For Chanderkala Lohani, resilience has been a lifelong companion. Widowed at a young age, she single-handedly raised three daughters and a son. At 64, she faced yet another formidable challenge when she was diagnosed with one of the most aggressive forms of breast cancer, alongside a previously undetected genetic heart condition that ruled out many standard treatment options. More than a decade later, when the cancer returned, Lohani once again defied the odds—this time with the help of cutting-edge medical technology.
Now 78, Lohani was initially diagnosed with triple-negative breast cancer after doctors обнаружed a small lump in the upper portion of her left breast. This subtype of breast cancer lacks three key receptors—estrogen, progesterone, and HER2—making it unresponsive to hormone therapies and HER2-targeted drugs.
Complicating her condition further was hypertrophic cardiomyopathy, a disorder that thickens the heart muscle and impairs blood flow. “General anaesthesia was not an option as it could have triggered a fatal cardiac event,” said Dr. Ramesh Sarin, surgical oncologist at Apollo Hospital, Delhi. “Chemotherapy and radiotherapy were also ruled out because of their cardiotoxic effects.”
Given the circumstances, doctors opted for surgery under local anaesthesia and sedation. “We were fortunate to remove the entire tumour,” Dr. Sarin said. But triple-negative breast cancer is known for its high recurrence rate, and Lohani was no exception. During a routine follow-up screening late last year—something she never missed—doctors обнаружed that the cancer had returned.
Once again, the same medical constraints applied. “She remained a high-risk patient, and we had to carefully weigh whether her co-morbidities or the cancer itself posed a greater threat,” Dr. Sarin explained.
This time, Lohani was offered a third option: cryoablation. The minimally invasive procedure destroys tumours by freezing them rather than surgically removing them. Approved by the US Food and Drug Administration (FDA), cryoablation allows patients to go home the same day and significantly reduces recovery time.
“It is a safe option for elderly patients or those who cannot undergo conventional surgery,” Dr. Sarin said. “I am even planning to use it for a 95-year-old patient. For people who are medically unfit for major surgery, this can be life-changing.”
How Cryoablation Works
While surgery remains the standard first-line treatment for breast cancer, cryoablation is emerging as an alternative for carefully selected patients. In this procedure, doctors insert a thin, needle-like probe into the tumour under ultrasound or CT guidance. Extremely cold temperatures are then applied, forming an ice ball that freezes and destroys cancer cells. The body gradually absorbs the dead tissue over time.
Because the procedure is done under local anaesthesia and involves no large incisions, it typically takes less than an hour. “Recovery is faster, pain is minimal, and scarring is limited,” Dr. Sarin said. Scans have since confirmed that Lohani’s tumour has been completely destroyed.
Who Is Eligible?
Cryoablation is not suitable for all patients. According to specialists, it works best for early-stage breast cancers—specifically T1 or T2 tumours measuring less than 5 cm—that have not spread to lymph nodes or other parts of the body. The tumour must also have clearly defined margins to ensure it can be fully frozen.
At present, cryoablation is mainly reserved for patients who are medically unfit for surgery due to age or other serious health conditions. It is not yet considered a standard replacement for surgery, as long-term outcomes are still under study.
Success Rates and Costs
Clinical trials have shown promising results. Studies report nearly 100% success in completely destroying very small tumours (≤1 cm), with success rates of over 90% for tumours up to 2 cm. In the large ICE3 trial involving early-stage, low-risk breast cancers, around 96–97% of patients treated with cryoablation and hormone therapy remained free of local recurrence after five years—comparable to outcomes seen with lumpectomy in similar cases.
However, the procedure comes at a higher cost. Cryoablation can cost between ₹2 lakh and ₹6 lakh, nearly twice the price of conventional breast cancer surgery. It is not routinely covered by insurance due to its status as a newer and less conventional treatment, though coverage may be granted if deemed medically necessary and pre-authorised.
For Lohani, the decision proved worthwhile. Her case stands as a powerful reminder that age need not be a barrier to fighting cancer—and that with the right blend of medical innovation and determination, even the toughest battles can be won.
