CMED professor uses new technique to treat benign breast tumors

The discovery of a new surgical procedure for breast cancer is being utilized by a Central Michigan University professor.

Dr. Sandra Howell, a College of Medicine professor of surgery, has been using a new surgical procedure known as cryoablation. The procedure is minimally invasive and provides an opportunity to remove benign tumors of the breast, also knows as fibroadenomas.

"This procedure is truly ground-breaking," Howell said. "The field of breast cancer research has rapidly developed in the past 15 years, and this new procedure appears to be very promising."

Before this procedure, patients with benign tumors had to endure an invasive surgery, known as a lumpectomy, that at times resulted in damaging viable tissue in the breasts, as well as disfiguring and scarring.

With this new procedure, a minimally invasive tool, roughly the size of a pencil, is used to administer liquid nitrogen to freeze the dead tissue.

After a core biopsy, which is read and interpreted by the pathologist, patients with multiple tumors can be deemed eligible for this procedure.

"This is not a procedure that we'd typically do for a single fibroadenoma," Howell said. "However, due to the nature of fibroadenomas, they are known to develop in more than one (tumor)."

After a patient is administered a local anesthetic to numb the area, a quarter-inch incision is made at the location of the fibroadenomas, which is determined via ultrasound.

"The ultrasound machine allows us to see the location and size of the fibroadenomas in real-time," Howell said.

Once the probe is inserted into the breast, real-time images from the ultrasound machine will help surgeons locate the center of the typically oblong fibroadenoma and 'spear' the fibroadenoma in the middle.

From there, liquid nitrogen is automatically administered in cycles to the area, determined by the patient's health and the size of the fibroadenoma.

After two cycles of freezing and thawing of the fibroadenoma have occurred, the probe is removed, and the surgeon will finish up the procedure, closing the incision with minimal, if any, visible scarring.

Although this procedure appears to be a clear front-runner as opposed to a traditional lumpectomy, Howell said there are some risks and side-effects she always makes sure her patients are aware of.

"One of the side-effects of this procedure is that when the 'ice ball' melts, what ever tissue was frozen is now dead tissue," she said. "Sometimes it can take time for the body to recognize the dead tissue, and replace it with either breast tissue or scar tissue."

As a result of this, some patients may experience a small bump near the location of the fibroadenoma, however the occurrence of this is rare, Howell said.

Other down sides include a lengthier, more time-consuming process, a 10 percent chance of recurrence if the entire fibroadenoma is not removed as well as the risk of infection, which exists with all surgical procedures.

This procedure has been used for the past 20 years for treatment of renal and prostate tumors, but is recently gaining momentum in the field of fibroadenomas in the breast.

Additionally, the American College of Surgeons Oncology Group is exploring a clinical study of using cryoablation to treat cancerous breast tumors, the results of which are expected in the next six to twelve months.

"This study is proving to be very exciting and promising," Howell said. "It appears as if the freezing of cancerous tumors 'kick-starts' the body's defense system in recognizing the tissues and proteins that are specific to the cancer cells."

Howell said there is still a long way to go in the fight against breast cancer, but there is a lot of exciting and promising information being discovered every day.


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