HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: 2341030931v1 234/1/63    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Littrup, P. J. Articles by Sakr, W. Search for Related Content PubMed PubMed Citation Articles by Littrup, P. J. Articles by Sakr, W.

Cryotherapy for Breast Fibroadenomas¹

¹ From the Departments of Radiology (P.J.L., T.H.), Surgery (M.W., K.C.A., D.B.), and Pathology (A.A., W.S.), and the Karmanos Cancer Center (L.F.G.), Wayne State University School of Medicine, Harper University Hospital, 3990 John R St, Detroit, MI 48201. Received June 19, 2003; revision requested August 27; final revision received August 11, 2004; accepted August 16. Supported in part by a grant from Sanarus Medical, who provided professional and technical fees and equipment free of charges. Address correspondence to P.J.L. (e-mail: peterlittrup@aol.com).

PURPOSE: To assess freezing protocols, imaging, and clinical outcomes of percutaneous ultrasonographically (US)-guided cryotherapy for breast fibroadenomas.

MATERIALS AND METHODS: Institutional review board approval and patient consent were obtained. Forty-two biopsy-confirmed fibroadenomas were treated in 29 patients (mean age, 27 years) by using a 2.4-mm cryoprobe inserted into the fibroadenoma with US guidance. The first seven patients underwent conscious sedation, but the other 22 patients required only local anesthesia. US and thermocouple monitoring of the procedure were performed to evaluate freeze protocols based on tumor size. Saline injections protected the skin and/or chest wall. US follow-up was performed at 1 week and at 1, 3, 6, and 12 months. Pre- and 12-month postcryotherapy mammograms were available for seven patients who were over 30 years old. ² and Student t tests were used to assess frequency and mean differences, respectively.

RESULTS: The 22 patients who underwent local anesthesia reported minimal discomfort. No significant complications were noted, and patients were very pleased with the resolution of palpable mass effect and cosmetic results. The average pretreatment fibroadenoma volume of 4.2 cm³± 4.7 (standard deviation) was reduced to 0.7 cm³± 0.8 at 12-month follow-up (73% reduction, P < .001). US produced excellent ice visualization beyond tumor margins, while thermocouples confirmed cytotoxic temperatures approximately 5 mm behind the visible leading edge. Two patients elected to undergo either removal or biopsy of a residual mass, which revealed a shrunken hyaline matrix with preserved collagenous architecture. Mammograms showed comparable resolution of mass effects with mild surrounding parenchymal reaction.

CONCLUSION: Cryotherapy of fibroadenomas is a safe, effective, and virtually painless clinic-based (ie, outpatient) treatment option with good cosmesis.

© RSNA, 2004

This article has been cited by other articles:

				M. R. Callstrom, T. D. Atwell, J. W. Charboneau, M. A. Farrell, M. P. Goetz, J. Rubin, J. A. Sloan, P. J. Novotny, T. J. Welch, T. P. Maus, et al. Painful Metastases Involving Bone: Percutaneous Image-guided Cryoablation--Prospective Trial Interim Analysis. Radiology, November 1, 2006; 241(2): 572 - 580. [Abstract] [Full Text] [PDF]

				A. Ahmed and P. Littrup Percutaneous cryotherapy of the thorax: safety considerations for complex cases. Am. J. Roentgenol., June 1, 2006; 186(6): 1703 - 1706. [Full Text] [PDF]