Duct Endoscopy in Assessing Cellular Atypia in the Breast Duct Fluid of Women With a Genetic Risk for Breast Cancer

NCT ID: NCT00082979

Last Updated: 2013-08-26

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

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE2

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2003-10-31

Brief Summary

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RATIONALE: Diagnostic procedures, such as breast duct endoscopy, may improve the ability to detect breast cancer earlier and plan more effective treatment.

PURPOSE: This phase II trial is studying how well breast duct endoscopy works in assessing cellular atypia (abnormal cells) in the breast ducts of women with a genetic risk for breast cancer.

Detailed Description

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OBJECTIVES:

Primary

* Correlate cell yield and morphology findings from ductal lavage with duct endoscopy findings and any subsequent surgical pathology findings in high-risk women with BRCA1, BRCA2, or p53 gene mutations who have cellular atypia.
* Determine the prevalence of occult breast cancer in patients with cellular atypia undergoing duct endoscopy.

Secondary

* Determine patient acceptance of duct endoscopy.
* Perform immunohistochemical analysis (including estrogen receptor, progesterone receptor, HER2-neu receptor, epidermal growth factor receptor, p53, and proliferation marker expression) for markers potentially associated with breast cancer in these patients.
* Determine potential molecular markers of malignancy by gene methylation, gene expression, and proteomics in these patients.

OUTLINE: Patients undergo nipple aspiration to identify productive ducts and collect fluid for tumor marker assessment followed by ductal lavage over 15 minutes. Patients undergo duct endoscopy over approximately 30 minutes under local anesthesia. If no abnormality is found, duct endoscopy is repeated in 6 months. If the repeat duct endoscopy is normal, patients continue to undergo nipple aspiration or ductal lavage as specified in protocols RMNHS-2242 and RMNHS-2269. If an abnormality is found during either the initial or repeat duct endoscopy, patients may undergo further assessment comprising imaging or biopsy and/or appropriate surgical intervention.

Fluid is analyzed for tumor markers by immunohistochemistry. Candidate genes are analyzed by gene methylation studies, gene expression arrays, and proteomic analysis.

Patients are followed for at least 5 years.

PROJECTED ACCRUAL: A total of 45-60 patients will be accrued for this study within 2 years.

Conditions

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Breast Cancer

Keywords

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breast cancer

Study Design

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Primary Study Purpose

DIAGNOSTIC

Interventions

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cytogenetic analysis

Intervention Type GENETIC

proteomic profiling

Intervention Type GENETIC

cytology specimen collection procedure

Intervention Type OTHER

immunohistochemistry staining method

Intervention Type OTHER

laboratory biomarker analysis

Intervention Type OTHER

breast duct lavage

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

DISEASE CHARACTERISTICS:

* Diagnosis of cellular atypia in nipple aspirate or ductal lavage fluid
* Enrollment on RMNHS-2242 or RMNHS-2269 required
* No inflammatory breast cancer
* Hormone receptor status:

* Not specified

PATIENT CHARACTERISTICS:

Age

* 18 to 64

Sex

* Female

Menopausal Status

* Any status

Performance status

* Not specified

Life expectancy

* Not specified

Hematopoietic

* Not specified

Hepatic

* Not specified

Renal

* Not specified

Other

* No prior allergy to eutectic mixture of local anesthetics (EMLA®) cream or lidocaine
* No severe illness that would preclude study participation
* No mental illness or handicap that would preclude study compliance
* No active infection or inflammation in the breast being studied
* No nursing within the past 12 months
* Not pregnant
* Not unconscious

PRIOR CONCURRENT THERAPY:

Biologic therapy

* Not specified

Chemotherapy

* Not specified

Endocrine therapy

* No prior tamoxifen

Radiotherapy

* Not specified

Surgery

* No prior subareolar surgery (e.g., papilloma resections, biopsies, or fine needle aspirations) or any other surgery that may disrupt the ductal systems within 2 cm of the nipple

* Biopsies and fine needle aspirations \> 2 cm from the nipple are allowed
* No prior breast implantation on proposed lavage side

Other

* No prior chemopreventative agents
Minimum Eligible Age

18 Years

Maximum Eligible Age

64 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Royal Marsden NHS Foundation Trust

OTHER

Sponsor Role lead

Principal Investigators

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Gerald Gui, MD, MS, FRCS(Edin), FRCS(Eng)

Role:

Royal Marsden NHS Foundation Trust

Locations

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Royal Marsden - London

London, England, United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Facility Contacts

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Gerald Gui, MD, MS, FRCS(Edin), FRCS(Eng)

Role: primary

Other Identifiers

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RMNHS-2282

Identifier Type: -

Identifier Source: secondary_id

EU-20351

Identifier Type: -

Identifier Source: secondary_id

CDR0000361751

Identifier Type: -

Identifier Source: org_study_id