Axillary Reverse Mapping in Preventing Lymphedema in Patients With Breast Cancer Undergoing Axillary Lymph Node Dissection
Purpose
This phase III trial studies how well axillary reverse mapping works in preventing lymphedema in patients with breast cancer undergoing axillary lymph node dissection. Axillary reverse mapping may help to preserve the lymph node drainage system around the breast so as to prevent lymphedema after surgery.
Conditions
- Breast Cancer Stage I
- Breast Cancer Stage II
- Breast Cancer Stage III
Eligibility
- Eligible Ages
- Over 18 Years
- Eligible Genders
- Female
- Accepts Healthy Volunteers
- No
Criteria
Inclusion Criteria:
- Documentation of Disease: cT1-3 patients undergoing axillary surgery who additionally
meet one of the following conditions:
- Clinically node negative patients undergoing mastectomy and sentinel lymph node
biopsy (SLNB) with possible axillary lymph node dissection (ALND) if SLNB is
positive. If ALND is performed during a separate operation, ARM procedure must be
repeated. Clinically node negative is defined by i) negative clinical exam and/or
ii) negative axillary US and/or iii) negative needle biopsy of sonographically
suspicious axillary nodes as applicable to each case.
- Clinically node positive patients as determined by needle biopsy and planned for
ALND regardless of type of breast surgery.
- Patients will be staged according to the TNM staging system.
- Prior Treatment: No prior axillary surgery except needle biopsy or concurrent SLNB.
o Prior neoadjuvant chemotherapy is allowed but must be completed at least 2 weeks
before registration.
- No prior history of ipsilateral breast cancer (invasive or ductal breast carcinoma in
situ [DCIS]). Lobular breast carcinoma in situ (LCIS) and benign disease are allowed.
(May have neoadjuvant chemotherapy which must be completed 2 weeks before
registration).
- No bilateral invasive breast cancer.
- No matted nodes.
- No history of lymphedema of either arm.
- No known allergies blue dyes, including make-up containing blue dye.
- In order to complete the mandatory patient-completed measures, participants must be
able to speak and/or read English.
- Female :
Men are excluded from this study because the number of men with breast cancer is
insufficient to provide a statistical basis for assessment of effects in this subpopulation
of people with breast cancer.
- Eastern Cooperative Oncology Group (ECOG) performance status 0, 1 or 2.
- Creatinine: =< 1.5 x upper limit of normal (ULN).
Study Design
- Phase
- Phase 3
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel Assignment
- Primary Purpose
- Prevention
- Masking
- None (Open Label)
Arm Groups
| Arm | Description | Assigned Intervention |
|---|---|---|
|
Active Comparator Group I (ALND) |
Patients receive isosulfan blue SC and undergo ALND. |
|
|
Experimental Group II (ARM, ALND) |
Patients undergo ARM. Patients then receive isosulfan blue and undergo ALND as in Group I. |
|
Recruiting Locations
Little Rock, Arkansas 72205
Site Public Contact
501-686-8274
La Jolla, California 92093
Martinez, California 94553-3156
Site Public Contact
925-957-5400
Santa Monica, California 90404
Site Public Contact
310-582-7448
Frankford, Delaware 19945
Newark, Delaware 19713
Newark, Delaware 19718
Rehoboth Beach, Delaware 19971
Coral Gables, Florida 33146
Site Public Contact
305-243-2647
Deerfield Beach, Florida 33442
Site Public Contact
305-243-2647
Fort Lauderdale, Florida 33308
Site Public Contact
954-267-7748
Gainesville, Florida 32610
Jacksonville, Florida 32207
