PLANTATION, Fla. – When Teresita Couso was diagnosed with breast cancer in July 2017, she talked to her doctor about her options.
"He said, 'It's in the early stages. It's about the size of a garbanzo bean, but we do need to get it out,'" Couso said.
After doing some research, Couso decided to take part in a clinical trial utilizing cryoablation; a minimally invasive procedure to kill the tumor by freezing it.
"This is basically the next step in the treatment of breast cancer," said interventional breast radiologist Dr. Michael Plaza. "The patient can have their breast cancer treated without surgery."
Plaza, with TopLineMD, is part of a nationwide study into cryoablation for breast cancer called "The Frost Trial."
The procedure is done in a doctor's office with just local anesthesia to numb the area of the tumor.
"We make a tiny 2 millimeter incision and go in with a thin needle," Plaza said.
The needle, which is connected to a nitrogen tank, is then inserted into the tumor and the freezing process begins.
"An iceball forms around the tumor, essentially destroying the tumor," Plaza said.
Because it's minimally invasive, Couso faced little downtime.
"He said I could go kayaking the next day after the procedure, and I'm a very active person so I like that," she said.
While cryoablation is approved for other types of cancers, Dr. Monica Yepes, director of breast imaging at the Sylvester Comprehensive Cancer Center in Plantation, has concerns about its use in breast cancer.
"When we actually remove a tumor surgically, we can check the margins to make sure we got all the cancerous tissue. With cryoablation, we don't have the same confidence," Yepes said.
And there's another potential drawback.
"The patient is going to feel the ice ball for up to six to 12 months," Plaza said.
Yepes said that can be disconcerting for patients and physicians.
"These are small tumors and it's possible the patient never felt a lump and now she has a lump," Yepes said.
Couso can feel a bit of a lump, but said it doesn't bother her, and she followed recommendations to make sure the cancer hadn't spread to her lymph nodes.
"I just had my six-month check-up and everything is clear, so I just can't say enough about cryoablation -- it's been great for me," she said.
The procedure can be done outside the confines of the clinical trial, but patients still must meet certain criteria, including:
- Patients must be age 50 or older
- Procedure can only be done on specific types of tumors
- The tumor must be less than a centimeter and a half in size.