Imaging Findings and Proposed Imaging Follow-up After Cryoablation for Treatment of Breast Cancer

US-guided cryoablation has emerged as a promising minimally invasive treatment modality for breast cancer. With the growing adoption and success of cryoablation as a breast cancer treatment, many of these patients are undergoing routine follow-up imaging. There is a growing body of evidence and literature regarding the expected imaging appearance of the postcryoablation breast. Although there are limited data to provide guidelines for imaging and BI-RADS assessment after cryoablation, radiologists are seeking guidance in this area as they encounter these patients in their practice. Our objective is to provide an overview of the expected imaging findings after breast cryoablation and propose an imaging follow-up algorithm and BI-RADS assessment scheme in this patient population. Based on a review of the literature and the authors' clinical experience, we propose that patients should have initial imaging at 3 to 6 months after cryoablation. Subsequent surveillance imaging after cryoablation can be performed at 6- or 12-month intervals. Modalities of mammography with or without a contrast-enhanced study (MRI, contrast-enhanced mammography) should be used for follow-up imaging. BI-RADS assessment should be given on these imaging studies to aid in patient tracking and guide future interventions and imaging follow-up. For patients in whom cryoablation is considered a successful and definitive treatment and follow-up imaging shows expected postablation findings with no suspicious abnormalities, BI-RADS 2 assessment is appropriate. For patients in whom cryoablation was considered palliative and/or incomplete, BI-RADS 6 assessment can be given.