Prognostic Study of Sentinel Lymph Node and Bone Marrow Metastases in Women With Stage I or Stage IIA Breast Cancer

NCT ID: NCT00003854

Last Updated: 2016-07-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

4590 participants

Study Classification

INTERVENTIONAL

Study Start Date

1999-04-30

Study Completion Date

2011-07-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

RATIONALE: Biopsy of sentinel lymph nodes and bone marrow may improve the ability to detect and determine the extent of cancer.

PURPOSE: Phase III prognostic study of sentinel lymph node metastases and bone marrow metastases in women who have stage I or stage IIA breast cancer.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

OBJECTIVES:

* Estimate the prevalence and evaluate the prognostic significance of sentinel lymph node micrometastases detected by immunohistochemistry in women with stage I or IIA breast cancer.
* Estimate the prevalence and evaluate the prognostic significance of bone marrow micrometastases detected by immunocytochemistry in these patients.
* Evaluate the hazard rate for regional recurrence in women whose sentinel nodes are negative by hematoxylin and eosin (H\&E) staining.
* Provide a mechanism for identifying women whose sentinel nodes contain metastases detected by H\&E so that these women can be considered as candidates for ACOSOG-Z0011.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Breast Cancer

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Surgery + radiotherapy + adjuvant therapy

Patients undergo bilateral anterior iliac crest bone marrow aspiration to test for presence of micrometastases. Patients then undergo breast-conserving therapy comprising segmental mastectomy and sentinel lymph node dissection (SLND) with planned postoperative whole-breast radiotherapy and systemic adjuvant therapy. The SLND comprises ipsilateral axillary sentinel node identification and histopathology.

Patients with no sentinel node identified intraoperatively and patients with sentinel node metastasis identified by hematoxylin and eosin (H\&E) who choose not to be registered to ACOSOG-Z0011 undergo axillary lymph node dissection involving removal of at least level I and II nodes.

All patients undergo whole-breast radiotherapy (excluding a supraclavicular field) 5 days a week for a maximum of 8 weeks.

Patients are followed at 30 days; at 6, 12, 18, 24, 30, and 36 months; and then annually until 10 years after surgery.

Group Type EXPERIMENTAL

immunohistochemistry staining method

Intervention Type OTHER

lymphangiography

Intervention Type PROCEDURE

sentinel lymph node biopsy

Intervention Type PROCEDURE

therapeutic conventional surgery

Intervention Type PROCEDURE

whole breast irradiation

Intervention Type RADIATION

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

immunohistochemistry staining method

Intervention Type OTHER

lymphangiography

Intervention Type PROCEDURE

sentinel lymph node biopsy

Intervention Type PROCEDURE

therapeutic conventional surgery

Intervention Type PROCEDURE

whole breast irradiation

Intervention Type RADIATION

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. Patient must be female.
2. Patient's clinical stage must be I or II (T1 or T2 N0 M0) and the tumor must be amenable to segmental mastectomy (lumpectomy).
3. Patient must have a tissue diagnosis of invasive breast carcinoma. Note: A patient can be registered to this study if they have a cytologic diagnosis suggestive of carcinoma from a fine needle aspiration (FNA) of a palpable or non-palpable breast lesion and the investigator believes the breast lesion is clinically suspicious for invasive breast carcinoma.
4. The date of the patient's first tissue diagnosis of invasive breast carcinoma or cytologic diagnosis of breast carcinoma must be no more than 60 days prior to SLND.
5. The patient who had segmental mastectomy (lumpectomy) performed previously, and is now referred to the local investigator for SLND, is eligible if the lumpectomy was less than or equal to 60 days prior to the SLND. Copies of the operative and pathology reports must be submitted as a part of the registration process.
6. Patient must have ECOG/Zubrod status of ≤2, as documented in patient's medical record.
7. Patient must be available for follow-up.
8. The patient with a history of a previous malignancy is eligible for this study as long as the patient meets the following criteria for a cancer survivor. A cancer survivor is eligible provided that the following criteria are met:

