Does Immediate Lymphatic Reconstruction Decrease the Risk of Lymphedema After Axillary Lymph Node Dissection

NCT ID: NCT04241341

Last Updated: 2025-11-06

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

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE3

Total Enrollment

180 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-01-22

Study Completion Date

2026-01-31

Brief Summary

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The researchers are doing this study to see if having immediate lymphatic reconstruction after axillary lymph node dissection (ALND) can decrease the development of lymphedema, a side effect of ALND. Other purposes of the study include:

Comparing the approach of immediate lymphatic reconstruction after ALND with the approach of ALND alone Looking at whether having immediate lymphatic reconstruction after ALND improves a person's quality of life Seeing if adding standard of care radiation therapy to either study approach (immediate lymphatic reconstruction after ALND or ALND alone) has an effect on development of lymphedema

Detailed Description

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Conditions

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Breast Cancer Lymphedema

Keywords

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Axillary Lymph Node Dissection Lymphatic Reconstruction 20-021

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Patients will be randomized to one of two groups:

ALND with ILR (intervention group) and ALND without ILR (control group; current standard treatment at Memorial Sloan Kettering \[MSK\]).
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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axillary lymph node dissection with ILR

Group Type EXPERIMENTAL

Axillary Lymph Node Dissection with Immediate Lymphatic Reconstruction

Intervention Type PROCEDURE

Axillary Lymph Node Dissection with Immediate Lymphatic Reconstruction

quality-of-life questionnaires

Intervention Type OTHER

Four validated patient reported outcome measures (PROMs): the Upper Limb Lymphedema-27 (ULL-27), the Quality of Life Measure for Limb Lymphedema (LYMQOL), the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R), and the Beck Anxiety Inventory (BAI). Study participants will undergo standard lymphedema measurements and quality-of-life questionnaires at baseline before ALND and postoperatively at 6 weeks (+/- 30 days) and at 6, 12, 18, and 24 months (+/- 30 days). If patients are unable to complete their questionnaires at the time of their in-office visit, a link to the questionnaires in REDCap will be emailed to them.

measured by arm volume

Intervention Type OTHER

Bilateral arm volumes will be measured with sequential circumferential measurements with the truncated cone formula. If a patient cannot return to Manhattan for these assessments but is seen by a lymphedema therapist in a regional location or at an institution outside of MSK as part of their routine cancer treatment, this data can be used in the final analysis

axillary lymph node dissection (ALND) without ILR

Group Type ACTIVE_COMPARATOR

Axillary Lymph Node Dissection without Immediate Lymphatic Reconstruction

Intervention Type PROCEDURE

Current standard treatment at Memorial Sloan Kettering \[MSK\]).

quality-of-life questionnaires

Intervention Type OTHER

Four validated patient reported outcome measures (PROMs): the Upper Limb Lymphedema-27 (ULL-27), the Quality of Life Measure for Limb Lymphedema (LYMQOL), the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R), and the Beck Anxiety Inventory (BAI). Study participants will undergo standard lymphedema measurements and quality-of-life questionnaires at baseline before ALND and postoperatively at 6 weeks (+/- 30 days) and at 6, 12, 18, and 24 months (+/- 30 days). If patients are unable to complete their questionnaires at the time of their in-office visit, a link to the questionnaires in REDCap will be emailed to them.

measured by arm volume

Intervention Type OTHER

Bilateral arm volumes will be measured with sequential circumferential measurements with the truncated cone formula. If a patient cannot return to Manhattan for these assessments but is seen by a lymphedema therapist in a regional location or at an institution outside of MSK as part of their routine cancer treatment, this data can be used in the final analysis

Interventions

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Axillary Lymph Node Dissection with Immediate Lymphatic Reconstruction

Axillary Lymph Node Dissection with Immediate Lymphatic Reconstruction

Intervention Type PROCEDURE

Axillary Lymph Node Dissection without Immediate Lymphatic Reconstruction

Current standard treatment at Memorial Sloan Kettering \[MSK\]).

Intervention Type PROCEDURE

quality-of-life questionnaires

Four validated patient reported outcome measures (PROMs): the Upper Limb Lymphedema-27 (ULL-27), the Quality of Life Measure for Limb Lymphedema (LYMQOL), the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R), and the Beck Anxiety Inventory (BAI). Study participants will undergo standard lymphedema measurements and quality-of-life questionnaires at baseline before ALND and postoperatively at 6 weeks (+/- 30 days) and at 6, 12, 18, and 24 months (+/- 30 days). If patients are unable to complete their questionnaires at the time of their in-office visit, a link to the questionnaires in REDCap will be emailed to them.

Intervention Type OTHER

measured by arm volume

Bilateral arm volumes will be measured with sequential circumferential measurements with the truncated cone formula. If a patient cannot return to Manhattan for these assessments but is seen by a lymphedema therapist in a regional location or at an institution outside of MSK as part of their routine cancer treatment, this data can be used in the final analysis

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Female breast cancer patients 18-75 years of age
* Patients consenting for unilateral ALND (prior history of SLNBx allowed if \<6 months from consent) OR patients consenting for unilateral SLNBx with possible ALND, with a clinically or radiographically positive lymph node OR a high likelihood of ALND per the Breast Surgeon
* Identification of at least one transected lymphatic channel and at least one vein to be used for bypass at the time of ALND during surgery

Exclusion Criteria

* Male breast cancer patients
* Non-English speaking participants
* Female breast cancer patients with axillary recurrence
* Female breast cancer patients who have a history of ALND
* Female patients requiring bilateral ALND for the treatment of their breast cancer
* Female breast patients treated with SLNBx only
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Memorial Sloan Kettering Cancer Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Michelle Coriddi, MD

Role: PRINCIPAL_INVESTIGATOR

Memorial Sloan Kettering Cancer Center

Locations

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Memorial Sloan Kettering Basking Ridge (Consent and Followup)

Basking Ridge, New Jersey, United States

Site Status

Memorial Sloan Kettering Monmouth (Consent Only)

Middletown, New Jersey, United States

Site Status

Memorial Sloan Kettering Bergen (Consent Only)

Montvale, New Jersey, United States

Site Status

Memorial Sloan Kettering Commack (Consent only)

Commack, New York, United States

Site Status

Memorial Sloan Kettering Westchester (Consent Only)

Harrison, New York, United States

Site Status

Memorial Sloan Kettering Cancer Center

New York, New York, United States

Site Status

Memorial Sloan Kettering Nassau (Consent only)

Uniondale, New York, United States

Site Status

Countries

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United States

Related Links

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http://www.mskcc.org/mskcc/html/44.cfm

Memorial Sloan Kettering Cancer Center

Other Identifiers

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20-021

Identifier Type: -

Identifier Source: org_study_id