Role of Axillary Lymph Node Dissection for Residual MACROMETASTASES After NEOADJUVANT Chemotherapy in Patients With HER2+ and Triple Negative Breast Cancer: The OPBC-11/MACRONAC Study (MACRONAC)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Walter P. Weber, Prof. Dr. med.
- Phone Number: +41 61 328 61 49
- Email: walter.weber@usb.ch
Study Contact Backup
- Name: Andy Schneider, PhD
- Phone Number: +41 61 328 42 98
- Email: andy.schneider@usb.ch
Study Locations
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Basel, Switzerland, 4031
- Recruiting
- Department Breast, Abdomen, Pelvis; Universitätsspital Basel
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Contact:
- Walter P. Weber, Prof. Dr. med.
- Phone Number: +41 61 328 61 49
- Email: walter.weber@usb.ch
-
Contact:
- Andy Schneider, PhD
- Email: andy.schneider@usb.ch
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Women and men with a diagnosis of stage I-III TNBC or HER2+ breast cancer at diagnosis. HER2+ is defined as an Immunohistochemistry (IHC) score of 3+ or positive FISH. TNBC is defined as ER and Progesterone Receptor (PR) IHC expression of 0 and HER2 negativity defined as either IHC expression of 0-1+ or lack of gene amplification (FISH < 2.0). Patients with ER low (1-10%) and/or PR low (1-10%) tumors are allowed.
- Any histological subtype
- For Clinical Nodal Stage (cN) 0 at presentation: any axillary staging technique including palpation with or without imaging is allowed. Dual tracer mapping is not required for SLN surgery.
- For cN+ at presentation: Percutaneous biopsy proven confirmation is required at diagnosis. Staging techniques after NAC include: SLN surgery with dual mapping or Targeted Axillary Dissection (TAD: imaging-guided localization of sampled node in combination with SLN procedure with or without dual mapping) or Tailored Axillary Surgery (TAS: removal of the sentinel lymph nodes as well as selective removal of all palpable disease and documentation of the removal of the initially biopsy-proven and clipped lymph node metastasis by specimen radiography) or the MARI procedure (Marking Axillary Lymph Nodes with Iodine Seeds).
- Received neoadjuvant chemotherapy
- Residual macrometastases (metastasis greater than 2 mm in diameter) detected on SLN surgery or TAD ot TAS or MARI (on frozen section or final pathology)
- Concomitant presence of Isolated Tumor Cells (ITCs) and micrometastases in other sentinel lymph nodes is allowed
- Following SLN surgery/TAD/TAS/MARI patients underwent completion ALND, nodal radiation therapy (RT), both or no further axillary treatment
- At least 1-year follow-up (had surgery at any time point until October 2024 at the latest) - Prior history of ductal carcinoma in situ (DCIS) is allowed
Exclusion Criteria:
- Did not undergo SLN surgery/TAD/TAS/MARI (e.g., went straight to ALND)
- Presence of ITCs or micrometastases alone in the sentinel nodes (or TAD nodes or MARI node or TAS nodes) without macrometastases
- HR+HER2- tumors (except ER low and or PR-low)
- Stage IV disease at presentation
- Inflammatory breast cancer at presentation
- Neoadjuvant endocrine therapy
- Macrometastases detected by Oncoplastic Breast Consortium (OSNA)
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Axillary lymph node dissection (ALND) cohort
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All trial data are/ have been collected within the clinical routine between 2013 and October 2024.
All data will be analyzed descriptively using adequate statistical measures and plots.
Clinico-pathological characteristics will be compared between patients treated with and without ALND.
Depending on the median follow-up of both cohorts (ALND, no ALND) the 3-year cumulative incidence rates will be compared between ALND and no ALND.
|
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No Axillary lymph node dissection (ALND) cohort
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All trial data are/ have been collected within the clinical routine between 2013 and October 2024.
All data will be analyzed descriptively using adequate statistical measures and plots.
Clinico-pathological characteristics will be compared between patients treated with and without ALND.
Depending on the median follow-up of both cohorts (ALND, no ALND) the 3-year cumulative incidence rates will be compared between ALND and no ALND.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
3-year rate of any axillary recurrence
Time Frame: 3-year follow-up after diagnosis of stage I-III TNBC or HER2+ breast cancer and SLN surgery/TAD/TAS/MARI
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3-year rate of any axillary recurrence (defined as isolated or combined with local or distant recurrence) in patients with residual macrometastases after NAC overall and by use of axillary dissection.
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3-year follow-up after diagnosis of stage I-III TNBC or HER2+ breast cancer and SLN surgery/TAD/TAS/MARI
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Walter P. Weber, Prof. Dr. med., Department Breast, Abdomen, Pelvis
- Study Director: Giacomo Montagna, MD MPH, Breast Service, Department of Surgery; Memorial Sloan Kettering Cancer Center
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
- Triple Negative Breast Cancer (TNBC)
- Axillary lymph node dissection (ALND)
- Breast Conserving Surgery (BCS)
- Human Epidermal Growth Factor Receptor 2 Positive/ Negative (HER2+/- )
- Hormone Receptor Positive/ Negative (HR+/-)
- Neoadjuvant Chemotherapy (NAC)
- Targeted Axillary Dissection (TAD)
- Tailored Axillary Surgery (TAS)
- Marking Axillary Lymph Nodes with Iodine Seeds (MARI)
- Sentinel Lymph Node (SLN)
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2026-00317 bb26Weber2
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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