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Fine RE, Gilmore RC, Dietz JR, Boolbol SK, Berry MP, Han LK, Kenler AS, Sabel M, Tomkovich KR, VanderWalde NA, Chen M, Columbus KS, Curcio LD, Feldman SM, Gold L, Hernandez L, Manahan ER, Seedman SA, Vaidya RP, Sevrukov AB, Aoun HD, Hicks RD, Simmons RM. ASO Visual Abstract: Cryoablation Without Excision for Low-Risk, Early-Stage Breast Cancer-3-Year Interim Analysis of Ipsilateral Breast Tumor Recurrence in the ICE3 Trial. Ann Surg Oncol 2021. [PMID: 34401989 DOI: 10.1245/s10434-021-10618-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Richard E Fine
- Margaret West Comprehensive Breast Center, West Cancer Center and Research Institute, Germantown, TN, USA.
| | - Richard C Gilmore
- Margaret West Comprehensive Breast Center, West Cancer Center and Research Institute, Germantown, TN, USA
| | | | | | - Michael P Berry
- Margaret West Comprehensive Breast Center, West Cancer Center and Research Institute, Germantown, TN, USA
| | | | | | - Michael Sabel
- The University of Michigan Health System, Ann Arbor, MI, USA
| | | | - Noam A VanderWalde
- Margaret West Comprehensive Breast Center, West Cancer Center and Research Institute, Germantown, TN, USA
| | - Margaret Chen
- Columbia University Medical Center, New York, NY, USA
| | | | | | | | | | | | | | | | | | | | | | | | - Rache M Simmons
- Weill Cornell Weill Medical College, Cornell University, New York, NY, USA
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Fine RE, Gilmore RC, Dietz JR, Boolbol SK, Berry MP, Han LK, Kenler AS, Sabel M, Tomkovich KR, VanderWalde NA, Chen M, Columbus KS, Curcio LD, Feldman SM, Gold L, Hernandez L, Manahan ER, Seedman SA, Vaidya RP, Sevrukov AB, Aoun HD, Hicks RD, Simmons RM. Cryoablation Without Excision for Low-Risk Early-Stage Breast Cancer: 3-Year Interim Analysis of Ipsilateral Breast Tumor Recurrence in the ICE3 Trial. Ann Surg Oncol 2021; 28:5525-5534. [PMID: 34392462 DOI: 10.1245/s10434-021-10501-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/07/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND The ICE3 trial is designed to evaluate the safety and efficacy of breast cryoablation, enabling women older than 60 years with low-risk early-stage breast cancers to benefit from a nonsurgical treatment and to avoid the associated surgical risks. METHODS The ICE3 trial is a prospective, multi-center, single-arm, non-randomized trial including women age 60 years or older with unifocal, ultrasound-visible invasive ductal carcinoma size 1.5 cm or smaller and classified as low to intermediate grade, hormone receptor (HR)-positive, and human epidermal growth factor receptor 2 (HER2)-negative. Ipsilateral breast tumor recurrence (IBTR) at 5 years was the primary outcome. A 3-year interim analysis of IBTR was performed, and the IBTR probability was estimated using the Kaplan-Meier method. RESULTS Full eligibility for the study was met by 194 patients, who received successful cryoablation per protocol. The mean age was 75 years (range, 55-94 years). The mean tumor length was 8.1 mm (range, 8-14.9 mm), and the mean tumor width was 7.4 mm (range, 2.8-14 mm). During a mean follow-up period of 34.83 months, the IBTR rate was 2.06% (4/194 patients). Device-related adverse events were reported as mild in 18.4% and moderate in 2.4% of the patients. No severe device-related adverse events were reported. More than 95% of the patients and 98% of the physicians reported satisfaction with the cosmetic results at the clinical follow-up evaluation. CONCLUSIONS Breast cryoablation presents a promising alternative to surgery while offering the benefits of a minimally invasive procedure with minimal risks. Further study within a clinical trial or registry is needed to confirm cryoablation as a viable alternative to surgical excision for appropriately selected low-risk patients.
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Affiliation(s)
- Richard E Fine
- Margaret West Comprehensive Breast Center, West Cancer Center and Research Institute, Germantown, TN, USA.
| | - Richard C Gilmore
- Margaret West Comprehensive Breast Center, West Cancer Center and Research Institute, Germantown, TN, USA
| | | | | | - Michael P Berry
- Margaret West Comprehensive Breast Center, West Cancer Center and Research Institute, Germantown, TN, USA
| | | | | | - Michael Sabel
- The University of Michigan Health System, Ann Arbor, MI, USA
| | | | - Noam A VanderWalde
- Margaret West Comprehensive Breast Center, West Cancer Center and Research Institute, Germantown, TN, USA
| | - Margaret Chen
- Columbia University Medical Center, New York, NY, USA
| | | | | | | | | | | | | | | | | | | | | | | | - Rache M Simmons
- Weill Cornell Weill Medical College, Cornell University, New York, NY, USA
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