Sentinel Node Biopsy in Breast Cancner: Omission of Axillary Clearance After Micrometastasis

NCT ID: NCT02049632

Last Updated: 2023-03-10

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

805 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-12-31

Study Completion Date

2022-12-31

Brief Summary

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Sentinel node (SN) biopsy in breast cancer has been demonstrated to be a reliable method, and several follow-up studies have shown that it is safe to refrain from completion axillary clearance (axillary lymph node dissection, ALND) in SN-negative patients. SN biopsy alone results in significantly less arm discomfort following the operation.

However, as a surprisingly low frequency of axillary relapse has been observed in patients without any axillary intervention (neither SN biopsy nor axillary clearance), or without completion ALND after a positive SN biopsy, the importance of ALND is being questioned, even for patients with SN metastases. A large, randomized study (ISBCG23-1) was not able to show any differences in 5-year disease-free survival between patients with SN micrometastases who had undergone ALND and those who had not.

This Swedish multicenter study will include patients with SN micrometastases. These women will not undergo ALND but will be registered in a study cohort. The patients will otherwise be treated in accordance with the national guidelines and will be clinically followed every year for five years, after 10 years and finally after 15 years. Hypothesis: To refrain from axillary clearance in breast cancer patients with sentinel node micrometastases does not impair survival.

Detailed Description

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From April 2017 onwards, only patients operated by mastectomy or those receiving neoadjuvant therapy and having a sentinel node biopsy before its initiation may be recruited into SENOMIC. The inclusion target has been met for those patients operated by breast-conserving therapy, and from now on, these patients will not be included in SENOMIC anymore. Recruitment of the above-mentioned patient selection will continue until 452 patients operated by mastectomy have been enrolled.

Conditions

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Breast Cancer

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Omission of axillary clearance

No axillary lymph node dissection after sentinel node biopsy and sentinel node micrometastases

Group Type EXPERIMENTAL

Omission of axillary clearance

Intervention Type PROCEDURE

Interventions

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Omission of axillary clearance

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients with clinically node-negative, invasive breast cancer ≤ 5 cm (T1-T2)
* Histopathology results demonstrate SN micrometastases.
* Patients who undergo mastectomy (protocol change from April 2017 onwards)
* The patient must have given verbal and written consent.

Exclusion Criteria

* Preoperatively diagnosed lymph node metastases.
* Sentinel node metastases \> 2 mm.
* Metastases beyond the ipsilateral axillary lymph nodes at the time of surgery.
* History of previous breast cancer.
* Pregnancy.
* Medical contraindication for systemic adjuvant therapy
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Centrallasarettet Västerås

OTHER

Sponsor Role collaborator

Uppsala University

OTHER

Sponsor Role collaborator

Karolinska Institutet

OTHER

Sponsor Role lead

Responsible Party

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Jana de Boniface

MD, PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jana M de Boniface, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Karolinska Institutet

Jan Frisell, Professor

Role: PRINCIPAL_INVESTIGATOR

Karolinska Institutet

Leif Bergkvist, Professor

Role: PRINCIPAL_INVESTIGATOR

Uppsala University

Yvette Andersson, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Västmanlands Hospital

Locations

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Sahlgrenska University Hospital

Gothenburg, , Sweden

Site Status

Helsingborgs Hospital

Helsingborg, , Sweden

Site Status

Kalmar Hospital

Kalmar, , Sweden

Site Status

Karlskrona Hospital

Karlskrona, , Sweden

Site Status

Kristianstad Hospital

Kristianstad, , Sweden

Site Status

Lidköping Hospital

Lidköping, , Sweden

Site Status

Linköping University Hospital

Linköping, , Sweden

Site Status

Lund and Malmö University Hospital

Lund, , Sweden

Site Status

Örebro University Hospital

Örebro, , Sweden

Site Status

Skövde Hospital

Skövde, , Sweden

Site Status

Karolinska University Hospital

Stockholm, , Sweden

Site Status

Capio St Görans Hospital

Stockholm, , Sweden

Site Status

Danderyds Hospital AB

Stockholm, , Sweden

Site Status

Southern General Hospital

Stockholm, , Sweden

Site Status

Sundsvall Hospital

Sundsvall, , Sweden

Site Status

Uddevalla Hospital

Uddevalla, , Sweden

Site Status

Umeå University Hospital

Umeå, , Sweden

Site Status

Akademiska Universitetssjukhuset

Uppsala, , Sweden

Site Status

Varberg Hospital

Varberg, , Sweden

Site Status

Växjö Hospital

Vaxjo, , Sweden

Site Status

Västmanlands Hospital

Västerås, , Sweden

Site Status

Västervik Hospital

Västervik, , Sweden

Site Status

Countries

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Sweden

Other Identifiers

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SENOMIC

Identifier Type: -

Identifier Source: org_study_id

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