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Cryoablation Specialist

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, Los Angeles, CA and Glendale, CA

Dennis R. Holmes, M.D., F.A.C.S., with locations in Santa Monica, Glendale, and Los Angeles, California, is an expert in breast cryoablation (tumor freezing) with over 15 years of experience treating benign tumors and breast cancers. He serves as principal investigator of the FROST Trial, a national clinical trial evaluating the use of cryoablation as an alternative to surgery for the treatment of early stage breast cancer.

Cryoablation (Tumor Freezing) Q & A

Joan Lunden Interviews Dr. Holmes about Cryoablation

 

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 of the breast. It is not until recently, however, that cryoablation has been adapted to treat breast cancer. The results of a national study co-authored by Dr. Holmes found cryoablation to be most effective at killing breast cancers measuring 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 the interior of the breast. A small (3 mm) skin incision is made, followed by the insertion of a needle-like instrument called a cryoprobe through the center of the breast cancer using ultrasound to guide the way. The cryoablation system is then turned on and liquid nitrogen circulates within the cryoprobe to freeze the cancer and a surrounding rim of normal tissue to a temperature of -185, an extremely cold cancer-killing temperature. The freezing process takes approximately 30 minutes and the entire procedure typically takes about 1 hour from start to finish.   

For detailed information about cryoablation and to observe a video of Dr. Holmes performing an actual cryoablation procedure, visit www.cryoablation.com.

 

View Cryoablation

 

Who is eligible to receive cryoablation?

Cryoablation may be obtained under the following circumstances:

  1. The FROST Trial:  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 the FROST Trial and serves as chair of this national trial. The FROST trial is open to women who 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 2.0 cm or less by mammogram, ultrasound, and MRI

The cost of all trial-related procedures (e.g., cryoablation, follow-up MRI’s and post-cryoablation needle biopsy) are free of charge to women who qualify for and participate in the FROST Trial.

  1. Off-Protocol: Women who are not eligible for the FROST Trial can possibly receive cryoablation on a case-by-case basis. Possible “off-protocol” uses of cryoablation were summarized in a recent medical journal article authored by Dr. Holmes, titled “Breast Cancer Care During a Pandemic: An Opportune Time For Cryoablation?” You may contact Dr. Holmes’s office to see if you may undergo cryoablation off-protocol.

Out-of-town patients may submit their imaging studies and pathology reports online to Dr. Holmes’s for assessment of your eligibility for the FROST Trial or for receipt of cryoablation off-protocol. 

What follow-up is needed after cryoablation?

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

Participants 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 younger than age 70
  • Possibly undergo a sentinel node biopsy if MammaPrint score is high

For Cryoablation Frequently Asked Questions, please visit www.cryoablation.com.

 

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