Therapeutic Nipple Sparing Mastectomy.

NCT ID: NCT02311959

Last Updated: 2024-12-24

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

PHASE3

Total Enrollment

450 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-02-09

Study Completion Date

2024-12-04

Brief Summary

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This is a phase III, multicentric, single arm study with a sequential design using the exact conditional Poisson test.

The primary objective of this prospective study is to evaluate whether selected breast carcinoma patients could be treated with nipple sparing mastectomy (NSM) with an acceptable low local recurrence rates.

450 patients will be included over a period of 4 years and will be followed for a 5 years period (twice a year).

All patients must have a complete preoperative evaluation (bilateral mammography, bilateral breast ultrasonography +/- MRI), and a histopathological diagnostic proof of carcinoma (invasive or in situ, all histopathological types, first treatment or relapse).

The study procedure is represented by nipple areola skin-sparing mastectomy followed by immediate breast reconstruction.

After surgery, early and late complications, including specific complications (suffering of the nipple-areolar complexe and suffering of the skin flaps), will be evaluate.

An esthetic evaluation (by patient and clinician) and a quality of life evaluation will be realized throughout the study.

A complementary study, prospective, non-interventional, will be proposed to patients who will benefit from the same surgical technique (NSM) followed by immediate reconstruction, but in the context of preventive surgery (prophylactic surgery for patients mutated or high genetic risk). The aim of this complementary study, which will include a maximum of 60 patients, is to evaluate associated morbidity in prophylactic NSM.

Data will be collected over a 3 months period after surgery.

Detailed Description

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Conditions

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Breast Cancer

Keywords

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Breast Invasive carcinoma In situ carcinoma Mastectomy Nipple areola Reconstruction Local recurrence

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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Invasive or in situ breast carcinoma.

Group Type EXPERIMENTAL

Nipple sparing mastectomy

Intervention Type PROCEDURE

Standardized surgical procedure by :

* Nipple sparing mastectomy with nipple core histopathology.
* Immediate breast reconstruction (flap and/or implant).
* +/- lymph node evaluation (sentinel node procedure or axillary dissection).

Interventions

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Nipple sparing mastectomy

Standardized surgical procedure by :

* Nipple sparing mastectomy with nipple core histopathology.
* Immediate breast reconstruction (flap and/or implant).
* +/- lymph node evaluation (sentinel node procedure or axillary dissection).

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patient with invasive breast carcinoma stage T1 or T2 and / or in situ (any histological type) proved on histopathological diagnosis.
* Patient with an indication of total mastectomy.
* Patient without preoperative indication of adjuvant radiotherapy according to regional and / or national guidelines.
* Disease located more than 2 cm from the nipple after complete clinical and radiologic breast evaluation (mammography, ultrasound +/- MRI).
* Initial breast cancer or recurrence.
* Patient wishing to receive immediate breast reconstruction.
* WHO performance \< or = 2.
* Patient older than 40 years.
* For patients of childbearing age, use an effective contraceptive methods for the duration of the study.
* For patients of childbearing potential, negative pregnancy test available before inclusion.
* Patient affiliated to a social health insurance in France.
* Patient who signed informed consent before enrollment in the study and before any specific procedure for the study.

Exclusion Criteria

* Positive node on physical examination or proved by cytology.
* Combination of 2 predictive factors of postoperative radiotherapy : macroscopic multifocal, grade 2 or 3, vascular emboli, overexpressed HER2 (human epidermal growth factor receptor-2), triple negative (Estrogen Receptor, Progesterone Receptor and HER2 negative).
* Neoadjuvant treatment for the current disease.
* Patient with bilateral breast cancer.
* Paget disease.
* T3 or T4 carcinoma.
* Metastatic breast cancer (disease staging realized according to national or regional guidelines).
* Breast hypertrophy requiring a nipple support flap.
* Nursing or pregnant woman.
* Patient participating in any other interventional clinical study.
* Any psychological, familial, geographic or social situation not to comply with medical monitoring and/or procedures in the study protocol.
* Patient protected by law.
Minimum Eligible Age

40 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Institut Paoli-Calmettes

OTHER

Sponsor Role collaborator

Institut Claudius Regaud

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Eva JOUVE, Md.

Role: PRINCIPAL_INVESTIGATOR

IUCT-O

Locations

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Centre Hospitalier de Blois

Blois, , France

Site Status

Institut Bergonie

Bordeaux, , France

Site Status

Pôle santé Léonard de Vinci

Chambray-lès-Tours, , France

Site Status

Centre Georges Francois Leclerc

Dijon, , France

Site Status

Hôpital privé Drôme Ardèche

Guilherand-Granges, , France

Site Status

Clinique du Mail

La Rochelle, , France

Site Status

Centre Hospitalier Universitaire Grenoble Alpes

La Tronche, , France

Site Status

Clinique Saint Amé

Lambres-lez-Douai, , France

Site Status

Hopital de Levallois-Perret

Levallois-Perret, , France

Site Status

Centre Oscar Lambret

Lille, , France

Site Status

Centre Leon Berard

Lyon, , France

Site Status

Hôpital de la Croix Rousse

Lyon, , France

Site Status

Institut Paoli Calmettes

Marseille, , France

Site Status

Clinique Clementville

Montpellier, , France

Site Status

Centre Hospitalier Universitaire de Montpellier

Montpellier, , France

Site Status

Institut Du Cancer de Montpellier

Montpellier, , France

Site Status

Centre Antoine LACASSAGNE

Nice, , France

Site Status

Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris

Paris, , France

Site Status

Ap-Hp - Hopital Tenon

Paris, , France

Site Status

CHRU Lyon Sud

Pierre-Bénite, , France

Site Status

Centre Hospitalier de Poitiers

Poitiers, , France

Site Status

Centre Eugène Marquis

Rennes, , France

Site Status

Centre Henri Becquerel

Rouen, , France

Site Status

Clinique Mathilde

Rouen, , France

Site Status

Hôpital René Huguenin

Saint-Cloud, , France

Site Status

Clinique Mutualiste Chirurgicale

Saint-Etienne, , France

Site Status

Hôpital Privé de la Loire

Saint-Etienne, , France

Site Status

Etablissement Rennais du Sein - CHP St Grégoire

Saint-Grégoire, , France

Site Status

INSTITUT DE CANCEROLOGIE DE L'OUEST - Site René Gauducheau

Saint-Herblain, , France

Site Status

Institut Claudius Regaud

Toulouse, , France

Site Status

Clinique Saint Jean

Toulouse, , France

Site Status

Institut de Cancerologie de Lorraine

Vandœuvre-lès-Nancy, , France

Site Status

Institut Gustave Roussy

Villejuif, , France

Site Status

Countries

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France

References

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Filleron T, Lusque A, Dalenc F, Ferron G, Roche H, Martinez A, Jouve E. Alternative methodological approach to randomized trial for surgical procedures routinely used. Contemp Clin Trials. 2018 May;68:109-115. doi: 10.1016/j.cct.2018.03.016. Epub 2018 Mar 30.

Reference Type DERIVED
PMID: 29608972 (View on PubMed)

Other Identifiers

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14 SEIN 10

Identifier Type: -

Identifier Source: org_study_id