title: Magnetic resonance-guided percutaneous cryosurgery of breast carcinoma: technique and early clinical results.
abstract: OBJECTIVE
  This phase I study was designed to demonstrate the feasibility, safety, efficacy and predictability of percutaneous cryosurgery, guided under magnetic resonance (MR) imaging, in the treatment of invasive breast carcinoma.
  
  
  METHODS
  Under the guidance of near-real-time T1-weighted FSE images of a 0.5-T open-configuration MR system, percutaneous cryosurgery was performed in 25 patients with operable invasive breast carcinoma, 4 weeks prior to their scheduled mastectomy. Predictive assessments by interventional radiologists using 4 breast-imaging techniques (mammography, sonography, scintigraphy and MR) were correlated with postmastectomy results of histopathology and assessed for predictability. Local and systemic morbidity were also evaluated during the month of follow-up preceding mastectomy.
  
  
  RESULTS
  Percutaneous cryosurgery resulted in no serious complications, either local or systemic. All tumoural tissues included in the cryogenic "iceball" were destroyed, with no viable histologic residues. Ablation was total in 13 of the 25 tumours treated. Combining periprocedural MR images with postprocedure scintimammographic findings enabled a 96% rate for predicting the cryosurgical results.
  
  
  CONCLUSIONS
  MR-guided cryosurgery of breast carcinoma is feasible, safe and efficient, with predictable results. Major drawbacks are that the cryolesion (a palpable iceball) persists for a month or more after the procedure, undermining the reliability of the physical examination; and that breast imaging (mammography, ultrasound and MR) presents the same difficulty of interpretation as the physical exam even 1 month after the procedure. More studies are required to refine this treatment method.
authors.affiliation: iMRI unit, Quebec City University Hospital, Quebec City, Que.
authors.forename: Jacques
authors.initials: J
authors.lastname: Morin
authors.forename: Amidou
authors.initials: A
authors.lastname: Traoré
authors.forename: Guy
authors.initials: G
authors.lastname: Dionne
authors.forename: Marcel
authors.initials: M
authors.lastname: Dumont
authors.forename: Bertrand
authors.initials: B
authors.lastname: Fouquette
authors.forename: Marie
authors.initials: M
authors.lastname: Dufour
authors.forename: Sonia
authors.initials: S
authors.lastname: Cloutier
authors.forename: Christian
authors.initials: C
authors.lastname: Moisan
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D003452:Cryosurgery / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008408:Mastectomy / Q000379:methods*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011877:Radionuclide Imaging; D016896:Treatment Outcome; D016217:Ultrasonography, Mammary