Every year in this country, approximately 500,000 fibroadenomas are removed in the operating room. Fibroadenomas are solid, benign breast tumors, and are very common in women between the ages of 18 and 40. Although they are not cancerous, they may increase in size, and women that have developed one fibroadenoma may develop others. In addition, they often are painful. Many women that have these masses will undergo surgery to remove them due to the anxiety that a lump in the breast causes. Traditional surgery for these lumps requires anesthesia, leaves a scar, and may require several days for recovery. The discomfort as a result of the procedure usually only lasts for a few days, but may last for as long as several months. In women that choose not to undergo surgery, it is usually recommended that they be re-examined every 3-6 months to ensure that the mass is not enlarging or changing. Often this need for frequent examination increases anxiety and worry among the patients that have these lumps.

A very unique and innovative technique called cryoablation can now be applied to these benign masses. Cryoablation is not a new technique, and in fact has been used for many years in the treatment of liver and prostate cancer. The procedure involves freezing the mass inside of the breast; the freezing actually kills the cells of the fibroadenoma. The dead cells are then gradually reabsorbed by the body. Instead of needing to go to the operating room, the procedure is performed in the office. Using ultrasound to locate the mass, local anesthesia is used to numb the area. A very small skin puncture (only 3 millimeters in size) is made, and a thin probe is inserted into the center of the mass. The entire procedure is visualized using ultrasound. Once the probe is in the center of the mass, the probe temperature is lowered to below freezing, and over the course of 10-20 minutes, an iceball develops that actually engulfs the fibroadenoma. When the procedure is completed, the probe is removed, and the site is covered with a bandaid – no stitches are needed. The procedure is associated with very little, if any pain due to the combination of the local anesthetic and the cold from the probe. Over the course of several months, the lump gradually resolves. The discomfort after the procedure is minimal, and most patients may return to normal activity relatively quickly. Because the incision is so small, there is very little, if any scarring. In addition, because no tissue is actually removed, there is no potential for deformity of the breast as may result from surgical removal.

The cryoablation device, the Visica Treatment System, has been FDA approved since 2002 for the treatment of benign breast masses such as fibroadenomas, and has been used since that time with good success rates. I have been treating patients with fibroadenomas in my practice with cryoablation since 2004 and have been very pleased with the results. In addition, the most recent position statement from the American Society of Breast Surgeons supports the use of cryoablation for the treatment of fibroadenomas in selected patients.

I believe that this is a significant advance in the treatment of benign breast lumps. Now women that want to have the lump removed due to enlargement of the lump, anxiety, or other reasons are able to have it treated in a minimally invasive fashion, which results in superior cosmetic results compared to surgical removal.