title: Percutaneous local ablation of unifocal subclinical breast cancer: clinical experience and preliminary results of cryotherapy.
abstract: OBJECTIVE
  To assess the ablative effectiveness, the oncological and cosmetic efficacy of image-guided percutaneous cryoablation in the treatment of single breast nodules with subclinical dimensions after identification with ultrasonography (US), mammography, magnetic resonance (MRI) and characterization by vacuum assisted biopsy.
  
  
  METHODS
  Fifteen women with a mean age of 73 ± 5 years (range 64-82 years) and lesion diameter of 8 ± 4 mm were undergoing cryotherapy technology with a single probe under US-guidance associated with intra-procedural lymph-node mapping and excision of the sentinel node. All the patients underwent surgical resection (lumpectomy) from 30 to 45 days after the percutaneous ablation.
  
  
  RESULTS
  The iceball size generated by the cryoprobe during the procedure at minus 40°C was 16 × 41 mm. In 14 of the 15 patients was observed a complete necrosis of the cryo-ablated lesion both in post-procedural MRI follow-up and anatomo-pathological evaluation after surgical resection. In one case there was a residual disease in post-procedural MRI and postoperative histological examination, probably justified by an incorrect positioning of the probe.
  
  
  CONCLUSIONS
  The percutaneous cryoablation as a "minimally invasive" technique can provide excellent oncological and cosmetic results on selected cases handled by experienced operators by using the tested devices.
authors.affiliation: Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, University Hospital "Tor Vergata", viale Oxford 81, 00133 Rome, Italy. guggi@tiscali.it
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Manenti
authors.forename: Tommaso
authors.initials: T
authors.lastname: Perretta
authors.forename: Eleonora
authors.initials: E
authors.lastname: Gaspari
authors.forename: Chiara A
authors.initials: CA
authors.lastname: Pistolese
authors.forename: Lia
authors.initials: L
authors.lastname: Scarano
authors.forename: Elsa
authors.initials: E
authors.lastname: Cossu
authors.forename: Elena
authors.initials: E
authors.lastname: Bonanno
authors.forename: Oreste C
authors.initials: OC
authors.lastname: Buonomo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Petrella
authors.forename: Giovanni
authors.initials: G
authors.lastname: Simonetti
authors.forename: Salvatore
authors.initials: S
authors.lastname: Masala
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D003452:Cryosurgery / Q000379:methods*; D017679:Cryotherapy / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008327:Mammography / Q000379:methods; D008495:Medical Oncology / Q000379:methods; D008875:Middle Aged; D009336:Necrosis; D014463:Ultrasonography / Q000379:methods