Evaluation of Ultrasonic Scissors and Diathermy for Axillary Clearance in Breast Cancer Patients

NCT ID: NCT05901064

Last Updated: 2023-06-13

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

RECRUITING

Clinical Phase

NA

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-01-21

Study Completion Date

2025-12-31

Brief Summary

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Breast surgery plays an important role in the treatment of breast cancer. This study investigates if the use of Harmonic Focus has advantages than the use of conventional diathermy in axillary clearance due to metastatic breast cancer.

Detailed Description

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Breast surgery plays an important role in the treatment of breast cancer. Sometimes cancer cells can spread to lymph nodes in the axill. The first lymph node affected in the armpit is called the sentinel node. Surgery to remove this node can answer the question of whether the cancer has spread to the axill. If the node is affected, further surgery is performed to remove most of the lymph nodes in the armpit, a so-called axillary clereance.

The breast unit at Linköping University Hospital performs about 60 axillary clereance per year. Axillary clereance is associated with a number of complications, such as infections, bleeding, pain, loss of sensation and limited mobility in the arm.

Accumulation of wound fluid in the surgical area is common, affecting about a quarter of patients undergoing surgery. Small amounts of wound fluid usually do not require treatment, but larger accumulations usually require drainage. Patients who have symptoms from armpit wound fluid have to make repeated return visits so that a nurse drains the fluid using a needle. This poses several risks to the patient such as infection and/or bleeding. This, in turn, can delay the start of additional treatment and can put a financial burden on both the patient and the healthcare system.

Today, the investigators use a device with a weak electric current (diathermy) to remove lymph nodes from the armpit. Harmonic Focus ® is a pair of scissors that instead uses ultrasound waves to divide the tissue. There are scientific studies showing that the use of ultrasonic scissors reduces the risk of fluid accumulation and thus the risk of complications after surgery\[1, 2\]. The investigators want to conduct a prospective study, an economic analysis comparing the costs of using diathermy versus Harmonic Focus®.

In addition, patients will complete a quality of life questionnaire before surgery, approximately 4-6 weeks after and one year after surgery. The results of the questionnaires will be compared between the Harmonic Focus® and the diathermy group.

Conditions

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Seroma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Double blinded randomized prospective study
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Caregivers
Neither the patients nor the health care providers know with whitch device (Harmonic Focus or diathermy) the patient will be operated.

Study Groups

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Harmonic Focus

Patients that are operated with Harmonic Focus

Group Type ACTIVE_COMPARATOR

Axillary clearance

Intervention Type PROCEDURE

Evaluating the use of Harmonic Focus in axillary clearance due to metastasis of breast cancer in axilla

Diathermy

Patients that are operated with conventional diathermy

Group Type ACTIVE_COMPARATOR

Axillary clearance

Intervention Type PROCEDURE

Evaluating the use of Harmonic Focus in axillary clearance due to metastasis of breast cancer in axilla

Interventions

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Axillary clearance

Evaluating the use of Harmonic Focus in axillary clearance due to metastasis of breast cancer in axilla

Intervention Type PROCEDURE

Other Intervention Names

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Axillary dissection

Eligibility Criteria

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Inclusion Criteria

* 18 years or older
* All patients who will undergo axillary evacuation
* Informed consent

Exclusion Criteria

* Patients who have previously undergone axillary evacuation.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Linkoeping

OTHER

Sponsor Role lead

Responsible Party

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CLuberth

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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University hospital of Linkoping

Linköping, Östergötland County, Sweden

Site Status RECRUITING

Countries

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Sweden

Facility Contacts

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Carlos Dussan, MD, PhD

Role: primary

+46706390116

Ervin Beka, MD, PhD-student

Role: backup

+46738430968

References

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Bohm D, Kubitza A, Lebrecht A, Schmidt M, Gerhold-Ay A, Battista M, Stewen K, Solbach C, Kolbl H. Prospective randomized comparison of conventional instruments and the Harmonic Focus((R)) device in breast-conserving therapy for primary breast cancer. Eur J Surg Oncol. 2012 Feb;38(2):118-24. doi: 10.1016/j.ejso.2011.11.003. Epub 2011 Dec 5.

