MRI Findings After Cryoablation of Primary Breast Cancer Without Surgical Resection

Published:August 24, 2018DOI:

      Rationale and Objectives

      To retrospectively evaluate findings on serial magnetic resonance imaging (MRI) after cryoablation for breast cancer lesions without subsequent surgical resection.

      Materials and Methods

      This study was approved by the Institutional Review Board and the requirement to obtain informed consent waived. Ductal carcinoma in situ or invasive carcinoma ≤15 mm, nuclear grade 1 or 2, estrogen receptor positive/human epidermal growth factor 2 negative without lymph node metastasis were treated with cryoablation without subsequent excision. Two observers independently reviewed the first two postcryoablation MRIs for shape (none, focus-to-mass, or nonmass enhancement) and suspicion of residual disease (positive or negative). Fisher's exact or the Mann–Whitney U test was used to assess significance. Interobserver agreement on findings was evaluated by calculating κ values.


      Fifty-four patients were enrolled. The first and second postcryoablation MRIs were performed 22–171 days and 82–487 days after cryoablation, respectively. Interobserver agreement ranged from fair to moderate (κ = 0.356–0.434). Observer 1 or 2 identified suspicious areas on the first postcryoablation MRI in seven cases (13.0%). These were significantly associated with focus-to-mass shape (vs non–focus-to-mass: nonmass enhancement or none) and residual disease or recurrence suspected by both observers (p < 0.001). There were no cases of both observers identifying suspicious findings on the second postcryoablation MRI.


      Suspicious findings can be detected within the treated area at the first postcryoablation MRI. These can resolve during subsequent adjuvant therapies and follow-up.

      Key Words


      DCIS (ductal carcinoma in situ), HER2 (human epidermal growth factor 2), ICC (intraclass correlation coefficient), MRI (magnetic resonance imaging)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Academic Radiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Chu KF
        • Dupuy DE
        Thermal ablation of tumours: biological mechanisms and advances in therapy.
        Nat Rev Cancer. 2014; 14: 199-208
        • Atwell TD
        • Vlaminck JJ
        • Boorjian SA
        • et al.
        Percutaneous cryoablation of stage T1b renal cell carcinoma: technique considerations, safety, and local tumor control.
        J Vasc Interv Radiol. 2015; 26: 792-799
        • Durand M.
        • Barret E.
        • Galiano M.
        • et al.
        Focal cryoablation: a treatment option for unilateral low-risk prostate cancer.
        BJU Int. 2014; 113: 56-64
        • Wang C.
        • Wang H.
        • Yang W.
        • et al.
        Multicenter randomized controlled trial of percutaneous cryoablation versus radiofrequency ablation in hepatocellular carcinoma.
        Hepatology. 2015; 61: 1579-1590
        • Moore W.
        • Talati R.
        • Bhattacharji P.
        • et al.
        Five-year survival after cryoablation of stage I non-small cell lung cancer in medically inoperable patients.
        J Vasc Interv Radiol. 2015; 26: 312-319
        • Manenti G.
        • Perretta T.
        • Gaspari E.
        • et al.
        Percutaneous local ablation of unifocal subclinical breast cancer: clinical experience and preliminary results of cryotherapy.
        Eur Radiol. 2011; 21: 2344-2353
        • Manenti G.
        • Scarano AL
        • Pistolese C
        • et al.
        Subclinical breast cancer: minimally invasive approaches. our experience with percutaneous radiofrequency ablation vs. cryotherapy.
        Breast Care. 2013; 8: 356-360
        • Poplack SP
        • Levine GM
        • Henry L.
        • et al.
        A pilot study of ultrasound-guided cryoablation of invasive ductal carcinomas up to 15 mm with mri follow-up and subsequent surgical resection.
        Am J Roentgenol. 2015; 204: 1100-1108
        • Pfleiderer SO
        • Freesmeyer MG
        • Marx C.
        • et al.
        Cryotherapy of breast cancer under ultrasound guidance: initial results and limitations.
        Eur Radiol. 2002; 12: 3009-3014
        • Sabel MS
        • Kaufman CS
        • Whitworth P.
        • et al.
        Cryoablation of early-stage breast cancer: work-in-progress report of a multi-institutional trial.
        Ann Surg Oncol. 2004; 11: 542-549
        • Cazzato RL
        • de Lara CT
        • Buy X.
        • et al.
        Single-centre experience with percutaneous cryoablation of breast cancer in 23 consecutive non-surgical patients.
        Cardiovasc Intervent Radiol. 2015; 38: 1237-1243
        • Littrup PJ
        • Jallad B.
        • Chandiwala-Mody P
        • et al.
        Cryotherapy for breast cancer: a feasibility study without excision.
        J Vasc Interv Radiol. 2009; 20: 1329-1341
        • Pusceddu C.
        • Sotgia B.
        • Amucano G.
        • et al.
        Breast cryoablation in patients with bone metastatic breast cancer.
        J Vasc Interv Radiol. 2014; 25: 1225-1232
        • Porter CAT
        • Woodrum DA
        • Callstrom MR
        • et al.
        MRI after technically successful renal cryoablation: early contrast enhancement as a common finding.
        Am J Roentgenol. 2010; 194: 790-793
        • Takaki H.
        • Nakatsuka A.
        • Cornelis F.
        • et al.
        False-Positive Tumor Enhancement After Cryoablation of Renal Cell Carcinoma: A Prospective Study.
        Am J Roentgenol. 2016; 206: 332-339
      1. ACR BI-RADS atlas: Breast imaging reporting and data system: mammography, ultrasound, magnetic resonance imaging, follow-up and outcome monitoring, data dictionary. 5th ed. ed: American College of Radiology; 2013.

        • Lobbes MB
        • Lalji UC
        • Nelemans PJ
        • et al.
        The quality of tumor size assessment by contrast-enhanced spectral mammography and the benefit of additional breast MRI.
        J Cancer. 2015; 6: 144-150
        • Hobbs MM
        • Taylor DB
        • Buzynski S
        • et al.
        Contrast-enhanced spectral mammography (CESM) and contrast enhanced MRI (CEMRI): Patient preferences and tolerance.
        J Med Imaging Radiat Oncol. 2015; 59: 300-305
        • Fallenberg EM
        • Dromain C
        • Diekmann F
        • et al.
        Contrast-enhanced spectral mammography versus MRI: Initial results in the detection of breast cancer and assessment of tumour size.
        Eur Radiol. 2014; 24: 256-264