Breast Lymph Node Mapping

This study is not yet open for participant recruitment. (see Contacts and Locations)
Verified February 2013 by University of British Columbia
Sponsor:
Information provided by (Responsible Party):
University of British Columbia
ClinicalTrials.gov Identifier:
NCT01038908
First received: December 22, 2009
Last updated: February 12, 2013
Last verified: February 2013
  Purpose

The purpose of this study is to map the arm lymphatic drainage system in the axilla with blue dye and the breast drainage system with a radioactive material. By identifying the arm lymphatics they can be protected during surgery and this may decrease the occurrence of lymphedema. The information obtained in this study may provide us with better surgical techniques to identify and protect the arm lymphatic drainage system in the axilla.


Condition Intervention Phase
Breast Cancer
Other: Isosulfan Blue (Patent Blue Dye V)
Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: Open Label
Official Title: Axillary Reverse Mapping in Breast Cancer

Resource links provided by NLM:


Further study details as provided by University of British Columbia:

Primary Outcome Measures:
  • Map arm lymphatic drainage system in the axilla [ Time Frame: 4 years ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Decrease the occurrence of lymphedema [ Time Frame: 4 years ] [ Designated as safety issue: No ]

Estimated Enrollment: 100
Study Start Date: June 2013
Estimated Study Completion Date: June 2014
Estimated Primary Completion Date: June 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: 1
Each patient will receive an injection of technetium-99m sulfur colloid directed subareolar or around the tumor. The material will be prepared as per manufacturer's specifications. The dose will be 20mBq given the same day of 80mBq given the day before. The Nuclear Medicine Department at St Paul's Hospital will perform the injection as per normal sentinel lymph node mapping protocol.
Other: Isosulfan Blue (Patent Blue Dye V)
  1. Inject radioactive isotope and scan for sentinel node (SLN) using gamma probe
  2. Pre-incision: SLN is identified
  3. Inject blue dye into patient's arm
  4. Complete procedure (SLNB and/or ALND)
Active Comparator: 2
Each patient will receive an injection of technetium-99m sulfur colloid directed subareolar or around the tumor. The material will be prepared as per manufacturer's specifications. The dose will be 20mBq given the same day of 80mBq given the day before. The Nuclear Medicine Department at St Paul's Hospital will perform the injection as per normal sentinel lymph node mapping protocol.
Other: Isosulfan Blue (Patent Blue Dye V)
  1. Inject radioactive isotope and scan for sentinel node (SLN) using gamma probe
  2. Pre-incision: SLN is not identified (No localization)
  3. Inject blue dye into breast (nothing in arm)

i. No localization: Inject blue dye into arm and perform ALND ii. Localization: Complete procedure (SLNB and/or ALND)


Detailed Description:

This study is a non-randomized Phase II study of the Axillary Reverse Mapping (ARM) procedure for patients presenting with breast cancer requiring lymph node evaluation. The study will enroll 100 subjects, and will have two study arms: one for patients requiring only the SLNB procedure (roughly 67% of enrollees), and one for patients requiring a full ALND (roughly 33% of enrollees). For the analysis of study efficacy, each arm will be compared to its procedure-appropriate historical control for evidence of decrease in the 1-year lymphedema rate among patients undergoing SLNB or ALND.

Additional data will be collected on the treatment population's (a) variability in location of arm lymphatics, and (b) incidence of SLN crossover with arm lymphatics, along with success-rate data for identifying SLNs and arm lymphatics during SLNB and/or ALND. This additional data will add to our level of knowledge and experience regarding lymph node surgery.

  Eligibility

Ages Eligible for Study:   19 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. 19-100 years old
  2. Not pregnant or breastfeeding
  3. Breast cancer requiring LN evaluation for the breast
  4. Willing participation following an informed consent process

Exclusion Criteria:

  1. Patient < 19 y/o or > 100 y/o
  2. Pregnant or breastfeeding
  3. Allergy to blue dye
  4. Locally advanced axillary disease
  5. History of receiving neoadjuvant chemotherapy treatment
  6. Prior axillary surgery or radiation therapy
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01038908

Contacts
Contact: Sam Wiseman, MD, FRCSC, FACS 604-806-9108 smwiseman@providencehealth.bc.ca

Locations
Canada, British Columbia
Mount Saint Joseph's Hospital Not yet recruiting
Vancouver, British Columbia, Canada
Contact: Sam Wiseman, MD, FRCSC, FACS    604-806-9108    smwiseman@providencehealth.bc.ca   
St. Paul's Hospital Not yet recruiting
Vancouver, British Columbia, Canada
Contact: Sam Wiseman, MD, FRCSC, FACS    604-806-9108    smwiseman@providencehealth.bc.ca   
Sponsors and Collaborators
University of British Columbia
Investigators
Principal Investigator: Sam Wiseman, MD, FRCSC, FACS University of British Columbia
Study Director: Urve Kuusk, MD, FRCSC University of British Columbia
Study Director: Carolyne Dingee, MD,FRCSC University of British Columbia
Study Director: Elaine McKevitt, MD, FRCSC University of British Columbia
  More Information

No publications provided

Responsible Party: University of British Columbia
ClinicalTrials.gov Identifier: NCT01038908     History of Changes
Other Study ID Numbers: H09-00926
Study First Received: December 22, 2009
Last Updated: February 12, 2013
Health Authority: Canada: Health Canada

Keywords provided by University of British Columbia:
sentinel lymph node biopsy (SLNB)
axillary lymph node dissection (ALND)
lymphatics
blue dye

Additional relevant MeSH terms:
Breast Neoplasms
Neoplasms by Site
Neoplasms
Breast Diseases
Skin Diseases

ClinicalTrials.gov processed this record on August 21, 2014