1. The patient has undergone potentially curative therapy for all prior malignancies.
2. There has been no evidence of any prior malignancies for at least five years with no evidence of recurrence (except for effectively treated basal cell or squamous carcinoma of the skin, carcinoma in-situ of the cervix that has been effectively treated by surgery alone, or lobular carcinoma in-situ of the ipsilateral or contralateral breast treated by surgery alone), and
3. The patient is deemed by their treating physician to be at low risk for recurrence from prior malignancies.
9. Signed and dated informed consent is obtained prior to patient registration.
10. Patients of childbearing potential must have a negative serum or urine pregnancy test within 14 days of beginning study interventions.
11. Patient must be able to physically undergo bilateral anterior iliac crest bone marrow aspiration.

Exclusion Criteria

1. Patient is lactating (breastfeeding).
2. Patient has been previously treated with chemotherapy, estrogen receptor antagonists (i.e. Tamoxifen) or selective estrogen receptor modulators (SERMs, i.e. Raloxifene) for this invasive breast cancer.
3. Patient has a previously placed pre-pectoral breast implant. NOTE: A subpectoral implant is allowed.
4. Patient is considered a poor surgical risk due to a non-malignant systemic disease (cardiovascular, renal, etc.), which would preclude the treatment options.
5. Patient has concurrent bilateral invasive breast malignancies.
6. Patient is not able to undergo and does not have access to radiation therapy as describedin Adjuvant Radiation Therapy in the Interventions section of the protocol.

Patients with active connective tissue disorders and those that live too far from a radiation treatment center, for example, would not be eligible.
7. Patient has clinically and radiologically identified multi-centric disease that is not amenable to a single lumpectomy.
8. Patient has had previous ipsilateral axillary surgery such as excisional biopsy of lymph node(s), treatment of hidradenitis.
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

Alliance for Clinical Trials in Oncology

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Armando E. Giuliano, MD

Role: STUDY_CHAIR

Saint John's Cancer Institute

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

University of Alabama at Birmingham Comprehensive Cancer Center

Birmingham, Alabama, United States

Site Status

Mobile Infirmary Medical Center

Mobile, Alabama, United States

Site Status

Providence Hospital - Mobile AL

Mobile, Alabama, United States

Site Status

Mayo Clinic Scottsdale

Scottsdale, Arizona, United States

Site Status

Washington Regional Medical Center

Fayetteville, Arkansas, United States

Site Status

St. Vincent Doctors Doctors Hospital

Little Rock, Arkansas, United States

Site Status

Baptist Health Medical Center

Little Rock, Arkansas, United States

Site Status

Kaiser Permanente Medical Center - Los Angeles

Los Angeles, California, United States

Site Status

Summit Medical Center

Oakland, California, United States

Site Status

St. Joseph Hospital - Orange

Orange, California, United States

Site Status

Huntington Memorial Hospital

Pasadena, California, United States

Site Status

University of California Davis Cancer Center

Sacramento, California, United States

Site Status

Donald N. Sharp Memorial Community Hospital

San Diego, California, United States

Site Status

UCSF Comprehensive Cancer Center

San Francisco, California, United States

Site Status

John Wayne Cancer Institute

Santa Monica, California, United States

Site Status

Memorial Hospital Cancer Center

Colorado Springs, Colorado, United States

Site Status

University of Colorado Cancer Center

Denver, Colorado, United States

Site Status

University of Connecticut Health Center

Farmington, Connecticut, United States

Site Status

CCOP - Christiana Care Health Services

Wilmington, Delaware, United States

Site Status

Lombardi Cancer Center

Washington D.C., District of Columbia, United States

Site Status

Morton Plant Mease Health Care

Clearwater, Florida, United States

Site Status

Lakeland Regional Medical Center

Lakeland, Florida, United States

Site Status

Watson Clinic

Lakeland, Florida, United States

Site Status

Bayfront Medical Center

St. Petersburg, Florida, United States

Site Status

Martin Memorial Cancer Medical Center

Stuart, Florida, United States

Site Status

Tallahassee Memorial Healthcare

Tallahassee, Florida, United States

Site Status

H. Lee Moffitt Cancer Center and Research Institute

Tampa, Florida, United States

Site Status

DeKalb Medical Center, Inc.

