Cryotherapy advocated for breast fibroadenomas. ('Virtually' Painless).

CHICAGO -- The use of cryotherapy to ablate breast fibroadenomas appears to provide a safe and effective alternative to surgery, Dr. Peter Littrup said at the annual meeting of the Radiological Society of North America.

In an observational study involving 26 patients aged 13-54 years, Dr. Littrup of Wayne State University, Detroit, and his colleagues froze a total of 38 fibroadenoma masses, none of which were larger than 4 cm.

Ultrasound follow-up over at least 12 months showed a slow retraction of the fibroadenoma, and that most of the masses break up and disappear. Although a few fibroadenomas became more dense as a result of localized scarring, by 6 months none of the masses were palpable. Regrowth was not observed in the one patient who had been followed out to 18 months.

The procedure takes approximately 20-30 minutes to perform and is similar in strategy to cryoablation of uterine fibroids, which involves ablating the central vascular supply.

The Visica Treatment System is manufactured by Sanarus Medical Inc., Pleasanton, Calif., and has received approval by the Food and Drug Administration for the treatment of fibroadenomas. During the procedure, a single 2-mm probe is placed in the mass through a 13-gauge needle. A trocar is initially inserted into the mass under ultrasound guidance and then retracted, exposing the full freezing surface of the probe.

"We then place the thermocouple at the edge of the mass, basically just inside of the capsule, so that any advancing ice ball doesn't push the thermocouple away in the mobile adjacent fat," he said.

The ice ball is then monitored both in sagittal and axial views. And in cases where there's a lobular appearance to the fibroadenoma, "we can monitor the ice very nicely so it covers the entire ...