The mass in her breast measured the size of a jelly bean.
Fortunately, the mass known as a fibroadenoma, was benign. Still, the darn thing was annoying. Positioned between the elastic of her bra and her rib cage, it caused occasional discomfort for Breanna, 24.
She went to Dr. Laura Pomerenke, one of southern Colorado’s most beloved doctors – a breast surgeon – who suggested a new procedure at UCHealth Memorial Hospital’s MaryLou Beshears Breast Care Clinic called cryoablation, or tumor freezing. Breanna opted to be the first person to receive the therapy at Memorial.
Cryoablation uses extreme cold (cryo) from liquid nitrogen to destroy diseased tissue (ablation). During cryoablation, Dr. Pomerenke guides a probe using image-guiding ultrasound to the tumor. Liquid nitrogen is then sent to the tip of the probe and quickly forms an ice ball around the tumor.
Outpatient procedure
Patients are awake during the procedure, which takes less than 20 minutes. They’re given local anesthesia to numb the area before the probe is inserted. Most women, like Breanna, are in and out of the clinic in an under an hour.
Making an analogy to what happens to the cells in a lesion, Dr. Pomerenke said: “If you take a piece of lettuce, and you stick it in the freezer and take it out, it will turn to mush because those cells will rupture. The body reabsorbs that.’’
Breanna, who had the procedure a few weeks ago at Dr. Pomerenke’s office, said: “It’s was probably as easy as you could explain it. … I have a minor scar, probably the tip of a pinkie nail, where the needle had to push through. Other than that, I have no other scarring, no other stretching, no other sign of a procedure at all.’’
Avoiding anesthesia
The advantage to cryoablation is that women can avoid general anesthesia, surgery and a longer recovery time. Within a year, 95 percent of patients said they could no longer feel the tumor because it is absorbed by the body.
“A fibroadenoma is the most common tumor in a young woman,’’ Dr. Pomerenke said. “About 10 percent of women will get a fibroadenoma at some time though not all need to be treated. If it is a small tumor that is not causing any symptoms, we can just leave it alone. Other tumors, if they are growing or causing pain, our other option was to take it out surgically. So this is a very reasonable option for a lot of women.’’
Cryoablation can be considered when a tumor is less than 4 cm in diameter and there is sufficient distance between the tumor and the skin, so the skin isn’t damaged by freezing during the procedure. All patients have a needle biopsy before cryoablation is considered.
“For some women, having a palpable mass is really distressing, even if a woman knows it is benign,’’ Dr. Pomerenke said. “Some women really prefer to have it removed, and we don’t like cutting healthy breast for benign tumors, so this is a nice option for them that they don’t have to feel the mass afterwards and they can kind of forget about it.’’
Self exam
Breanna discovered the tumor during a self-exam.
“When Dr. Pomerenke explained it to me, it seemed like a no-brainer. I would recommend it 100 percent because of the fact that you don’t have to go under anesthesia, go into an operating room or be cut open,’’ Breanna said. “I’d recommend it for anyone who needs a quick recovery time and who doesn’t want to be put under.’’
To date, more than 4,500 patients around the country have been treated with the Visica cryoablation procedure. Cryoablation has been used to treat skin lesions but applications have since expanded to treat cancers of the breast, liver, lung and kidney.
Clinical trials are underway in the United States using cryoablation for early-stage breast cancer tumors and Memorial may, in the future, consider patients for such trials, Pomerenke said.
Cryoablation is another way that Memorial’s breast program tries to serve patients.
“It’s another tool in our bag,’’ she said.
For more information about cryoablation, call 719-477-0211.