MUltimodal Targeted Axillary Surgery

NCT ID: NCT04039893

Last Updated: 2021-10-15

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

160 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-10-23

Study Completion Date

2022-11-15

Brief Summary

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The present trial will prospectively evaluate the accuracy of both a systematic predefined axillary ultrasound imaging together with tumor load quantification of suspicious and sentinel axillary lymph nodes to predict overall tumor load in the axilla.

Detailed Description

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Axillary node clearance (ANC) is a controversial intervention in the surgical treatment of breast cancer. Different studies have shown that in some patients with infiltrated axillary lymph nodes but low tumor burden, ANC can be safely omitted. However, indications for ANC persist in nowadays for patients with positive axillary lymph nodes and upfront surgery and patients with positive lymph nodes after neoadjuvant treatment. The present prospective study will evaluate the ability to establish an axillary tumor load with two steps. The first step will be a preoperative predefined systematic axillary ultrasound imaging workflow. The second step will be the tumor load evaluation of suspicious and sentinel axillary lymph nodes. We will also evaluate which patients have infiltrated nodes only beneath the second intercostobrachial nerve. The trial intends to identify patients for who a complete axillary node clearance could be spared.

Conditions

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Node-positive 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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Node-positive breast cancer patients

All patients with positive lymph nodes for who an axillary node clearance is proposed as part of the surgical treatment

Group Type OTHER

Systematic axillary ultrasound imaging

Intervention Type DIAGNOSTIC_TEST

Before surgery, all patients will be explored with a pre-defined systematic and reproducible axillary ultrasound imaging workflow intending to establish the number of neoplastic lymph nodes.

Sentinel node

Intervention Type DIAGNOSTIC_TEST

Sentinel nodes will be identified with a radioisotope tracer and blue dye or fluorescein.

Excision of suspicious lymph nodes

Intervention Type PROCEDURE

Nodes suspected to be infiltrated both by physical exploration and/or ultrasound will be excised and evaluated separately.

Two steps axillary node clearance

Intervention Type PROCEDURE

Axillary node clearance will be performed in two steps comprising inferior and superior clearance. The second intercostobrachial nerve will be considered the limit defining the border between superior and inferior axilla.

Interventions

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Systematic axillary ultrasound imaging

Before surgery, all patients will be explored with a pre-defined systematic and reproducible axillary ultrasound imaging workflow intending to establish the number of neoplastic lymph nodes.

Intervention Type DIAGNOSTIC_TEST

Sentinel node

Sentinel nodes will be identified with a radioisotope tracer and blue dye or fluorescein.

Intervention Type DIAGNOSTIC_TEST

Excision of suspicious lymph nodes

Nodes suspected to be infiltrated both by physical exploration and/or ultrasound will be excised and evaluated separately.

Intervention Type PROCEDURE

Two steps axillary node clearance

Axillary node clearance will be performed in two steps comprising inferior and superior clearance. The second intercostobrachial nerve will be considered the limit defining the border between superior and inferior axilla.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Node-positive breast cancer patients confirmed by biopsy or cytology
* Positivity confirmed before the surgical treatment

Exclusion Criteria

* Inability to confirm positive lymph nodes by biopsy or cytology
* Inability to understand the protocol design
* Poor understanding of the Spanish language
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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GEICAM

UNKNOWN

Sponsor Role collaborator

Parc de Salut Mar

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Maria Vernet-Tomas, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Parc de Salut Mar

Locations

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Hospital del Mar

Barcelona, , Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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Maria Vernet-Tomas, MD, PhD

Role: CONTACT

34932483132

Facility Contacts

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Eli Fite Collet

Role: primary

References

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Vernet-Tomas M, Banos N, Sabadell D, Corominas JM, Mestre-Fusco A, Suarez-Pinera M, Carreras R. p53 expression in breast cancer predicts tumors with low probability of non-sentinel nodes infiltration. J Obstet Gynaecol Res. 2015 Jul;41(7):1115-21. doi: 10.1111/jog.12670. Epub 2015 Feb 6.

Reference Type BACKGROUND
PMID: 25657069 (View on PubMed)

Nicolau P, Gamero R, Rodriguez-Arana A, Plancarte F, Alcantara R, Carreras R, Sabadell D, Vernet-Tomas M. Imaging and pathology features to predict axillary tumor load in breast cancer. J Obstet Gynaecol Res. 2018 Feb;44(2):331-336. doi: 10.1111/jog.13490. Epub 2017 Oct 13.

Reference Type BACKGROUND
PMID: 29027318 (View on PubMed)

Other Identifiers

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2018/8361/I

Identifier Type: -

Identifier Source: org_study_id