THE TECHNOLOGY OF PUNCTIONAL CRYOABLATION OF MALIGNANT BREAST TUMORS

Abstract

The cryoablation of malignant breast tumors technology with the use of modern miniinvasive equipment based on liquid nitrogen is represented. Navigation method, monitoring and postoperative observation of patients are presented in detail. In clinical cases, where surgical operation alternatives can be considered, indications to cryoablation are: elderly patients and slow growth of tumor; enough distance from the skin; precise ultrasound visualization of tumor borders; limited lesion size, which allow icy front to fully cover the tumor; specialized oncological center conditions; navigational and miniinvasive cryogenic equipment availability; additional special training for oncologists; careful psychological training for patients and their relatives; informed consent formalization by patient and her refusal of standard treatment. Procedure starts with trepan-biopsy to get the material for immunohistochemical investigations. The first probe is installed paratumorally in the deepest point and its cryofixation in tissues is performed without large glaciation zone formed. After that other probes and injectional microthermocouples are installed in tumor's outline, then cooling is started. Capture of healthy tissues must be 1 sm with exposition retention during 10 minutes and passive warming during 10-15 minutes. Second cooling is obligatorily in the same probes' position and in the same time-intervals. All the common rules of diagnostics and complex treatment are preserved. The clinical case of successful cryoablation is presented.