Decatur, Georgia, United States

Site Status

St. Francis Medical Center

Honolulu, Hawaii, United States

Site Status

Kaiser Permanente Medical Center

Honolulu, Hawaii, United States

Site Status

St. Luke's Regional Medical Center

Boise, Idaho, United States

Site Status

St. Elizabeth's Hospital

Belleville, Illinois, United States

Site Status

Belleville Memorial Hospital

Belleville, Illinois, United States

Site Status

Northwestern University Medical Center

Chicago, Illinois, United States

Site Status

CCOP - Evanston

Evanston, Illinois, United States

Site Status

Evanston Northwestern Health Care

Evanston, Illinois, United States

Site Status

Little Company of Mary Hospital - Evergreen Park

Evergreen Park, Illinois, United States

Site Status

Loyola University Medical Center

Maywood, Illinois, United States

Site Status

Saint Anthony Memorial Health Center - Michigan City Campus

Michigan City, Indiana, United States

Site Status

University of Kansas Medical Center

Kansas City, Kansas, United States

Site Status

Central Baptist Hospital

Lexington, Kentucky, United States

Site Status

Norton Healthcare System

Louisville, Kentucky, United States

Site Status

James Graham Brown Cancer Center

Louisville, Kentucky, United States

Site Status

Woman's Hospital

Baton Rouge, Louisiana, United States

Site Status

Baton Rouge General Medical Center

Baton Rouge, Louisiana, United States

Site Status

Anne Arundel Medical Center

Annapolis, Maryland, United States

Site Status

Lahey Clinic - Burlington

Burlington, Massachusetts, United States

Site Status

Barbara Ann Karmanos Cancer Institute

Detroit, Michigan, United States

Site Status

Henry Ford Hospital

Detroit, Michigan, United States

Site Status

McLaren Regional Cancer Center

Flint, Michigan, United States

Site Status

Genesys Regional Medical Center

Grand Blanc, Michigan, United States

Site Status

Spectrum Health - Butterworth Campus

Grand Rapids, Michigan, United States

Site Status

Henry Ford Medical Center - West Bloomfield

West Bloomfield, Michigan, United States

Site Status

Park Nicollet Clinic

Saint Louis Park, Minnesota, United States

Site Status

Keesler Medical Center - Keesler AFB

Keesler Air Force Base, Mississippi, United States

Site Status

Singing River Hospital

Pascagoula, Mississippi, United States

Site Status

Columbia Regional Hospital

Columbia, Missouri, United States

Site Status

Ellis Fischel Cancer Center - Columbia

Columbia, Missouri, United States

Site Status

University of Missouri-Columbia Hospital and Clinics

Columbia, Missouri, United States

Site Status

Lester E. Cox Medical Centers

Springfield, Missouri, United States

Site Status

St. Louis University Health Sciences Center

St Louis, Missouri, United States

Site Status

Barnes-Jewish Hospital

St Louis, Missouri, United States

Site Status

Norris Cotton Cancer Center

Lebanon, New Hampshire, United States

Site Status

Fox Chase Virtua Health Cancer Program at Virtua Memorial Hospital

Mount Holly, New Jersey, United States

Site Status

Lutheran Medical Center

Brooklyn, New York, United States

Site Status

Roswell Park Cancer Institute

Buffalo, New York, United States

Site Status

Kingston Hospital

Kingston, New York, United States

Site Status

Benedictine Hospital

Kingston, New York, United States

Site Status

St. Luke's-Roosevelt Hospital Center - Roosevelt Division

New York, New York, United States

Site Status

New York Presbyterian Hospital - Cornell Campus

New York, New York, United States

Site Status

Highland Hospital of Rochester

Rochester, New York, United States

Site Status

University of Rochester Medical Center

Rochester, New York, United States

Site Status

Lineberger Comprehensive Cancer Center, UNC

Chapel Hill, North Carolina, United States

Site Status

Carolinas Medical Center

Charlotte, North Carolina, United States

Site Status

Durham Regional Hospital

Durham, North Carolina, United States

