- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02926729
Real-Time Assessment Of Breast Cancer Lumpectomy Specimen Margins With Nonlinear Microscopy
Study Overview
Status
Conditions
Detailed Description
The purpose of this research study is to improve the treatment of breast cancer and reduce the number of patients who require repeat surgical procedures to completely remove breast malignancy.
In standard procedures, pathologists evaluate tissue samples on a microscope after the surgery is over. The new investigative imaging instrument is an advanced type of microscope that enables evaluation during surgery.
The microscope will not be used directly on the participant or in the operating room, but instead will be used to image tissue immediately after excision but prior to the conclusion of surgery. If pathologic examination using NLM concludes that there is invasive cancer or ductal carcinoma in situ (DCIS) at or close to the margin of the specimen, the surgeon will be notified and may decide to do additional surgical shavings before the patient leaves the operating room, in order to improve the likelihood of achieving clean margins and reduce the probability that the patient will be advised to have another operation to achieve clean margins. For both patients on the experimental arm (NLM) and the control arm (without NLM), standard pathologic evaluation of the specimen will be done some days after the lumpectomy is completed. That pathologic evaluation will decide whether or not to recommend that the patient has additional surgery in order to achieve clean margins. The primary outcome measure is the percentage of patients in each group who are advised to have additional surgery for this reason.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: James Connolly, MD
- Phone Number: 617-667-4344
- Email: jconnoll@bidmc.harvard.edu
Study Locations
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-
Massachusetts
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Boston, Massachusetts, United States, 02115
- Recruiting
- Beth Israel Deaconess Medical Center
-
Contact:
- James Connolly, MD
- Phone Number: 617-667-4344
- Email: jconnoll@bidmc.harvard.edu
-
Principal Investigator:
- James Connolly, MD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patient scheduled to undergo lumpectomy for breast cancer at BIDMC.
- Core needle biopsy revealing invasive breast cancer or DCIS.
- Female.
- Minimum age of 21 years.
- Eligible for breast conserving surgery, lumpectomy and radiation.
- Estrogen receptor positive (ER+) on core needle biopsy, or if estrogen receptor negative (ER-), have evaluable estrogen receptor status with positive internal control on core biopsy.
- Progesterone receptor positive (PR+) on core needle biopsy if biopsy indicates invasive cancer, or if progesterone receptor negative (PR-) on biopsy indicating invasive cancer, have evaluable progesterone receptor status with positive internal control on core biopsy.
- HER2 IHC and/or FISH ordered on core biopsy, if biopsy indicates invasive cancer.
- Oncotype DX or other genetic assay performed on core biopsy or not requested.
- Ability to understand and the willingness to sign a written informed consent document.
Exclusion Criteria:
- Contraindicated for radiation therapy.
- Pregnancy. (Pregnant women will be excluded from this study because radiation therapy is contraindicated during pregnancy.)
- Current invasive cancer or DCIS at the site of a previous surgery.
- Any systemic neoadjuvant (or preoperative) therapy between the core biopsy and lumpectomy.
- Involvement in another therapeutic trial for breast cancer at Dana Farber or elsewhere.
- Risk of poor cosmetic outcome after initial lumpectomy and possible additional excision, as assessed by a study surgeon.
- Recommendation for mastectomy based on radiology.
- Patients that have complex DCIS as indicated on radiology, which would require excising a large tissue volume.
- No or equivocal ER, PR or HER2 testing performed prior to surgery if biopsy indicates invasive cancer.
- No or equivocal ER testing performed prior to surgery if biopsy indicates ductal carcinoma in situ.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: DOUBLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Experimental
Standard lumpectomy followed by nonlinear microscopy imaging of excised surgical margins.
If invasive cancer or DCIS at or close to the margin is detected, additional excision may be performed.
|
Following standard lumpectomy excision, excised tissue will be imaged with NLM.
If invasive cancer or ductal carcinoma in situ (DCIS) is detected on or close to the margin, additional excision may be performed.
Following surgery, final margins will be evaluated using paraffin embedded histopathology as per standard procedure.
Paraffin embedded histopathology will be used to make a final margin determination.
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ACTIVE_COMPARATOR: Control
Standard lumpectomy without nonlinear microscopy imaging.
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Lumpectomy with postoperative paraffin embedded histopathology to make a final margin determination.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Rate of recommendation for repeat surgery on postoperative histopathology
Time Frame: 2 years
|
The percent of patients in each arm who have a recommendation for additional surgery because of near or involved margins as a result of the standard postoperative histopathologic review (by a pathologist blinded to whether the patient was on the experimental or control arm).
|
2 years
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: James Connolly, MD, Beth Israel Deaconess Medical Center
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ANTICIPATED)
Study Completion (ANTICIPATED)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 16-145
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
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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