Site Public Contact
904-202-7468
Jacksonville, Florida 32224-9980
Site Public Contact
855-776-0015
Miami, Florida 33136
Site Public Contact
305-243-2647
Miami, Florida 33176
Site Public Contact
305-243-2647
Orlando, Florida 32806
Plantation, Florida 33324
Site Public Contact
305-243-2647
Fayetteville, Georgia 30214
Chicago, Illinois 60612
Oak Lawn, Illinois 60453-2699
Site Public Contact
800-323-8622
Goshen, Indiana 46526
Kansas City, Kansas 66160
Overland Park, Kansas 66211
Westwood, Kansas 66205
Annapolis, Maryland 21401
Clinton Township, Michigan 48038
Detroit, Michigan 48202
West Bloomfield, Michigan 48322
Camden, New Jersey 08103
Site Public Contact
856-325-6757
Somerville, New Jersey 08876
East Hills, New York 11548
New York, New York 10032
Rochester, New York 14623
Rochester, New York 14642
Site Public Contact
585-275-5830
West Islip, New York 11795
Site Public Contact
631-376-4444
Chapel Hill, North Carolina 27599
Winston-Salem, North Carolina 27157
Site Public Contact
336-713-6771
Akron, Ohio 44307
Beachwood, Ohio 44122
Chardon, Ohio 44024
Cincinnati, Ohio 45219
Cleveland, Ohio 44106
Cleveland, Ohio 44195
Columbus, Ohio 43210
Columbus, Ohio 43213
Mentor, Ohio 44060
Middleburg Heights, Ohio 44130
Parma, Ohio 44129
Ravenna, Ohio 44266
Sandusky, Ohio 44870
Wadsworth, Ohio 44281
West Chester, Ohio 45069
Westlake, Ohio 44145
Westlake, Ohio 44145
Oklahoma City, Oklahoma 73104
Philadelphia, Pennsylvania 19104
Philadelphia, Pennsylvania 19104
Site Public Contact
800-474-9892
Philadelphia, Pennsylvania 19107
Site Public Contact
800-789-7366
Pittsburgh, Pennsylvania 15232
Site Public Contact
412-647-8073
Providence, Rhode Island 02905
Site Public Contact
401-274-1122
Angleton, Texas 77515
Conroe, Texas 77384
Dallas, Texas 75235
Dallas, Texas 75390
Galveston, Texas 77555-0565
Houston, Texas 77030
Houston, Texas 77030
Houston, Texas 77079
League City, Texas 77573
League City, Texas 77573
Site Public Contact
800-917-8906
Sugar Land, Texas 77478
Richmond, Virginia 23235
Richmond, Virginia 23298
Issaquah, Washington 98029
Seattle, Washington 98122-4307
Brookfield, Wisconsin 53045
Grafton, Wisconsin 53024
Green Bay, Wisconsin 54311
Milwaukee, Wisconsin 53215
Milwaukee, Wisconsin 53233
Wauwatosa, Wisconsin 53226
West Allis, Wisconsin 53227
More Details
- NCT ID
- NCT03927027
- Status
- Recruiting
- Sponsor
- Alliance for Clinical Trials in Oncology
Detailed Description
PRIMARY OBJECTIVES: I. To determine the occurrence of post-surgery lymphedema by conical geometric measures in clinical T1-3, N0-3, M0 breast cancer patients undergoing axillary surgery and randomized to Group 1 (no axillary reverse mapping [ARM]) versus Group II (ARM). SECONDARY OBJECTIVES: I. To compare between the study groups the lymphedema symptom intensity and distress as measured by the Lymphedema Symptom Intensity and Distress Survey-Arm (LSIDS-A). II. To evaluate the technical success of performance of ARM procedure: Identification of ARM lymphatics, and the ability to spare or reapproximate ARM lymphatics. III. To compare the rate of regional recurrence between patients randomized to receive ARM versus no ARM. EXPLORATORY OBJECTIVES: I. To assess the occurrence of lymphedema as a function of radiotherapy use and targets. OUTLINE: Patients are randomized to 1 of 2 groups. GROUP I: Patients receive isosulfan blue subcutaneously (SC) and undergo axillary lymph node dissection (ALND). GROUP II: Patients undergo ARM. Patients then receive isosulfan blue and undergo ALND as in Group I. After completion of study, patients are followed up for 3 years.