SINGAPORE, Nov 18 — When a 54-year-old banking and finance professional discovered that she had Stage 1 breast cancer during a routine health check earlier this year, she chose to deep-freeze the cancer.

Jolyn — not her real name as she did not want to be identified — is among the first few breast cancer patients in Singapore to have undergone a minimally invasive procedure called cryoablation, which uses extreme temperatures between -40°C and -170°C to destroy diseased cells.

It was an unconventional choice that spared her the need for surgery or the removal of her breast.

It was not a typical move because depending on the type and stage of their breast cancer and other factors, some women may choose to get rid of their entire breast once and for all. Others opt to remove just the tumour and some surrounding tissue in a surgical procedure known as lumpectomy. 

For Jolyn, she started on the treatment in March this year with consultant general surgeon ​Jendana Chanyaputhipong from The PanAsia Surgery Group.

During the procedure, the surgeon uses a thin needle called a cryoprobe and inserts it through the skin to get directly to the cancerous tumour.

Jendana, whose sub-speciality is in breast surgery, said that a cooling gas is then pumped through the cryoprobe to freeze the target tissue rapidly.

During the 30-minute-or-so procedure, the tissue is allowed to thaw before a second freeze cycle is performed to ensure cancer cells are completely destroyed.

Besides PanAsia Surgery Group, Changi General Hospital (CGH) has also performed cryoablation treatment on two breast cancer patients — its first case in May last year.

The treatment is carried out as a day-surgery procedure, Jendana said. Patients may choose to be awake or sedated during the surgery.

Dr Rameysh Danovani Mahmood, a consultant from the department of diagnostic radiology at CGH, said that there are no surgical excisions involved in cryoablation and the structure of the breast is kept largely intact after the procedure.

Jolyn said that while there was some temporary discomfort due to swelling, she felt "virtually no pain” and was up and about at home after the procedure. She worked from home in the few days that followed.

"The appearance of the breast is virtually the same as before, except for the temporary swelling,” she said. "I felt close to normal even on the same day and was doing simple household tasks.

"So much so I had to remind myself not to exert myself with more laborious tasks — such as lifting anything heavy or raising my hand above shoulder height, as cautioned (by the doctor).”

Things to consider before taking up treatment

Breast cancer is the most common women’s cancer. About one in 11 women will develop breast cancer in their lifetime, the Singapore Cancer Society said.

Surgery is so far the gold standard of care in treating the cancer.

However, as more breast cancer patients seek less invasive treatments that minimise scarring and deformities to the breast, researchers are exploring the use of minimally invasive, non-surgical treatments such as cryoablation as an alternative to surgery for certain low-risk, early-stage breast cancers.

Jendana said that among breast cancer patients who are fit to undergo surgery, not all are keen to go under the knife.

"Having cryoablation as an alternative to treat certain types of breast cancer is certainly attractive to researchers, as well as beneficial for the patients themselves because it is minimally invasive and causes less scarring and deformity,” she said.

Doctors would consider this therapy depending on the type of breast cancer and tumours.   

They said that the deep-freezing technique, which has been used to treat certain cancers such as "small” liver cancer and prostate cancer, has shown promise in the treatment of selected breast cancer patients.

Based on the current available evidence, Dr Rameysh, for example, said that the treatment should be reserved for: