Injection Methods in Finding the Sentinel Lymph Node During Lymphatic Mapping and Sentinel Lymph Node Biopsy in Patients With Invasive Breast Cancer

NCT ID: NCT00438477

Last Updated: 2012-07-30

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

COMPLETED

Clinical Phase

NA

Total Enrollment

74 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-06-30

Study Completion Date

2008-04-30

Brief Summary

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RATIONALE: Diagnostic procedures, such as lymphoscintigraphy using an injection under the nipple or near the tumor, may help doctors find out how far the disease has spread.

PURPOSE: This clinical trial is studying two different injection methods to compare how well they find the sentinel lymph node during lymphatic mapping and sentinel lymph node biopsy in patients with invasive breast cancer.

Detailed Description

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OBJECTIVES:

* Compare subareolar injection with peritumoral injection in identifying the sentinel node during breast lymphatic mapping in patients with invasive breast cancer.
* Compare the lymphatic drainage patterns using lymphoscintigraphy of the breast with subareolar injection vs peritumoral injection.

OUTLINE: At least 2 days before scheduled surgery, patients receive technetium Tc 99m sulfur colloid by peritumoral injection followed by lymphoscintigraphy. Images are obtained at 30 minutes and after 2 and 3 hours, provided no drainage is noted. Patients then receive technetium Tc 99m sulfur colloid by subareolar injection followed by another lymphoscintigraphy.

At the time of surgery, patients receive isosulfan blue by subareolar injection. A handheld gamma probe is used to locate the sentinel node. If the sentinel node is identified, it is excised and the scheduled breast surgery is performed. If the sentinel node cannot be identified, patients undergo the scheduled breast surgery.

PROJECTED ACCRUAL: A total of 100 patients will be accrued for this study within 12.5 months.

Conditions

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Breast Cancer

Keywords

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recurrent breast cancer stage IIIA breast cancer stage IIIB breast cancer stage IIIC breast cancer stage II breast cancer

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Injection Methods

One injection site with radioactive tracer intraparenchymal/peritumoral (around the tumor), and other subareolar (around the nipple)

Group Type EXPERIMENTAL

Isosulfan Blue

Intervention Type DRUG

At time of surgery, breast injected with 3-5 cc of isosulfan blue in subareolar or peritumoral position.

Lymphangiography

Intervention Type PROCEDURE

2 lymphoscintigraphy images performed following peritumoral and subareolar injection of breast

Technetium Tc 99m sulfur colloid

Intervention Type RADIATION

At least 2 days before scheduled surgery, receive technetium Tc 99m sulfur colloid by peritumoral injection; and again the day before surgery by subareolar injection.

At the time of surgery, patients receive isosulfan blue by subareolar injection.

Interventions

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Isosulfan Blue

At time of surgery, breast injected with 3-5 cc of isosulfan blue in subareolar or peritumoral position.

Intervention Type DRUG

Lymphangiography

2 lymphoscintigraphy images performed following peritumoral and subareolar injection of breast

Intervention Type PROCEDURE

Technetium Tc 99m sulfur colloid

At least 2 days before scheduled surgery, receive technetium Tc 99m sulfur colloid by peritumoral injection; and again the day before surgery by subareolar injection.

At the time of surgery, patients receive isosulfan blue by subareolar injection.

Intervention Type RADIATION

Other Intervention Names

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lymphazurin

Eligibility Criteria

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Inclusion Criteria

1. Patients must have either pathologic, radiologic or clinical evidence of breast cancer with invasion, suspicious for invasion or microinvasion.
2. Patients who are candidates for a total mastectomy or segmental mastectomy or axillary dissection.
3. Patients who have undergone neoadjuvant chemotherapy who have an FNA confirmed lymph node positive for metastatic disease prior to induction chemotherapy and are then found to have grossly palpable disease but are ultrasound node negative at time of study entry.
4. Patients must sign an informed consent and be registered before the procedure is performed.

Exclusion Criteria

1. A pregnancy test will be required preoperatively in women of childbearing potential and patients who are pregnant will be excluded from this study.
2. Patients who have undergone neoadjuvant chemotherapy who have an FNA confirmed lymph node metastatic disease prior to induction chemotherapy and are then found to have grossly suspicious palpable disease and are ultrasound node positive at the time of study entry.
3. Patients with known allergy to isosulfan blue dye or any related compounds.
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

M.D. Anderson Cancer Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Gildy V. Babiera, MD

Role: STUDY_CHAIR

M.D. Anderson Cancer Center

Ebrahim Delpassand, MD

Role: STUDY_CHAIR

M.D. Anderson Cancer Center

Locations

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M. D. Anderson Cancer Center at University of Texas

Houston, Texas, United States

Site Status

Countries

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United States

Related Links

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http://www.mdanderson.org

UT MD Anderson Cancer Center Website

Other Identifiers

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P30CA016672

Identifier Type: NIH

Identifier Source: secondary_id

View Link

MDA-ID-01538

Identifier Type: OTHER

Identifier Source: secondary_id

CDR0000355838

Identifier Type: REGISTRY

Identifier Source: secondary_id

ID01-538

Identifier Type: -

Identifier Source: org_study_id