Noninvasive Technique Removes Benign Breast Tumors

It's quick, painless and done on outpatient basis

WEDNESDAY, Dec. 3, 2003 (HealthDayNews) -- Using a small probe that freezes and kills abnormal breast tissue, radiologists reduced the size of noncancerous breast tumors in 27 women by an average of 73 percent.

The procedure, called cryotherapy, combines ultrasound and the probe in a type of image-guided therapy that is a painless, quick and noninvasive alternative to surgery, says Dr. Peter J. Littrup. He is a radiologist at Wayne State University and director of the image-guided therapy program at Karmanos Cancer Institute, both in Detroit.

"We can treat major tumors on an outpatient basis with minimum discomfort. It is a great boon for patients and patient care," says Littrup, who presented the findings Dec. 3 at the Radiological Society of North America's annual meeting in Chicago.

Cryotherapy is currently used to treat cancerous tumors in the prostate, Littrup says. He is also involved in preliminary trials using the procedure to remove malignant tumors in the lung and kidney. He reported on those trials as well at the meeting.

Benign breast lumps affect approximately 10 percent of women, most in their late teens and early 20s; they are twice as common in black women as white women, Littrup says. While most lumps aren't removed, approximately 1 million are excised annually because of their size, continued growth or for cosmetic reasons, he says.

To perform the procedure, doctors first numb the area around the tumor, which is visible through ultrasound. Next, they insert a cyroprobe -- similar to a large needle -- into the middle of the lesion and inject liquid nitrogen into it. An ice ball forms at the tip of the probe and continues to grow until the ultrasound confirms the entire lump has been engulfed, killing the tissue around the tumor, Littrup says.

The benefits of the procedure, Littrup says, are that the ice is easily visible in the ultrasound so doctors can be precise in seeing the tumor; the method is painless; and it doesn't affect the collagen in the breast so it keeps its shape. Also, there is no significant scarring.

Insurers don't automatically pay for the procedure for benign lumps, Littrup says -- "it depends on the insurers." But because the patient don't have to stay overnight, the procedure is cost-effective, he says.

Littrup has begun another pilot study to treat breast cancers with cryotherapy.

Dr. George Hermann, a radiologist at Mount Sinai Medical Center in New York City, says the procedure is interesting, but he questions its use for benign breast lumps.

"You still have to do a biopsy, and then if it is benign, ask the question, 'Do you have to remove it?'" he says.

Further, he says, if cryotherapy is used to remove a cancerous tumor, there's no way to evaluate the mass afterward because it's gone. When a lump is surgically removed, you can study it, which is important to treatment, Hermann says.

But Littrup says cryotherapy has already been shown effective in cancer treatment as a way to treat tumors without surgical intervention.

"We're seven years down the road with prostate cancer," he says, adding that improvements in technology such as new, smaller probes and better screening will only improve results with other cancers.

More information

To learn more about cryotherapy, visit the University of Missouri Health Care and the National Cancer Institute.

SOURCES: Peter J. Littrup, M.D., professor, radiology, urology and radiation oncology, Wayne State University, and director, image-guided therapy program, Karmanos Cancer Institute, Detroit; George Hermann, M.D. professor, medicine, Mount Sinai Medical Center, New York City; Dec. 3, 2003, presentation, Radiological Society of North America annual meeting, Chicago
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