Ultrasound-guided cryoablation is safe, effective, and well tolerated by patients with breast cancer, according to results published on 22 December in Clinical Breast Cancer.
Researchers led by Dr. Jacopo Cucchiari, from Careggi University Hospital in Florence, Italy, found that cryoablation led to high complete ablation rates for larger tumors (15 mm or greater), and women reported less anxiety and better quality of life compared with conventional surgery.
“The procedure allows rapid recovery, without major complications in elderly patients,” Cucchiari and colleagues wrote.
With growing interest in less-invasive treatment strategies for breast cancer, cryoablation has emerged as a potentially favorable option. Prior research suggests cryoablation can effectively treat many small breast tumors while also maintaining a high safety profile.
These studies focused on early-stage, low-grade invasive ductal carcinoma hormone receptor-positive and HER2-negative cancers, with a tumor size less than 15 mm. The researchers noted a lack of data on the efficacy and safety in patients with other subtypes of low-grade breast cancers.
The Cucchiari team investigated the safety and efficacy of cryoablation for treating breast cancer tumor subtypes 12 months after treatment.
The single-center prospective study included 36 women with an average age of 84.5 years with 39 biopsy-proven breast tumors. The women underwent cryoablation between 2021 and 2023. The 39 tumors included the following subtypes: luminal A, luminal B, invasive ductal carcinoma (IDC), and IDC plus ductal carcinoma in situ. Of the total women, 28 underwent contrast-enhanced mammography (CEM) for tumor staging.
The group reported completed ablation rates of 100% for breast tumors 15 mm or smaller and 84.6% for tumors larger than 15 mm, respectively. And no procedure-related unexpected adverse events occurred in the women, it added.
The investigators also reported higher complete ablation rates for luminal A (100%) compared with luminal B (88.9%) tumors and for Ki67 ≤ 20% (100%) compared with Ki67 >20% (80%). However, these differences did not achieve statistical significance.
For measuring pain, patients reported a median decrease of one unit on visual analogue scale (VAS) scoring at six months after cryoablation (p = 0.009). This remained consistent at 12 months post cryoablation (p = 0.003).
Using multiple questionnaires completed by patients, the researchers found improvements in depression, anxiety, physical functioning, and limitations due to physical and emotional problems.
The results add to growing evidence supporting cryoablation as a “valuable and effective treatment option for early breast cancer, especially in elderly patients with comorbidities,” the study authors wrote.
They added that further randomized trials and long-term studies are needed and that the results highlight CEM’s efficacy in evaluating cryoablation by showing concordance enhancement and histology.
Read the full study here.
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnieeurope.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&fit=crop&h=100&q=70&w=100)
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnieeurope.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
