Prospective Surveillance for Breast Cancer-Related Lymphedema (PROTECT)
Prospective Surveillance for Breast Cancer-Related Lymphedema: A Randomized Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Design and setting: This trial is a multi-center single-blind trial involving five hospitals in Denmark.
Procedure: All women booked for surgery for breast cancer at one of the study sites will be invited to participate. Women, who provide written informed consent, will have BIS measurements, and perform self-measurements of arm circumference. Further, participants will complete a sociodemographic questionnaire which will be used to ensure recruitment of a representable sample. This data will be collected at the hospital of surgery at pre-treatment. After surgery, women who had >6 lymph nodes removed and have planned radiation therapy will be randomized 1:1 into intervention or control.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Bolette S Rafn, PhD
- Phone Number: +45 22913873
- Email: bolette.skjoedt.rafn@regionh.dk
Study Contact Backup
- Name: Christoffer Johansen, Professor
- Phone Number: +45 26169014
- Email: christoffer.johansen@regionh.dk
Study Locations
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-
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Copenhagen, Denmark, 2100
- Copenhagen University Hospital Rigshospitalet
-
Herlev, Denmark
- Herlev Hospital
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Odense, Denmark
- Odense University Hospital
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- female;
- ≥18 years;
- surgery for breast cancer (unilateral and bilateral) including ALDN with >6 lymph nodes removed;
- can effectively communicate verbally in Danish;
Exclusion Criteria:
- surgery for breast cancer with SLNB or < 6 nodes removed;
- pre-existing lymphedema (primary or secondary);
- previous treatment for breast cancer;
- pace maker;
- conditions known to cause swelling (pregnancy, congestive heart failure, chronic/acute renal disease, cor pulmonale, nephrotic syndrome, nephrosis, liver failure or cirrhosis, pulmonary edema, and thrombophlebitis or deep vein thrombosis in the arms).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Intervention (INT)
INT participants will be asked to perform self-measurements of arm circumference at five points along the arm at home every three months.
Additional measurements can be performed if the participants experience signs of BCRL.
Participants will report the self-measurements in cm and mm in an online questionnaire, or over the phone to a physiotherapist navigator, along with reporting sign and symptoms of BCRL.
|
A participant with an increase from pre-surgery in total arm volume of ≥6% by self-measurement, or symptoms of BCRL ≥2 NRS will receive an assessment by a lymphedema therapist.
At this appointment, participants will receive a physical examination of the arm along with a BIS measurement.
A participant is considered having subclinical BCRL if an increase in lymphedema index (L-DEX) ≥7 from pre-surgery measured by BIS is identified.
A fitted compression garment and gauntlet is then provided, free of charge, for daily wear 10 hours/day for four weeks along with a recommendation to use the arm for daily activities and maintain regular physical activity.
Following the four-week compression period, participants will be re-measured using BIS to evaluate response.
Participants who do not respond to compression will receive CDT delivered by the lymphedema therapist.
|
|
No Intervention: Control (CON)
The CON group will follow the usual post-operative care.
CON participants will be prompted every 6 months by an online questionnaire to report if they have been diagnosed with BCRL and if so, month of initiation of treatment.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Prevalence of chronic lymphedema
Time Frame: At 24 months post-surgery
|
A binary outcome (y/n) defined as BIS ≥10 from pre-surgery or outside normal range ±10
|
At 24 months post-surgery
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Time-to-treatment
Time Frame: INT group: will be collected throughtout the study period. CON group: at 6, 12, 18 and 24 months post-surgery
|
INT group: The time (weeks) from surgery to first elevated L-DEX score which triggers immediate treatment along with time (weeks) to resolution of BCRL from diagnosis.
For CON: time from surgery to BCRL diagnosis, time from diagnosis to BCRL treatment, and time from initiation to termination of treatment
|
INT group: will be collected throughtout the study period. CON group: at 6, 12, 18 and 24 months post-surgery
|
|
Health-related quality of life
Time Frame: pre-treatment, 6, 12, 18 and 24 months post-surgery
|
This will be measured by the EQ-5D questionnaire
|
pre-treatment, 6, 12, 18 and 24 months post-surgery
|
|
Arm function
Time Frame: pre-treatment, 6, 12, 18 and 24 months post-surgery
|
This will be measured by the QuickDASH questionnaire
|
pre-treatment, 6, 12, 18 and 24 months post-surgery
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- PROTECT
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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