By Jill Barville Correspondent |
August 25, 2015 - Updated: August 27, 8:45 a.m.
The first time Katherine Gawenit, 30, found a lump in her breast
she was a 19-year-old college freshman.
"That was a scary one," she said.
Gawenit immediately called her mother, then made a doctor's
appointment. An ultrasound revealed a tumor and she was advised to
have it surgically removed and tested for cancer.
Gawenit's grandmother and an aunt both had breast cancer so she
One long month after finding the lump Gawenit learned the
results from her surgery and could breathe a sigh of relief. She
had a fibroadenoma, a benign breast tumor not uncommon in
Since then, Gawenit has had three more fibroadenomas removed, a
golf-ball sized tumor when she was 25 and two additional tumors
this year. Compared to the surgeries she had for the first two
tumors, she said the last treatment was by far
In January, the Breast Health Center at Rockwood Clinic
purchased an IceCure machine so they could offer patients like
Gawenit cryoablation, a newer, noninvasive treatment that freezes
the tumor with liquid nitrogen.
It's estimated that 10 percent of women will get a fibroadenoma
during their lifetime. Most of them, like Gawenit, are women in
their reproductive years.
"They think they're the only one this has happened to but 10
percent of people get them," said Dr. Moira O'Riordan, a diagnostic
radiologist at Rockwood's Breast Health center. "They're very
scared and very young … They think cancer."
Any lump, O'Riordan stressed, should be evaluated to rule out
cancer. But a big part of her job is reassuring women who come in
for a diagnostic ultrasound.
"When you do the ultrasound, you can tell it's a fibroadenoma,"
she said, adding that the diagnosis is always verified by
For pregnant and breastfeeding women, or women older than 40,
doctors usually have a watch-and-wait approach with regular
ultrasounds to make sure the tumor isn't growing or changing.
Younger women may also monitor smaller tumors if they aren't
causing discomfort or emotional distress.
But many patients opt to remove the hard lumps because they can
be painful and continue to grow.
O'Riordan said removal is also a precaution because in very rare
cases a fibroadenoma can turn into a phyllodes tumor - malignant,
When Gawenit found her first two tumors, surgical excision was
the standard treatment. It still is in many places.
The Food and Drug Administration approved cryoablation to treat
fibroadenomas in 2002, though it's been used for many years to
treat liver and prostate tumors, said Rockwood surgeon Dr. Renu
Sinha, noting it isn't recommended for malignant tumors but is a
cost-effective, noninvasive option to surgery for benign
First, the area is numbed with lidocaine. Guided by ultrasound,
the radiologist injects saline solution into the tissue surrounding
the mass, creating a buffer.
Then the radiologist inserts a probe into the tumor and infuses
it with liquid nitrogen. On the ultrasound screen the
colder-than-ice fluid looks like a dark ball that grows as it
freezes. The procedure is complete when the ice ball eclipses the
tumor, which is easy to see because these types of tumors have
"It's super cool and very fun," O'Riordan said. "You can see
that you got it all."
From start to finish the procedure takes a few minutes.
Compared to surgery, said Gawenit, the procedure and recovery
was a breeze.
She'd learned about cryoablation from Sinha while they were
monitoring two tumors found during Gawenit's
"People who have fibroadenomas will tend to have them," Sinha
said, adding that they're also common during pregnancy thanks to an
influx of hormones. Sometimes the tumors go away after birth but
Gawenit's didn't. They were uncomfortable and after weaning her
baby she wanted them out.
"I was always worried. What if there was a change?" said
Gawenit, noting she wanted cryoablation instead of surgery but it
wasn't available in Spokane.
She was making plans to have the procedure in Western Washington
when Sinha called her with good news.
"It's not available everywhere but we convinced Rockwood to
support this," Sinha said. "This is a great thing
Gawenit was one of their first.
"It was a cold sensation in one spot, like an ice pack," Gawenit
said. "It was easier than a biopsy."
The recovery, she said, was also easier. She was swollen for
about a day as her body reabsorbed the saline solution but she
didn't miss the pain, stitches, scarring and longer recovery she
experienced when her other tumors were surgically removed.
"When I had surgery, it was three days before I could lift
anything. It was a week before I could lift my kids. My husband had
to take a week off of work to help," she said, adding that she
continued to have residual pain at the surgical site from
"This time, there was no pain, no scar. I didn't think
Her doctors will continue to monitor the area with ultrasound as
the tumor softens, dies and disappears.
"In about a year, it's gone," said Sinha.
Cryoablation could someday be a treatment option for elderly
women who don't want the risks of surgery to remove small,
cancerous breast tumors.
"For older patients who have a higher risk for surgery than the
breast cancer, it's great," said Rockwood breast surgeon Dr. Renu
Sinha, noting a preliminary trial showed 94 percent success and
Rockwood hopes to become one of the sites for a new
Sponsored by IceCure Medical, the breast cancer trial is
recruiting 160 menopausal women older than 65 who have low-grade,
cancerous tumors smaller than 1.5 centimeters and who don't test
positive for the Her2 breast cancer gene.
The goal is to evaluate how effective cryoablation is for those
older patients with early stage breast cancer. For more information
about the study and participating clinics, go to
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