Site Status

Duke Comprehensive Cancer Center

Durham, North Carolina, United States

Site Status

Cape Fear Valley Health System

Fayetteville, North Carolina, United States

Site Status

Tri-Health Good Samaritan Hospital

Cincinnati, Ohio, United States

Site Status

Ireland Cancer Center

Cleveland, Ohio, United States

Site Status

Arthur G. James Cancer Hospital - Ohio State University

Columbus, Ohio, United States

Site Status

Toledo Hospital

Toledo, Ohio, United States

Site Status

St. Vincent Mercy Medical Center

Toledo, Ohio, United States

Site Status

Sacred Heart Hospital

Allentown, Pennsylvania, United States

Site Status

Fox Chase Cancer Center

Philadelphia, Pennsylvania, United States

Site Status

Mercy Hospital of Pittsburgh

Pittsburgh, Pennsylvania, United States

Site Status

York Cancer Center

York, Pennsylvania, United States

Site Status

Women and Infants Hospital of Rhode Island

Providence, Rhode Island, United States

Site Status

Kent County Memorial Hospital

Warwick, Rhode Island, United States

Site Status

Sarah Cannon-Minnie Pearl Cancer Center

Nashville, Tennessee, United States

Site Status

Vanderbilt-Ingram Cancer Center

Nashville, Tennessee, United States

Site Status

Baptist Hospital

Nashville, Tennessee, United States

Site Status

Texas Cancer Center at Brackenridge Hospital

Austin, Texas, United States

Site Status

Zale Lipshy University Hospital

Dallas, Texas, United States

Site Status

Simmons Cancer Center - Dallas

Dallas, Texas, United States

Site Status

St. Paul University Hospital

Dallas, Texas, United States

Site Status

Baylor University Medical Center

Dallas, Texas, United States

Site Status

University of Texas Medical Branch

Galveston, Texas, United States

Site Status

University of Texas - MD Anderson Cancer Center

Houston, Texas, United States

Site Status

Ben Taub General Hospital

Houston, Texas, United States

Site Status

Methodist Hospital

Houston, Texas, United States

Site Status

Joe Arrington Cancer Research and Treatment Center

Lubbock, Texas, United States

Site Status

Huntsman Cancer Institute

Salt Lake City, Utah, United States

Site Status

Latter Day Saints Hospital

Salt Lake City, Utah, United States

Site Status

Cancer Center at the University of Virginia

Charlottesville, Virginia, United States

Site Status

Carilion New River Valley Medical Center

Christiansburg, Virginia, United States

Site Status

Inova Fairfax Hospital

Falls Church, Virginia, United States

Site Status

Carilion Health System - Cancer Center of Western Virginia

Roanoke, Virginia, United States

Site Status

Columbia Lewis-Gale Medical Center

Salem, Virginia, United States

Site Status

University of Washington Medical Center

Seattle, Washington, United States

Site Status

University of Wisconsin Comprehensive Cancer Center

Madison, Wisconsin, United States

Site Status

Aurora Sinai Medical Center

Milwaukee, Wisconsin, United States

Site Status

St. Luke's Medical Center

Milwaukee, Wisconsin, United States

Site Status

Froedtert Memorial Lutheran Hospital

Milwaukee, Wisconsin, United States

Site Status

Peter MacCallum Cancer Institute

East Melbourne, Victoria, Australia

Site Status

Cork University Hospital

Cork, , Ireland

Site Status

St. Vincent's University Hospital

Dublin, , Ireland

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States Australia Ireland

References

Explore related publications, articles, or registry entries linked to this study.

Olson JA Jr, McCall LM, Beitsch P, Whitworth PW, Reintgen DS, Blumencranz PW, Leitch AM, Saha S, Hunt KK, Giuliano AE; American College of Surgeons Oncology Group Trials Z0010 and Z0011. Impact of immediate versus delayed axillary node dissection on surgical outcomes in breast cancer patients with positive sentinel nodes: results from American College of Surgeons Oncology Group Trials Z0010 and Z0011. J Clin Oncol. 2008 Jul 20;26(21):3530-5. doi: 10.1200/JCO.2007.15.5630.

