding lobular carcinoma, extensive intraductal component, or evidence of lymphovascular invasion), and clinically lymph node (N0)-negative
Patients who undergo cryoablation for breast cancer must also use endocrine therapy, per the FDA approval of the treatment. “These patients are potentially not ideal candidates for surgery,” McArthur says.
How effective is cryoablation for breast cancer?
Because every breast cancer case is unique, it’s difficult to put an exact number on how effective cryoablation is for the disease. However, results from the ICE 3 trial, which were published in the Annals of Surgical Oncology in 2024, found that the rate of tumor recurrence five years after cryoablation was 4.3% and breast cancer survival was 96.7%.
“It’s been shown to be an effective alternative to surgery in older populations that have hormone receptor-positive breast cancer,” McArthur says. “Surgery is considered standard of care but, for some patients, cryoablation can be a terrific alternative.”
What to expect during a cryoablation appointment
Cryoablation is performed at some hospitals and breast imaging centers. “It’s an outpatient procedure,” McArthur says. Meaning, you can go home afterward.
The procedure is done under local anesthesia, so a healthcare provider will numb the area of your breast near the tumor. The doctor will typically use ultrasound to locate the tumor, before inserting a thin, needle-like device into the tumor. Liquid nitrogen or argon gas is then injected to create an ice ball around the cells. The ice kills the tumor along with a margin of tissue around it.
The doctor may do several freeze/thaw cycles. “In our clinical trial, it’s administered over two to three freeze/thaw cycles,” McArthur says. When the freeze/thaw cycles are completed, the doctor will remove the needle and bandage the incision.
The procedure is typically done in 30 minutes. “It’s a very efficient approach,” McArthur says. The dead tumor cells are typically cleared by the body’s white blood cells over time.
Potential side effects of cryoablation
You may notice some bruising and pain at the injection site, but this is typically minor. “In all of the patients treated with cryoablation in our clinical trials, I’ve had one patient who needed Tylenol for discomfort,” McArthur says. “Otherwise, it’s a really well-tolerated procedure with no downtime.”
McArthur says that cryoablation “holds a lot of potential” for certain breast cancer patients. “We are showing outstanding improvements,” she says. Cryoablation is not for every breast cancer patient. If you have breast cancer and are interested in cryoablation, talk to your oncologist to see if you may be a good candidate for the procedure.