Reference Type BACKGROUND
PMID: 22152942 (View on PubMed)

Faisal M, Fathy H, Shaban H, Abuelela ST, Marie A, Khaled I. A novel technique of harmonic tissue dissection reduces seroma formation after modified radical mastectomy compared to conventional electrocautery: a single-blind randomized controlled trial. Patient Saf Surg. 2018 May 17;12:8. doi: 10.1186/s13037-018-0155-3. eCollection 2018.

Reference Type BACKGROUND
PMID: 29796089 (View on PubMed)

Giuliano AE, Hunt KK, Ballman KV, Beitsch PD, Whitworth PW, Blumencranz PW, Leitch AM, Saha S, McCall LM, Morrow M. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA. 2011 Feb 9;305(6):569-75. doi: 10.1001/jama.2011.90.

Reference Type BACKGROUND
PMID: 21304082 (View on PubMed)

Galimberti V, Cole BF, Zurrida S, Viale G, Luini A, Veronesi P, Baratella P, Chifu C, Sargenti M, Intra M, Gentilini O, Mastropasqua MG, Mazzarol G, Massarut S, Garbay JR, Zgajnar J, Galatius H, Recalcati A, Littlejohn D, Bamert M, Colleoni M, Price KN, Regan MM, Goldhirsch A, Coates AS, Gelber RD, Veronesi U; International Breast Cancer Study Group Trial 23-01 investigators. Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases (IBCSG 23-01): a phase 3 randomised controlled trial. Lancet Oncol. 2013 Apr;14(4):297-305. doi: 10.1016/S1470-2045(13)70035-4. Epub 2013 Mar 11.

Reference Type BACKGROUND
PMID: 23491275 (View on PubMed)

de Boniface J, Frisell J, Andersson Y, Bergkvist L, Ahlgren J, Ryden L, Olofsson Bagge R, Sund M, Johansson H, Lundstedt D; SENOMAC Trialists' Group. Survival and axillary recurrence following sentinel node-positive breast cancer without completion axillary lymph node dissection: the randomized controlled SENOMAC trial. BMC Cancer. 2017 May 26;17(1):379. doi: 10.1186/s12885-017-3361-y.

Reference Type BACKGROUND
PMID: 28549453 (View on PubMed)

Sowa Y, Numajiri T, Kawarazaki A, Sakaguchi K, Taguchi T, Nishino K. Preventive effects on seroma formation with use of the harmonic focus shears after breast reconstruction with the latissimus dorsi flap. J Plast Surg Hand Surg. 2016 Dec;50(6):349-353. doi: 10.1080/2000656X.2016.1178129. Epub 2016 May 5.

Reference Type BACKGROUND
PMID: 27146859 (View on PubMed)

Selvendran S, Cheluvappa R, Tr Ng VK, Yarrow S, Pang TC, Segara D, Soon P. Efficacy of harmonic focus scalpel in seroma prevention after axillary clearance. Int J Surg. 2016 Jun;30:116-20. doi: 10.1016/j.ijsu.2016.04.041. Epub 2016 Apr 29.

Reference Type BACKGROUND
PMID: 27142863 (View on PubMed)

Hung SH, Chu D, Chen FM, Chen T, Chen RC. Evaluation of the harmonic scalpel in breast conserving and axillary staging surgery. J Chin Med Assoc. 2012 Oct;75(10):519-23. doi: 10.1016/j.jcma.2012.07.006. Epub 2012 Sep 15.

Reference Type BACKGROUND
PMID: 23089404 (View on PubMed)

He Q, Zhuang D, Zheng L, Fan Z, Zhou P, Zhu J, Lv Z, Chai J, Cao L. Harmonic focus versus electrocautery in axillary lymph node dissection for breast cancer: a randomized clinical study. Clin Breast Cancer. 2012 Dec;12(6):454-8. doi: 10.1016/j.clbc.2012.07.014. Epub 2012 Oct 3.

Reference Type BACKGROUND
PMID: 23040644 (View on PubMed)

Other Identifiers

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LinkoepingU

Identifier Type: -

Identifier Source: org_study_id

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