title: Office-based cryoablation of breast fibroadenomas with long-term follow-up.
abstract: Approximately 10% of women will experience a breast fibroadenoma in their lifetime. Cryoablation is a new treatment that combines the better attributes of the current standards: surveillance and surgery. It is a minimally invasive office-based procedure that is administered without the use of general anesthesia, involving minimal patient discomfort and little to no scarring. This work aimed to establish the long-term (2-3 years) efficacy, safety, and satisfaction of the procedure, as well as the impact of cryoablation on mammogram and ultrasound images. Thirty-seven treated fibroadenomas were available for assessment with an average follow-up period of 2.6 years. Of the original 84% that were palpable prior to treatment, only 16% remained palpable to the patient as of this writing. Of those fibroadenomas that were initially < or = 2.0 cm in size, only 6% remained palpable. A median volume reduction of 99% was observed with ultrasound. Ninety-seven percent of patients and 100% of physicians were satisfied with the long-term treatment results. Mammograms and ultrasounds showed cryoablation produced no artifact that would adversely affect interpretation. Cryoablation for breast fibroadenomas has previously been reported as safe and effective both acutely and at the 1-year follow-up mark, and thus has been implemented as a treatment option. At long-term follow-up, cryoablation as a primary therapy for breast fibroadenomas demonstrates progressive resolution of the treated area, durable safety, and excellent patient and physician satisfaction. The treatment is performed in an office setting rather than an operating room, resulting in a cost-effective and patient-friendly procedure. Cryoablation should be considered a preferred option for those patients desiring definitive therapy for their fibroadenomas without surgical intervention.
authors.affiliation: University of Washington and the Bellingham Breast Center, Bellingham, Washington 98225, USA. breastcare@aol.com
authors.forename: Cary S
authors.initials: CS
authors.lastname: Kaufman
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Littrup
authors.forename: Laurie A
authors.initials: LA
authors.lastname: Freeman-Gibb
authors.forename: J Stanley
authors.initials: JS
authors.lastname: Smith
authors.forename: Darius
authors.initials: D
authors.lastname: Francescatti
authors.forename: Rache
authors.initials: R
authors.lastname: Simmons
authors.forename: Lewis H
authors.initials: LH
authors.lastname: Stocks
authors.forename: Lisa
authors.initials: L
authors.lastname: Bailey
authors.forename: Jay K
authors.initials: JK
authors.lastname: Harness
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Bachman
authors.forename: C Alan
authors.initials: CA
authors.lastname: Henry
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D003452:Cryosurgery / Q000009:adverse effects / Q000379:methods*; D005260:Female; D018226:Fibroadenoma / Q000175:diagnosis* / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008327:Mammography / Q000379:methods; D008875:Middle Aged; D009367:Neoplasm Staging; D017060:Patient Satisfaction; D011446:Prospective Studies; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome; D016217:Ultrasonography, Mammary / Q000379:methods