New treatment for breast lumps

A radical new ice treatment is claimed to shrink and dissolve benign breast lumps. The painfree procedure takes just 30 minutes, requires no stitches and leaves no scarring.

The pioneering therapy is now being used in two small-scale trials to test its effectiveness at tackling cancerous breast tumours.

It is estimated that eight out of ten breast biopsies result in a benign diagnosis, with the most common cause being a fibroadenoma.

These lumps are commonly found in women aged under 30 and are caused by over-development of fibrous tissue in the breast.

The lumps, which may be about an inch in diameter and feel hard like marbles, can be diagnosed with a combination of physical examination, mammography or ultrasound, and a biopsy.

Once the patient is diagnosed, she is faced with deciding what action to take. The lumps usually remain the same size, but if they grow, or become uncomfortable, they can be surgically removed.

Many women who opt to have treatment to get rid of their fibroadenomas do so because they find them physically and emotionally unacceptable.

Until now, the only real treatment, other than ongoing observation, has been a lumpectomy - surgery which involves sedation or general anaesthesia, stitches and a two to three-day recovery period.

Scarring associated with surgery can also make future mammograms and breast examinations more difficult, because the scar tissue can obscure the breast cancer cells.

In the new Visica Treatment System, cold therapy or 'cryoablation' attacks the unwanted lumps in a technique similar to that used to treat prostate and liver cancers.

Doctors first use ultrasound to pinpoint the location of the tumour, and then give the patient a local anaesthetic to numb the area.

The tingling associated with the anaesthetic is the only discomfort reported by most patients.

A three-millimetre diameter needle or probe - about the width of a matchstick - is then put into the patient's breast through an incision so small that it requires only a small adhesive dressing and no stitches afterwards.

Once the probe has come into contact with the lump, argon gas is pumped through to create a very cold tip to the needle. The lump is rapidly frozen at a temperature of about minus 170C.

That low temperature is cold enough to turn the tissue into a tiny ice ball, which the doctor can detect with ultrasound.

The sheer intensity of the cold makes the cells brittle and they break up. The blood supply that the cells need to stay alive is also frozen, causing them to shrivel and die.

Eventually, over the next few months, the lump shrinks and disappears.
The results from one study showed that patients' fibroadenomas had shrunk by an average of 92 per cent after 12 months.

'Patients were pleased with this simple procedure and were impressed by how easily their fibroadenomas disappeared,' says Dr Cary Kaufman, medical director of the Bellingham Breast Centre in Washington DC, United States, where trials were carried out.

'Several patients had previously undergone breast surgery for benign breast lumps, but preferred the convenience and comfort of the Visica procedure.'

A report of the study says that no long-term side-effects were seen, that the appearance of the skin and breast was 'excellent', and that patient satisfaction was 'exceptional'.

Ultrasound follow-up over the next 12 months showed progressive shrinkage, and in most cases the tumours disappeared.

The procedure has now been approved for use on benign tumours by the Food and Drug Administration in America.