Reference Type BACKGROUND
PMID: 18640934 (View on PubMed)

Hunt KK, Ballman KV, McCall LM, Boughey JC, Mittendorf EA, Cox CE, Whitworth PW, Beitsch PD, Leitch AM, Buchholz TA, Morrow MA, Giuliano AE. Factors associated with local-regional recurrence after a negative sentinel node dissection: results of the ACOSOG Z0010 trial. Ann Surg. 2012 Sep;256(3):428-36. doi: 10.1097/SLA.0b013e3182654494.

Reference Type RESULT
PMID: 22868365 (View on PubMed)

Giuliano AE, Hawes D, Ballman KV, Whitworth PW, Blumencranz PW, Reintgen DS, Morrow M, Leitch AM, Hunt KK, McCall LM, Abati A, Cote R. Association of occult metastases in sentinel lymph nodes and bone marrow with survival among women with early-stage invasive breast cancer. JAMA. 2011 Jul 27;306(4):385-93. doi: 10.1001/jama.2011.1034.

Reference Type RESULT
PMID: 21791687 (View on PubMed)

Wilke LG, Ballman KV, McCall LM, Giuliano AE, Whitworth PW, Blumencranz PW, Reintgen DS, Burak WE, Leitch AM, Hunt KK. Adherence to the National Quality Forum (NQF) breast cancer measures within cancer clinical trials: a review from ACOSOG Z0010. Ann Surg Oncol. 2010 Aug;17(8):1989-94. doi: 10.1245/s10434-010-0980-9. Epub 2010 Mar 23.

Reference Type RESULT
PMID: 20309640 (View on PubMed)

Wilke LG, McCall LM, Posther KE, Whitworth PW, Reintgen DS, Leitch AM, Gabram SG, Lucci A, Cox CE, Hunt KK, Herndon JE 2nd, Giuliano AE. Surgical complications associated with sentinel lymph node biopsy: results from a prospective international cooperative group trial. Ann Surg Oncol. 2006 Apr;13(4):491-500. doi: 10.1245/ASO.2006.05.013. Epub 2006 Mar 2.

Reference Type RESULT
PMID: 16514477 (View on PubMed)

Leitch AM, Beitsch PD, McCall LM, Posther K, Newman LA, Herndon JE 2nd, Hunt KK, Giuliano AE. Patterns of participation and successful patient recruitment to American College of Surgeons Oncology Group Z0010, a phase II trial for patients with early-stage breast cancer. Am J Surg. 2005 Oct;190(4):539-42. doi: 10.1016/j.amjsurg.2005.06.024.

Reference Type RESULT
PMID: 16164916 (View on PubMed)

Posther KE, McCall LM, Blumencranz PW, Burak WE Jr, Beitsch PD, Hansen NM, Morrow M, Wilke LG, Herndon JE 2nd, Hunt KK, Giuliano AE. Sentinel node skills verification and surgeon performance: data from a multicenter clinical trial for early-stage breast cancer. Ann Surg. 2005 Oct;242(4):593-9; discussion 599-602. doi: 10.1097/01.sla.0000184210.68646.77.

Reference Type RESULT
PMID: 16192820 (View on PubMed)

Katz MS, McCall L, Ballman K, Jagsi R, Haffty BG, Giuliano AE. Nomogram-based estimate of axillary nodal involvement in ACOSOG Z0011 (Alliance): validation and association with radiation protocol variations. Breast Cancer Res Treat. 2020 Apr;180(2):429-436. doi: 10.1007/s10549-020-05555-z. Epub 2020 Feb 10.

Reference Type DERIVED
PMID: 32043193 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

GUMC-00152

Identifier Type: -

Identifier Source: secondary_id

CDR0000067017

Identifier Type: REGISTRY

Identifier Source: secondary_id

ACOSOG-Z0010

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.