Cryoablation Within the Evolving Paradigm of Multidisciplinary Breast Cancer Treatment De-Escalation

Treatment de-escalation is increasingly shaping the management of breast cancer, aiming to reduce treatment intensity, minimize toxicity, and improve quality-of-life outcomes without compromising effectiveness and survival. Breast cancer cryoablation, a minimally invasive image-guided percutaneous technique that destroys tumor cells through controlled freezing and thawing, has emerged as an alternative to surgery for select patients with early-stage disease. Support for this approach has grown following recent prospective trials demonstrating its safety and efficacy, US Food and Drug Administration approval of the ProSense Cryoablation System for early-stage low-risk breast cancers in women 70 years of age and older, and inclusion of breast cancer cryoablation in updated American Society of Breast Surgeons treatment guidelines. In this review, we summarize the mechanistic rationale, clinical evidence, and practical considerations for clinical adoption of breast cancer cryoablation in the evolving paradigm of treatment de-escalation.