Duct Endoscopy in Assessing Cellular Atypia in the Breast Duct Fluid of Women With a Genetic Risk for Breast Cancer
Recruitment status was Recruiting
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Purpose
RATIONALE: Diagnostic procedures, such as breast duct endoscopy, may improve the ability to detect breast cancer earlier and plan more effective treatment.
PURPOSE: This phase II trial is studying how well breast duct endoscopy works in assessing cellular atypia (abnormal cells) in the breast ducts of women with a genetic risk for breast cancer.
| Condition | Intervention | Phase |
|---|---|---|
|
Breast Cancer |
Genetic: cytogenetic analysis Genetic: proteomic profiling Other: cytology specimen collection procedure Other: immunohistochemistry staining method Other: laboratory biomarker analysis Procedure: breast duct lavage |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Primary Purpose: Diagnostic |
| Official Title: | Evaluation of the Role of Duct Endoscopy in the Assessment of Cellular Atypia Within Breast Duct Fluid in High-Risk Women Carrying BRCA1/2 or p53 Gene Mutations |
- Comparison of cell yields and morphology from ductal lavage vs the ductal anatomy visualized at duct endoscopy [ Designated as safety issue: No ]
- Prevalence of occult pathology (malignant and benign) as assessed by duct endoscopy on intraduct sampling [ Designated as safety issue: No ]
- Sensitivity and specificity of ductal lavage to duct endoscopy in detecting atypia or malignancy [ Designated as safety issue: No ]
- Comparison of cell yields vs final surgical pathology [ Designated as safety issue: No ]
| Estimated Enrollment: | 60 |
| Study Start Date: | October 2003 |
OBJECTIVES:
Primary
- Correlate cell yield and morphology findings from ductal lavage with duct endoscopy findings and any subsequent surgical pathology findings in high-risk women with BRCA1, BRCA2, or p53 gene mutations who have cellular atypia.
- Determine the prevalence of occult breast cancer in patients with cellular atypia undergoing duct endoscopy.
Secondary
- Determine patient acceptance of duct endoscopy.
- Perform immunohistochemical analysis (including estrogen receptor, progesterone receptor, HER2-neu receptor, epidermal growth factor receptor, p53, and proliferation marker expression) for markers potentially associated with breast cancer in these patients.
- Determine potential molecular markers of malignancy by gene methylation, gene expression, and proteomics in these patients.
OUTLINE: Patients undergo nipple aspiration to identify productive ducts and collect fluid for tumor marker assessment followed by ductal lavage over 15 minutes. Patients undergo duct endoscopy over approximately 30 minutes under local anesthesia. If no abnormality is found, duct endoscopy is repeated in 6 months. If the repeat duct endoscopy is normal, patients continue to undergo nipple aspiration or ductal lavage as specified in protocols RMNHS-2242 and RMNHS-2269. If an abnormality is found during either the initial or repeat duct endoscopy, patients may undergo further assessment comprising imaging or biopsy and/or appropriate surgical intervention.
Fluid is analyzed for tumor markers by immunohistochemistry. Candidate genes are analyzed by gene methylation studies, gene expression arrays, and proteomic analysis.
Patients are followed for at least 5 years.
PROJECTED ACCRUAL: A total of 45-60 patients will be accrued for this study within 2 years.
Eligibility| Ages Eligible for Study: | 18 Years to 64 Years |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
- Diagnosis of cellular atypia in nipple aspirate or ductal lavage fluid
- Enrollment on RMNHS-2242 or RMNHS-2269 required
- No inflammatory breast cancer
Hormone receptor status:
- Not specified
PATIENT CHARACTERISTICS:
Age
- 18 to 64
Sex
- Female
Menopausal Status
- Any status
Performance status
- Not specified
Life expectancy
- Not specified
Hematopoietic
- Not specified
Hepatic
- Not specified
Renal
- Not specified
Other
- No prior allergy to eutectic mixture of local anesthetics (EMLA®) cream or lidocaine
- No severe illness that would preclude study participation
- No mental illness or handicap that would preclude study compliance
- No active infection or inflammation in the breast being studied
- No nursing within the past 12 months
- Not pregnant
- Not unconscious
PRIOR CONCURRENT THERAPY:
Biologic therapy
- Not specified
Chemotherapy
- Not specified
Endocrine therapy
- No prior tamoxifen
Radiotherapy
- Not specified
Surgery
No prior subareolar surgery (e.g., papilloma resections, biopsies, or fine needle aspirations) or any other surgery that may disrupt the ductal systems within 2 cm of the nipple
- Biopsies and fine needle aspirations > 2 cm from the nipple are allowed
- No prior breast implantation on proposed lavage side
Other
- No prior chemopreventative agents
Contacts and Locations| United Kingdom | |
| Royal Marsden - London | Recruiting |
| London, England, United Kingdom, SW3 6JJ | |
| Contact: Gerald Gui, MD, MS, FRCS(Edin), FRCS(Eng) 44-20-7808-2783 gerald.gui@rmh.nhs.uk | |
| Investigator: | Gerald Gui, MD, MS, FRCS(Edin), FRCS(Eng) | Royal Marsden NHS Foundation Trust |
More Information
Additional Information:
No publications provided
| ClinicalTrials.gov Identifier: | NCT00082979 History of Changes |
| Other Study ID Numbers: | CDR0000361751, RMNHS-2282, EU-20351 |
| Study First Received: | May 14, 2004 |
| Last Updated: | June 21, 2011 |
| Health Authority: | Unspecified |
Keywords provided by National Cancer Institute (NCI):
|
breast cancer |
Additional relevant MeSH terms:
|
Breast Neoplasms Neoplasms by Site Neoplasms Breast Diseases Skin Diseases |
ClinicalTrials.gov processed this record on May 16, 2013