Thoracoscopic Sentinel Lymph Node Biopsy in Patients With Stage I or Stage II Breast Cancer

NCT ID: NCT00450723

Last Updated: 2017-02-07

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

39 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-05-31

Study Completion Date

2011-03-31

Brief Summary

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RATIONALE: Diagnostic procedures, such as thoracoscopic sentinel lymph node biopsy, may help find breast cancer that has spread to lymph nodes between the breasts. It may also help doctors plan the best treatment.

PURPOSE: This clinical trial is studying how well thoracoscopic sentinel lymph node biopsy finds sentinel lymph nodes that are located between the breasts in patients with stage I or stage II breast cancer.

Detailed Description

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OBJECTIVES:

* Determine the occurrence rate of internal mammary sentinel lymph nodes in patients with medially or centrally located stage I or II breast cancer.
* Determine the safety, feasibility, and success rate of thorascopic internal mammary sentinel lymph node biopsy in these patients.
* Determine the rate of metastatic disease in internal mammary sentinel lymph nodes obtained thoracoscopically in these patients.

OUTLINE: Patients undergo standard axillary sentinel lymph node dissection during surgery (i.e., lumpectomy or mastectomy). Patients receive a radioactive tracer (i.e., technetium Tc 99m sulfur colloid) and isosulfan blue by peritumoral injection for identification of the axillary and internal mammary sentinel lymph nodes (IMSLN). Identified axillary sentinel lymph nodes are dissected. Identified IMSLNs are removed through the lumpectomy/mastectomy incision, if accessible. If they are not accessible, patients undergo thorascopic IMSLN biopsy to remove the nodes.

All removed sentinel lymph nodes (axillary or internal mammary) are examined for gross and microscopic carcinoma for future therapy planning.

PROJECTED ACCRUAL: A total of 50 patients will be accrued for this study.

Conditions

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Breast Cancer

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Sentinel Lymph Node Biopsy

Group Type EXPERIMENTAL

Isosulfan blue

Intervention Type DRUG

Administered pre-surgery; injection of 2 cc of Isosulfan Blue in four equal aliquots of 0.5 cc as routinely done for the axillary sentinel node procedure.

Axillary Lymph Node Dissection

Intervention Type PROCEDURE

Axillary Lymph Node Dissection

Surgery

Intervention Type PROCEDURE

The surgery will be performed under general anesthesia with a single lumen endo-tracheal tube. The patient will be laid in a semi decubitus position on the opposite side with the ipsilateral arm bent over the head and attached to an arm rest.

Sentinel Lymph Node Biopsy

Intervention Type PROCEDURE

Sentinel Lymph Node Biopsy

Thoracoscopic Surgery

Intervention Type PROCEDURE

Performed only if internal mammary sentinel node cannot be retrieved via same incision of lumpectomy/mastectomy.

Technetium Tc 99m Sulfur Colloid

Intervention Type RADIATION

Two to three hours prior to surgery, a peritumoral injection of filtered Technetium Sulfur Colloid will be performed in four 0.25 mci/2cc aliquots

Interventions

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Isosulfan blue

Administered pre-surgery; injection of 2 cc of Isosulfan Blue in four equal aliquots of 0.5 cc as routinely done for the axillary sentinel node procedure.

Intervention Type DRUG

Axillary Lymph Node Dissection

Axillary Lymph Node Dissection

Intervention Type PROCEDURE

Surgery

The surgery will be performed under general anesthesia with a single lumen endo-tracheal tube. The patient will be laid in a semi decubitus position on the opposite side with the ipsilateral arm bent over the head and attached to an arm rest.

Intervention Type PROCEDURE

Sentinel Lymph Node Biopsy

Sentinel Lymph Node Biopsy

Intervention Type PROCEDURE

Thoracoscopic Surgery

Performed only if internal mammary sentinel node cannot be retrieved via same incision of lumpectomy/mastectomy.

Intervention Type PROCEDURE

Technetium Tc 99m Sulfur Colloid

Two to three hours prior to surgery, a peritumoral injection of filtered Technetium Sulfur Colloid will be performed in four 0.25 mci/2cc aliquots

Intervention Type RADIATION

Other Intervention Names

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Lymphazurin

Eligibility Criteria

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Inclusion Criteria

DISEASE CHARACTERISTICS:

* Histologically confirmed breast cancer

* Stage I or II disease (T1-T2, N0, M0/MX disease)

* No chest wall invasion by tumor (T3 disease)
* Medially or centrally located lesion
* No multicentric disease

* Multifocal disease allowed
* No clinically positive axillary nodes
* No enlarged internal mammary nodes by CT scan
* Hormone receptor status not specified

PATIENT CHARACTERISTICS:

* Male or female
* Menopausal status not specified
* American Society of Anesthesiologists (ASA) physical status classification 1-2
* Not pregnant or nursing
* Negative pregnancy test
* No other concurrent known, invasive malignancy
* No known chronic pulmonary disease
* No known allergy to methylene blue or isosulfan blue

PRIOR CONCURRENT THERAPY:

* No prior thoracic or cardiac surgery
* No prior ipsilateral chest tube placement

* Contralateral chest tube placement allowed
* No prior neoadjuvant chemotherapy
* No prior radiotherapy to the mediastinum
Minimum Eligible Age

18 Years

Maximum Eligible Age

120 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Miami

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Eli Avisar, MD

Role: STUDY_CHAIR

University of Miami Sylvester Comprehensive Cancer Center

Locations

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University of Miami Sylvester Comprehensive Cancer Center - Miami

Miami, Florida, United States

Site Status

Countries

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United States

References

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Avisar E, Molina MA, Scarlata M, Moffat FL. Internal mammary sentinel node biopsy for breast cancer. Am J Surg. 2008 Oct;196(4):490-4. doi: 10.1016/j.amjsurg.2008.06.003. Epub 2008 Aug 23.

Reference Type RESULT
PMID: 18723148 (View on PubMed)

Other Identifiers

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SCCC-2003161

Identifier Type: OTHER

Identifier Source: secondary_id

WIRB-20050911

Identifier Type: OTHER

Identifier Source: secondary_id

20040015

Identifier Type: -

Identifier Source: org_study_id

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