Cryoablation, offered for the first time in Quebec at the Centre hospitalier de l’Université de Montréal (CHUM) since last year, is now available to a larger number of breast cancer patients, according to The Canadian Press. Initially reserved for patients with tumours measuring no more than 1.5 centimetres, this innovative cold ablation technique can now sometimes be used to reduce the size of larger tumours and prevent complications. Dr. Matthew Seidler, head of breast imaging at the CHUM’s radiology department, said that left alone, a tumour will continue to grow to the point where it can cause pain and even break through the skin and become infected. “This is really difficult to manage, especially for an elderly patient who is at the end of their life,” he explained. “In some cases, we can now offer cryoablation as a palliative treatment to reduce the size of the tumour so that it causes fewer symptoms.” Cryoablation involves “freezing” the cancerous tumour using an ultra-fine needle. The procedure, which is performed under local anesthetic, leaves virtually no scarring, and the patient is usually discharged the same day. Rapid freezing at -40 degrees Celsius and subsequent thawing cause a cascade of cell deaths that can destroy the tumour. Not only does the cold cause the cancer cells to die, but it also triggers the expression of tumour antigens that are then recognized by the human body, causing an inflammatory response by the immune system. In the context of breast cancer, Seidler pointed out that “it is not necessarily the tumour in the breast that kills patients, but when the patient develops metastases,” and the disease spreads elsewhere. When the tumour is small, he added, we can be reasonably certain that it will be completely frozen. But with a larger tumour, “it is more difficult to be sure that the tumour is completely enclosed by our ice cube and ... there is a risk of residual disease.” “In a situation like this, the goal is rather to reduce the tumour burden to avoid complications,” explained Dr Seidler. In 2025, he added, breast cancer treatment involves an “arsenal” of therapies – surgery, radiotherapy, immunotherapy, chemotherapy, etc. – as a “multidisciplinary approach” often yields the “best results.” “The treatments have a synergistic effect,” said Seidler. “It’s always better to combine treatments when possible.” The recently unveiled results of the ICE3 clinical trial support this. The data reveal that 3.6 per cent of the 194 patients treated with cryoablation had relapsed after five years, “which is still very good,” said Seidler. The relapse rate was only 2.6 per cent among patients who received adjuvant therapy in addition to cryoablation. “It’s statistics like these that encourage me to explain to my patients that yes, cryoablation can be a good option, but ideally it should be combined with other treatments if possible,” said Seidler. That said, cryoablation remains a new technique, and the scientific literature on it is sparse compared to that available for other treatments. It’s important to raise awareness among the medical community, treat more patients to gain experience, and generate data that will reveal whether the technique can be extended “to other indications,” said Seidler. “I hope that in a year’s time we will be able to offer this treatment to even more patients,” he said. This report by The Canadian Press was first published in French June 5, 2025.
