Breast Cancer: Axillary Conservation After Neoadjuvant Chemotherapy in Micro Metastatic Sentinel Lymph Nodes.

NCT ID: NCT04019678

Last Updated: 2021-04-19

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 850 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2019-06-21
• Study Completion Date: 2027-06-21

Brief Summary

Italian multicentric non inferiority clinical study to verify whether the omission of axillary lymph node intervention in patients with SLN (Sentinel Lymph Nodes) ypN1mi after NAC (Neo Adiuvant Chemotherapy) does not lead to a significant deterioration in survival or in the risk of regional or distant recurrence, compared to patients with negative SLN (SLN ypN0) after NAC ,where the omission of axillary treatment is currently the standard treatment.

Detailed Description

The study includes patients with cN+ positive axillary lymph nodes at initial diagnosis and who also have negative clinical and instrumental evaluation after NAC. Based on the sentinel lymph nodes definitive histological evaluation patients are allocated in one of the 2 comparison groups (Group 1 experimental or Group 2 standard) or in Group 3 internal control group. Group 3 is not used in statistical comparison with the other two groups but it's aim is to evaluate the appropriateness of the cases.

Referring to bio-pathologic characteristics after surgery patients will receive:

• no further treatment
• complementary radiotherapy
• adjuvant medical therapy (hormonal therapy and/or biological therapy)

Irradiation:

Group 1 (experimental) and Group 2 (standard): irradiation won't be performed neither in the axillary region nor in the other lymph node stations

Group 3 (internal control): after conservative or radical surgery, patients will be subjected to loco-regional irradiation according to Guidelines.

Duration:

Patients enrollment in the study protocol will last for 3 years. Patients will have to be followed for the subsequent 5 years during which they will have to undergo to periodic visits and follow-up checks provided for by the current standard guidelines:

• clinical examination every six months for the first 5 years
• mammography and breast ultrasound yearly
• axillary ultrasound yearly

Conditions

Breast Cancer

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: OTHER
• Blinding Strategy: NONE

Study Groups

Group 1: experimental

patients with micro metastatic sentinel lymph node and/or parasentinella lymph node (ypN1mi). Axillary dissection is not performed.

Group Type: EXPERIMENTAL

Omission of Axillary dissection

Intervention Type: PROCEDURE

In Group 1 and 2: Axillary dissection won't be performed

Group 2: standard

patients with negative sentinel lymph node (ypN0) or with ITC finding (ypN0 / YpN0 (i +)). Axillary dissection is not performed as standard treatment.

Group Type: ACTIVE_COMPARATOR

Omission of Axillary dissection

Intervention Type: PROCEDURE

In Group 1 and 2: Axillary dissection won't be performed

Interventions

Omission of Axillary dissection

In Group 1 and 2: Axillary dissection won't be performed

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

1. Age: 18 ≤75 years

2. Breast carcinoma with infiltrating histotype

3. Tumor size: cT1 - cT2 - cT3

4. Positive axillary lymph nodes (cN +) at the initial diagnosis by clinical, ultrasound and cyto-microhistology evaluation

5. Neoadjuvant chemotherapy performed

6. Negative axillary lymph nodes (cN-) from the NAC by clinical and ultrasound assessment

7. Absence of distant metastases (M0)

8. Negative medical history for previous infiltrating breast cancer

Exclusion Criteria

1. Current pregnancy or lactation status

2. Inflammatory breast cancer

3. In situ breast cancer

4. Synchronous contralateral breast cancer

5. Co-morbidity and/or medical disorder precluding any adjuvant therapy

6. Co-morbidity and/or medical/mental disorder making impossible making a regular follow-up

7. Other cancers in the previous 3 years (except forcarcinoma in situ of the uterine cervix, basalioma, squamous cell carcinoma or non-melanoma skin cancer)

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 75 Years
• Eligible Sex: FEMALE
• Accepts Healthy Volunteers: No

Sponsors

Istituto Clinico Humanitas

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Corrado Tinterri, MD

Role: PRINCIPAL_INVESTIGATOR

Istituto Clinico Humanitas

Locations

Istituto Clinico Humanitas

Rozzano, MI, Italy

Site Status: RECRUITING

Countries

Italy

Central Contacts

Corrado Tinterri, MD

Role: CONTACT

corrado.tinterri@cancercenter.humanitas.it

+390282244012

Facility Contacts

Corrado Tinterri, MD

Role: primary

corrado.tinterri@cancercenter.humanitas.it

+390282244012

Other Identifiers

651

Identifier Type: -

Identifier Source: org_study_id