Identification of Sentinel Lymph Nodes Using Indocyanine Green in Breast Cancer Patients

NCT ID: NCT07311278

Last Updated: 2025-12-30

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

NA

Total Enrollment

493 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-06-08

Study Completion Date

2026-10-31

Brief Summary

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This study aims to evaluate the (inter)national implementation of a new diagnostic method for sentinel lymph node (SLN) detection in breast cancer. While Technetium-99m (99mTc) is the current gold standard for SLN detection, it has drawbacks such as limited availability, logistical challenges, radiation exposure, and potential side effects. Extensive research indicates that Indocyanine Green (ICG) is an equally effective and potentially more practical alternative. Conducting this study will help accelerate the implementation of ICG in clinical practice.

Detailed Description

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An important part of oncological treatment for breast cancer is determining the lymph node status. A commonly used method for this is the sentinel lymph node (SLN) procedure. Analysis of this node plays a key role in determining both treatment and prognosis.

Currently, the gold standard for SLN localization is the use of Technetium-99m (99mTc). However, this method has several disadvantages. Since not every hospital has a Nuclear Medicine Department, patients often need to be referred to another facility for 99mTc injection and nuclear imaging. This process can be burdensome for patients and poses logistical challenges when scheduling surgeries. In addition, the use of 99mTc involves exposure to radioactive material, and adverse effects such as allergic reactions have been reported. Recent studies have shown that the use of Indocyanine Green (ICG) is equally effective for sentinel lymph node localization as Technetium.

The aim of this study is to evaluate the national and international implementation process of a new diagnostic method for SLN detection.

Conditions

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Breast Cancer

Keywords

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indocyanine green fluorescence sentinel lymph node biopsy sentinel lymph node mapping sentinel lymph node procedure ICG implementation

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Phase I: pre-implemtation phase

SLN biopsy using single tracer techentium (current standard)

Group Type OTHER

Phase I: Technetium is administered as single tracer to identify the SLN (current standard).

Intervention Type PROCEDURE

During this phase, surgeons will use technetium to identify the SLN as this is the current standard of care. This phase will serve as a control group.

Phase II: transition phase

SLN biopsy using double tracer technetium and ICG (learning curve)

Group Type OTHER

Phase II: SLN biopsy using double tracer technetium and ICG (learning curve)

Intervention Type PROCEDURE

During this phase, surgeons will primarily use ICG to identify the sentinel lymph node (SLN), while technetium will serve as a control. This approach allows surgeons to gain proficiency with ICG-guided SLN biopsy and safely advance through the learning curve.

Phase III: post-implementation phase

SLN biopsy using single tracer ICG (alternative method)

Group Type OTHER

Phase III: ICG is administered as single tracer to identify the SLN (alternative method).

Intervention Type PROCEDURE

During this phase, surgeons will use ICG as a singe tracer to identify the SLN.

Interventions

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Phase I: Technetium is administered as single tracer to identify the SLN (current standard).

During this phase, surgeons will use technetium to identify the SLN as this is the current standard of care. This phase will serve as a control group.

Intervention Type PROCEDURE

Phase II: SLN biopsy using double tracer technetium and ICG (learning curve)

During this phase, surgeons will primarily use ICG to identify the sentinel lymph node (SLN), while technetium will serve as a control. This approach allows surgeons to gain proficiency with ICG-guided SLN biopsy and safely advance through the learning curve.

Intervention Type PROCEDURE

Phase III: ICG is administered as single tracer to identify the SLN (alternative method).

During this phase, surgeons will use ICG as a singe tracer to identify the SLN.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Clinically node-negative, DCIS or invasive breast cancer confirmed by biopsy
* Preoperative axillary ultrasound to confirm clinical node-negative status
* Indication for breast cancer surgery with SLNB via axillar incision
* Written informed consent according to ICH/GCP and national regulations.

Exclusion Criteria

* Patients \< 18 years old.
* Indication for breast cancer surgery with SLNB via mastectomy incision
* Combined MARI procedure
* Known allergy for Indocyanine Green (ICG) or intravenous contrast or iodine
* History of axillary lymph node dissection
* Hyperthyroidism or thyroid cancer
* Pregnancy or breast-feeding
* Psychological, familial, sociological or geographical factors that could potentially hamper compliance with the study protocol
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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St. Antonius Hospital

OTHER

Sponsor Role lead

Responsible Party

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Tessa Dinger

Medical Doctor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Ospedale Pederzoli

Peschiera del Garda, , Italy

Site Status

Jeroen Bosch Ziekenhuis

's-Hertogenbosch, , Netherlands

Site Status

FlevoZiekenhuis

Almere Stad, , Netherlands

Site Status

Antoni van Leeuwenhoek Ziekenhuis

Amsterdam, , Netherlands

Site Status

Reinier de Graaf Gasthuis

Delft, , Netherlands

Site Status

Van Weel-Bethesda Ziekenhuis

Dirksland, , Netherlands

Site Status

Maastricht Universitair Medisch Centrum

Maastricht, , Netherlands

Site Status

Erasmus Medisch Centrum

Rotterdam, , Netherlands

Site Status

HagaZiekenhuis

The Hague, , Netherlands

Site Status

Bernhoven Ziekenhuis

Uden, , Netherlands

Site Status

Isala Ziekenhuis

Zwolle, , Netherlands

Site Status

Countries

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Italy Netherlands

Other Identifiers

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NL79223.100.22

Identifier Type: -

Identifier Source: org_study_id