Treat breast cancer without resorting to the scalpel. A high percentage of patients with this early stage tumor can avoid surgery and achieve the same oncological outcome thanks to percutaneous cryoablation treatment. This is the aim of the new Precice clinical study, promoted by the European Institute of Oncology and supported by the Veronesi Foundation, which is recruiting 234 patients ‘over 50’ with small breast cancer (up to 15 mm in diameter) at low risk. Those eligible for cryoablation will be included in the standard therapeutic path – with radiotherapy and adjuvant chemotherapy if necessary – but the removal of the tumor will take place without surgical cuts, allowing patients to return home on the same day of treatment without scars or prostheses.
Cryoablation – explains the IEO in a note – is a consolidated technique that uses very low temperatures to destroy tissues and can be performed with a percutaneous approach with simple local anesthesia. In summary, the breast procedure involves reaching the tumor with a probe the size of a needle (cryoprobe) under ultrasound guidance: when the target is reached, the probe releases its refrigerant charge, which can reach -190 degrees, destroying the tumor and its margins.
Many studies have already confirmed the ability of this technique to obtain local control comparable to surgery, offering a better cosmetic result, fewer complications and extremely low costs. For example, the results of the American Ice3 trial (Cryoablation of Low Risk Small Breast Cancer) are significant. The trial, which involved women with small, low-risk tumors, showed that cryoablation is effective in controlling the tumor without the need for surgery. The success rate of cryoablation in the Ice3 trial is promising, with a five-year absence of disease recurrence in 96.4% of patients. The data indicates that this technique can represent a valid and less invasive alternative to traditional surgery, the experts highlight.
“Surgery is the standard treatment for women with breast cancer and is the cornerstone of treatment for this disease. Over the last 40 years, however, the commitment of all breast specialists in the world, and on the front line here at the European Institute of Oncology – states Paolo Veronesi, director of the Senology Program of the IEO and president of the Veronesi Foundation – has been concentrated on reduce the invasiveness of the surgical procedure to a minimum to obtain the least possible impact on the woman’s life with the same oncological safety. Percutaneous treatments such as cryoablation go exactly in this direction and our goal is to include them in our breast cancer treatment offer – he announces – so that the woman who comes to us with a diagnosis of breast cancer always has the reassuring awareness to receive tailor-made therapy whatever the stage and type of your disease. In Italy we are pioneers in cryoablation and we are the first to perform it in the context of a clinical study with results that can be shared and reproducible in other centers.”
“The percutaneous techniques of interventional radiology for breast cancer, represented above all by cryoablation, are today able to open up new concrete prospects for conservative treatment. To treat conservatively, two conditions are in fact necessary: a very early diagnosis and minimally invasive instruments capable of grasping the advantage of intercepting an extremely small tumor is one of these tools and is certainly among the most innovative – remarks Franco Orsi, director of Interventional Radiology Ieo – With this first Italian study we want to demonstrate that the use of cryoablation percutaneous in the treatment of low-risk breast cancer is not inferior to surgery. The scientific hypothesis is that cryoablation in selected cases is the right alternative to the surgical approach because, with equal effectiveness, it ensures the patient a better quality of life. (reduced morbidity, no need for general anesthesia, better cosmetic results) and a consequent lower psychological impact as well as a better cost/benefit ratio”.
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