A Study on Predicting the Risk of Distant Metastasis in Breast Cancer Using AI-Generated Spatial Pathological Maps

NCT ID: NCT07244094

Last Updated: 2025-11-24

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

NOT_YET_RECRUITING

Total Enrollment

400 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-11-15

Study Completion Date

2027-03-07

Brief Summary

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The goal of this observational study is to develop and validate an artificial intelligence (AI) model for predicting the risk of distant metastasis in patients with primary breast cancer. The main question it aims to answer is:

Can a multimodal AI model, trained on routinely available histopathological images, accurately predict the long-term risk of breast cancer metastasis?

Researchers will analyze existing hematoxylin and eosin (H\&E) and immunohistochemistry (IHC) stained tissue slides from patients who underwent surgery between 2015 and 2025. Clinical data will be used to train the AI model and evaluate its performance in predicting metastasis.

Detailed Description

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Conditions

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Breast Cancer

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

RETROSPECTIVE

Study Groups

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Patients with primary breast cancer who have experienced distant metastasis outcomes within 5 years

Diagnostic Test: AI-Based Spatial Pathomic Analysis

Intervention Type OTHER

This is an observational study with no therapeutic or procedural interventions. The "intervention" refers to the analytical method applied to existing data. Archived tissue samples (H\&E and IHC stained slides) will be digitally scanned and analyzed by a multimodal artificial intelligence (AI) model to develop a risk prediction tool for distant metastasis. Patients' clinical data will be collected for model training and validation. No direct interaction with patients occurs, and no treatment decisions are influenced by this study.

Patients with primary breast cancer who have not experienced distant metastasis for at least 5 years

Diagnostic Test: AI-Based Spatial Pathomic Analysis

Intervention Type OTHER

This is an observational study with no therapeutic or procedural interventions. The "intervention" refers to the analytical method applied to existing data. Archived tissue samples (H\&E and IHC stained slides) will be digitally scanned and analyzed by a multimodal artificial intelligence (AI) model to develop a risk prediction tool for distant metastasis. Patients' clinical data will be collected for model training and validation. No direct interaction with patients occurs, and no treatment decisions are influenced by this study.

Interventions

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Diagnostic Test: AI-Based Spatial Pathomic Analysis

This is an observational study with no therapeutic or procedural interventions. The "intervention" refers to the analytical method applied to existing data. Archived tissue samples (H\&E and IHC stained slides) will be digitally scanned and analyzed by a multimodal artificial intelligence (AI) model to develop a risk prediction tool for distant metastasis. Patients' clinical data will be collected for model training and validation. No direct interaction with patients occurs, and no treatment decisions are influenced by this study.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Female patients aged 18 years or older.
2. Histologically confirmed primary invasive breast carcinoma.
3. Underwent curative surgical resection (mastectomy or breast-conserving surgery) between January 2015 and December 2025.
4. Before initiating the neoadjuvant therapy, there was a retention of the primary tumor specimen.
5. Availability of high-quality, digitizable Hematoxylin and Eosin (H\&E) stained whole-slide images (WSIs).
6. Availability of consecutive tissue sections from the same tumor block for multiplex immunohistochemistry (mIHC) staining (including markers such as Pan-CK, CD3, CD20).
7. Complete clinicopathological data and follow-up information must be available, including but not limited to: TNM stage, histological grade, molecular subtype (ER, PR, HER2 status), adjuvant treatment records, and clearly documented distant metastasis-free survival (DMFS) data.
8. A minimum follow-up of 5 years for patients with detailed information for distant metastasis events.

Exclusion Criteria

1. Pure ductal carcinoma in situ (DCIS) without an invasive component.
2. Special histological subtypes of invasive carcinoma (e.g., metaplastic carcinoma) with distinct biological behaviors.
3. No original lesion samples were retained before neoadjuvant therapy.
4. Presence of contralateral breast cancer or a history of any other prior malignancy (except for cured non-melanoma skin cancer or carcinoma in situ of the cervix).
5. H\&E or IHC slides with significant technical artifacts (e.g., fading, folds, heavy knife marks, tissue tearing, uneven staining) that preclude reliable image analysis.
6. Low tumor cellularity (e.g., tumor area \< 10% in the scanned field of view).
7. Unavailable or unalignable consecutive tissue sections, preventing spatial registration of H\&E and mIHC images.
8. Lack of essential clinicopathological or follow-up data required for model training or validation.
Minimum Eligible Age

18 Years

Maximum Eligible Age

95 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Second Affiliated Hospital, School of Medicine, Zhejiang University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Jilin Cancer Hospital

Changchun, Jilin, China

Site Status

Cancer Institute and Hospital, Tianjin Medical University, China

Tianjin, Tianjin Municipality, China

Site Status

2nd Affiliated Hospital, School of Medicine, Zhejiang University, China

Hangzhou, Zhejiang, China

Site Status

The Fourth Affiliated Hospital of Zhejiang University School of Medicine

Hangzhou, Zhejiang, China

Site Status

Countries

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China

Central Contacts

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Jiaojiao Zhou

Role: CONTACT

0571-87784527

Facility Contacts

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Tao Liu

Role: primary

0431-85871915

Xiaojing Guo

Role: primary

022-23537796

Jiaojiao Zhou

Role: primary

0571-87784527

Baizhou Li

Role: primary

0579 89935398

Other Identifiers

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2025-1104

Identifier Type: -

Identifier Source: org_study_id

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