Future of the breast cancer fightSaturday, October 22, 2016
Dr Duane Chambers
BREAST cancer remains the leading cause of cancer-related deaths in Jamaican women above the age of 25 years. Breast cancer accounts for 29.4 per cent of all cancers in Jamaica, with an incidence rate of 43.1 per 100,000 in women and 0.6 in men. To put it in stark terms, for every 21 women in Jamaica, one will develop breast cancer in her lifetime.
Breast cancer also has a tremendous national socioeconomic impact. The high cost of treating the disease has led to bankruptcy for many Jamaican families. The indirect effect on productivity for those directly affected and also for those caring for the affected has also been significant. Breast cancer therefore poses a major public health challenge and a threat to national economic and social development.
The radiologist resides in the trenches of the fight against breast cancer. Yearly mammograms, beginning at 40 years, remain the gold standard for breast cancer screening in Jamaica. Other modalities such as magnetic resonance imaging (MRI), ultrasound, X-ray, and computed tomography (CT) are used to help determine the extent of the disease.
Radiologists also biopsy suspicious lesions in the breast and other parts of the body to establish tissue diagnosis of the disease and, by extension, help to select the most appropriate method of treatment.
It is safe to say that many of the treatment methods for breast cancer are associated with significant downtime. Imagine though, a treatment that is associated with 100 per cent cure of early breast cancer and benign breast masses, takes 30 minutes and causes very little downtime for recovery.
The future is now. Sanarus technologies will present their cryoablation technique for management of benign breast masses and early-stage breast cancer at the Jamaica Cancer Society’s Breast Cancer Awareness Seminar on October 23, 2016 at the Jamaica Pegasus Hotel.
Cryotherapy is a process that uses extremely cold temperature to destroy targeted tissue by a process called tissue necrosis. The necrotic tissue is resolved over time by the body and replaced with healthy tissue. Breast cryoablation has been shown to be more effective than traditional surgical excision for the following reasons:
• One hundred per cent tumour ablation within the ablation zone;
• Quick turnaround: Under 30-minute procedure;
• Ultrasound guided;
• Minimally invasive: conserves breast shape;
• Shown to not adversely affect mammogram or ultrasound interpretation;
• Excellent cosmesis: one 3mm incision;
• Requires only local anaesthesia
• One-day recovery time: less time off work.
The Visica 2 cryoablation system has been FDA-approved for the ablation of both cancerous and benign breast tissue.
BEFORE CRYOABLATION, CERTAIN CRITERIA MUST BE MET:
• The lesion must be visible on ultrasound;
• The diagnosis must be confirmed histologically;
• Lesions must be less than 4 cm in diameter.
The cryotherapy procedure is pretty straightforward.
Imaging: Ultrasound imaging is used to locate the tumour.
Placement: Local anaesthetic is given and the ice probe is placed percutaneously through a small incision site.
Freeze-thaw-freeze: A controlled ice ball is formed. The freeze-thaw-freeze cycle fully ablates the tumour in the breast.
Removal: The probe is removed and a small sterile bandage is applied. The tissue is naturally resorbed over time.
• Three to six month post cryoablation follow-up visit recommended.
• Necrotic tissue can show up in mammography until fully resolved so it is important for the patient to tell the imaging specialist that she has had cryoablation.
• Bruising and swelling may occur but will diminish over time.
•Lesion can be potentially palpable for up to a year or more, post cryoablation, depending on the original size.
• Similar to a core biopsy, strenuous activities should be avoided for a brief time.
For all the reasons in the table below, cryotherapy is a viable option to traditional lumpectomy for the management of benign and early-stage malignant breast masses. It is an impressive weapon in the arsenal employed to fight breast cancer. It is my hope that this weapon will soon be deployed in Jamaica.
Dr Duane Chambers is a consultant radiologist and founding partner of Imaging and Intervention Associates located at shops 58 and 59 Kingston Mall, 8 Ocean Boulevard. He may be contacted through the office numbers 618-4346 or 967-7748.