Sentinel Lymph Node Biopsy With Hybrid Technique in Breast Cancer

NCT ID: NCT04274946

Last Updated: 2020-02-19

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

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-01-01

Study Completion Date

2025-01-01

Brief Summary

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Sentinel lymph node (SLN) biopsy is the gold standard method to stage axilla in breast cancer. The aim of the study is to compare the efficiency of various methods to identify SLN is breast cancer patients.

Detailed Description

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Various markers has been used for SLN biopsy including isosulfan blue (patent blue), indocyanine green (ICG), radioisotope colloid (RAIC) and ultrasound (US) with several advantages and disadvantages. In this study investigators designed an algorithm using the combination of mapping with patent blue, ICG, RAIC and US to compare the accurate identification of SLN in breast cancer patients. The protocol is based on the hypothesis that identification rate of SLN is increased with multiple agents. Patent blue and ICG provides visual guidance. The combination of dyes with sonographic and RAIC method have the potential to prevent obstacles and ensure better outcomes as an identification strategy.

Patent blue provides visual identification of the SLN. ICG fluorescence can be detected percutaneously and by means of fluorescence imaging system in real time. RAI has several advantages, but disadvantages as well, like cost and invisibility. RAI can only be detected and confirmed by means of sound and numerical value through gamma probe. All breast cancer patients underwent axillary ultrasound before SLNB with different mapping combinations. The determination of abnormal axillary lymph node was followed by ultrasound-guided FNA cytology of these nodes. The sonographic abnormality criteria of the nodes were defined as; completely hypoechoic node, asymmetric focal hypoechoic node, cortical lobulation more than 3, cortical thickness \>2mm, totally spheric appearance, absence of fatty hilum and compromise of normal vascularity (hypervascularization from various poles). Patients with negative results of FNA would undergo SLNB. Lymphatic mapping was performed with abovementioned dyes and radioactive colloid. Before the incising for SLNB real time intraoperative US was performed and suspicious axillary lymph nodes were seen by ultrasound guidance. In the SLNB operation, radioactive or dyed nodes and sonographically suspicious nodes were removed and labeled separately for pathological examination.

Conditions

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Breast Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Prospective, single-center, randomized study.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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RAI+PB+US

Sentinel lymph node mapping with dual tracer (radioisotope and patent blue) and intraoperative ultrasound to identify SLN in the breast cancer patients

Group Type ACTIVE_COMPARATOR

Sentinel lymph node biopsy

Intervention Type PROCEDURE

Sentinel lymph node biopsy(SLNB) procedure with different mapping methods using combination of radioactive colloid, patent blue, indocyanine green associated with intraoperative ultrasound.

RAI+ICG+US

Sentinel lymph node mapping with dual tracer (radioisotope and ICG) and intraoperative ultrasound to identify SLN in the breast cancer patients

Group Type EXPERIMENTAL

Sentinel lymph node biopsy

Intervention Type PROCEDURE

Sentinel lymph node biopsy(SLNB) procedure with different mapping methods using combination of radioactive colloid, patent blue, indocyanine green associated with intraoperative ultrasound.

RAI+PB+ICG+US

Sentinel lymph node mapping with triple tracer (radioisotope,ICG and patent blue) and intraoperative ultrasound to identify SLN in the breast cancer patients

Group Type EXPERIMENTAL

Sentinel lymph node biopsy

Intervention Type PROCEDURE

Sentinel lymph node biopsy(SLNB) procedure with different mapping methods using combination of radioactive colloid, patent blue, indocyanine green associated with intraoperative ultrasound.

PB+ICG+US

Sentinel lymph node mapping with triple tracer (ICG and patent blue) and intraoperative ultrasound to identify SLN in the breast cancer patients

Group Type EXPERIMENTAL

Sentinel lymph node biopsy

Intervention Type PROCEDURE

Sentinel lymph node biopsy(SLNB) procedure with different mapping methods using combination of radioactive colloid, patent blue, indocyanine green associated with intraoperative ultrasound.

Interventions

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Sentinel lymph node biopsy

Sentinel lymph node biopsy(SLNB) procedure with different mapping methods using combination of radioactive colloid, patent blue, indocyanine green associated with intraoperative ultrasound.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Histologically confirmed primary breast cancer by core needle, incisional or excisional biopsy
* cN0 patients
* In patients with abnormal axillary lymph nodes sonographically US-guided FNA cytology of these nodes were performed and FNA cytology negative patients planed to undergo SLNB with different mapping techniques.

Exclusion Criteria

* Patients with neoadjuvant therapy
* Patients with pathological diagnosed ductal carcinoma in situ by excisional biopsy
* Patients with pathologically proven axillary disease
* Patients with T4d tumor
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Bulent Ecevit University

OTHER

Sponsor Role lead

Responsible Party

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Guldeniz Karadeniz Cakmak

Head of General Surgery Departmet

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Güldeniz Karadeniz Cakmak, MD

Role: STUDY_CHAIR

Bülent Ecevit University Department of Surgery

Rabiye Uslu Erdemir, MD

Role: STUDY_DIRECTOR

Bülent Ecevit University Department of Nucleer Medicine

Hakan Bakkal, MD

Role: PRINCIPAL_INVESTIGATOR

Bülent Ecevit University Department of Radiation Oncology

Hüseyin Engin, MD

Role: PRINCIPAL_INVESTIGATOR

Bülent Ecevit University Department of Clinical Oncology

Locations

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Bülent Ecevit University

Zonguldak, , Turkey (Türkiye)

Site Status RECRUITING

Countries

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Turkey (Türkiye)

Central Contacts

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Guldeniz Karadeniz Cakmak, MD

Role: CONTACT

05323371860

Facility Contacts

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guldeniz karadeniz cakmak

Role: primary

05323371860

Other Identifiers

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2019-09-09

Identifier Type: -

Identifier Source: org_study_id

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