Ultrasound-guided cryoablation: Our experience in percutaneous treatment as an alternative to surgery for fibroadenomas of the breast lesions

T. Díaz de Bustamante Durbán, M.J. Roca Navarro, Y. Navarro Monforte, D. Garrido Alonso, F. García Martínez, M.V. Córdoba Chicote, J.M. Oliver Goldaracena
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Abstract

Objectives

To review the tolerance to and medium-term efficacy of ultrasound-guided cryoablation as an alternative to surgical treatment of fibroadenomas of the breast in our hospital.

Methods

We analyzed data from the 12 patients with fibroadenomas treated with ultrasound-guided cryoablation in our hospital between November 2020 and July 2022. Cryoablation was performed with a system using argon gas (Galil Boston Scientific®) or liquid nitrogen (Prosense Ice Cure®) following a triple-phase (freeze-thaw-freeze) protocol of variable duration depending on the size of the lesion. Patients were followed up with ultrasonography at 3, 6, 12, and 18 months.

Results

All patients tolerated the procedure well. Two patients reported moderate pain in the hours immediately after the procedure; no other complications occurred. The findings during follow-up included decreased volume of the fibroadenoma (47.07% at 3 months, 77.79% at 6 months, 81.77% at 12 months, and 88.81% at 18 months), blurring of the nodule’s margins, a significantly reduced or absent signal within the lesion in the Doppler study, an echogenic band (representing edema, hemorrhage, and fat necrosis), and hypoechoic areas suggestive of fibrosis surrounding the fibroadenoma.

Conclusions

Cryoablation is done on an outpatient basis, avoiding general anesthesia, thus making it less expensive. Cryoablation yields better cosmetic results than surgery.

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超声引导下的冷冻消融术:乳腺纤维腺瘤经皮治疗替代手术的经验
方法 我们分析了 2020 年 11 月至 2022 年 7 月期间在我院接受超声引导冷冻消融治疗的 12 例乳腺纤维腺瘤患者的数据。冷冻消融术采用氩气(Galil Boston Scientific®)或液氮(Prosense Ice Cure®)系统,根据病灶大小采用三阶段(冷冻-解冻-冷冻)方案,持续时间长短不一。患者分别在 3、6、12 和 18 个月时接受超声波随访。两名患者在术后数小时内出现中度疼痛,但未出现其他并发症。随访结果包括纤维腺瘤体积减小(3 个月时为 47.07%,6 个月时为 77.79%,12 个月时为 81.77%,18 个月时为 88.81%)、纤维腺瘤变小(3 个月时为 47.07%,6 个月时为 77.79%,12 个月时为 81.77%,18 个月时为 88.结论冷冻消融术在门诊进行,避免了全身麻醉,因此费用较低。与手术相比,冷冻消融术的美容效果更好。
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