Dennis R. Holmes, M.D., F.A.C.S. -  - Breast Cancer Surgeon

Dennis R. Holmes, M.D., F.A.C.S.

Breast Cancer Surgeon located in Santa Monica, CA

Cryoablation Specialist
Dennis R. Holmes, M.D., F.A.C.S., with locations in Beverly Hills, Santa Monica, Glendale, and Los Angeles, California, is an expert in cryoablation and serves as principal investigator of the FROST Trial, a national clinical trial evaluating the use of cryoablation (tumor freezing) as an alternative to surgery for the treatment of early stage breast cancer.

Cryoablation (Tumor Freezing) Q & A

by Dennis R. Holmes, M.D., F.A.C.S.

What is cryoablation?

Cryoablation is a groundbreaking new treatment for breast tumor freezing.  Cryoablation has been used for many years on liver, skin, and cervical cancers, as well as, benign tumors within the breast.  However, cryoablation has only recently been adapted to treat breast cancer.   A recent national study in which Dr. Holmes participated, found cryoablation to be 100% effective at killing tumors 1 cm or smaller, and 92% effective at killing tumors 2 cm or smaller.  

How is cryoablation performed?

The cryoablation procedure is similar to having an ultrasound-guided needle biopsy of the breast.  The procedure is performed in the office with the patient awake and comfortable.  First, ultrasound of the breast  is performed to identify the location of the cancer.  Next, local anesthetic is injected into the skin and into to interior of the breast.   A small (3mm) skin incision is made.  Then a needle-like instrument called a cryoprobe is inserted through the skin incision and passed through the center of the breast cancer.  The cryoablation system is then turned on and liquid nitrogen flows through the cryoprobe to freeze the cancer and a surrounding rim of normal tissue to a temperature of -185, an extremely cold cancer-killing temperatures.  The freezing process takes approximately 30 minutes, and the entire procedure takes about 1 hour from start to finish.   


View Cryoablation


Who is eligible to receive cryoablation?

Cryoablation is available to participants in the Freezing Instead of Removal Of Small Tumors (FROST) Trial, a national study of the use of cryoablation in the treatment of early-stage breast cancer.   Dr. Holmes designed and serves as chair of this national trial.  The FROST is open to women that meet the following criteria:

  • Age 50 or older
  • Have had a needle biopsy of the cancer showing invasive ductal carcinoma
  • Have had a needle biopsy showing a breast cancer that is estrogen sensitive
  • Have breast cancer that is clearly visible by ultrasound
  • Have breast cancer measuring 1.5cm or less by mammogram, ultrasound, and MRI

Women not meeting these criteria may be offered cryoablation outside of the FROST Trial on a case-by-case basis.

What follow-up is needed after cryoablation?

To verify complete tumor kill, patients treated with cryoablation are required to undergo a repeat needle biopsy of the killed tumor six months after cryoablation to confirm that no living cancer remains.  Surgical removal of the cancer will be recommended if living cancer cells are found.

Also, participations in the FROST Trial must undergo the following treatments:  

  • Take an anti-estrogen pill daily for a minimum of 5 years.
  • Receive traditional 3 or 6 weeks of whole breast radiotherapy if
  • Undergo a sentinel node biopsy if
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