Supine MRI in Breast Cancer Patients Undergoing Upfront Surgery or Receiving Neoadjuvant Therapy

This research study involves the use of a common breast imaging modality (magnetic resonance imaging, 'MRI') and is investigating its role in evaluating surgical decision making for breast cancer when it is performed with the patient in a new position (lying on one's back) as opposed to in the standard position (lying on one's stomach).

Study Overview

• Status: Completed
• Conditions: Breast Cancer
• Intervention / Treatment: Device: Ultrasound; Procedure: Standard of Care; Device: Supine MRI; Other: Neoadjuvant Therapy (NAT); Device: Mammography; Device: Standard MRI

Detailed Description

The procedure involved is called a supine breast magnetic resonance imaging (MRI).In this study, the investigators are evaluating the value of supine MRI in surgical decision making for women with breast cancer either undergoing upfront surgery or for those anticipating surgery after receiving neoadjuvant therapy.

The purpose of this study is to assess the value of supine breast MRI as a new imaging method to assist in surgical treatment planning. It is possible that the use of supine breast MRI will help your doctor see the size and location of tumors more accurately

• Study Type: Interventional
• Enrollment (Actual): 57
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Massachusetts
    • Boston, Massachusetts, United States, 02115
      • Brigham and Women's Hospital
    • Boston, Massachusetts, United States, 02115
      • Dana Farber Cancer Institute

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Participants must be female
• Participants must have a pre-operative standard mammogram with or without ultrasound.
• Participants must have biopsy confirmed and clinical stage I, stage II, or stage III non-inflammatory breast carcinoma. If biopsy was done at an outside hospital, pathology will be reviewed at (BWH, BWFH)
• Patient must meet standard MRI guidelines and be able and willing to undergo MRI
• Participants must be candidates for definitive local therapy with breast conserving therapy or deemed as potential candidates following NAT (this takes into account tumor to breast size ratio appropriate for BCT, and the ability to undergo standard radiation therapy post-operatively).
• Study participants will be restricted to those aged ≥18 years old. This age group is selected because it encompasses the majority of women likely to receive neoadjuvant therapy
• Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria:

• Participants with a known BRCA 1 or 2 mutation.
• Participants with a known Li-Fraumeni or Cowden's Disease.
• Participants with prior mantle radiation.
• Participants with inflammatory breast cancer or multi-centric disease
• Participants who are pregnant.
• Participants who are already enrolled in a conflicting investigational trial
• Participants with known active collagen vascular disease.
• Participants with prior history of ipsilateral breast carcinoma treated with BCS and radiation therapy.
• Patients who have biopsy confirmed multi-centric disease.
• Participants who are unable to undergo MRI because of documented contra-indications for contrast-enhanced MRI, including but not limited to renal failure
• Participants who exceed the weight limit for the operative surgical table, 350 lbs or who will not fit into the 60 cm diameter bore of the MRI scanner.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Diagnostic
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Supine MRI; Standard MRI will be performed; Supine MRI will be performed; Participant will receive mammography and ultrasound; Breast Radiologist will take a brief survey.; Patients will undergo upfront surgery or receive Neoadjuvant Therapy per standard of care; Standard of care will be performed	Device: Ultrasound; Procedure: Standard of Care; Device: Supine MRI; Other: Neoadjuvant Therapy (NAT); Device: Mammography; Device: Standard MRI

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Correlation Between Prone Breast MRI for Estimation of Tumor Size and Final Pathology Tumor Size	Comparing tumor size as measured on prone MRI images with tumor size as measured on final pathology among pts undergoing upfront surgery and among pts undergoing neoadjuvant chemotherapy. In the neoadjuvant chemotherapy group the post-treatment MRI images were used.	time between MRI date (when prone imaging measurements were obtained) and surgery date; median 25.5 days (range 11-40days)
Correlation Between Supine Breast MRI for Estimation Of Tumor Size and The Pathologic Tumor Size	Compared tumor size as reported by radiologist on the clinical report between Supine Breast MRI and The Pathologic Residual Tumor Size as reported by the pathologist on the final surgical pathology report..	time between supine breast MRI imaging and surgery; median 25.5 days, range 11-40 days
Correlation of Breast Tumor Dimensions Between Prone and Supine Imaging Positions.	Correlate maximal tumor Dimensions as measured by the radiologist between the Prone and Supine MRI Images	at time of MRI imaging

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The Perceived Benefit Of Supine MRI For Surgical Planning As Measured By The Collective Results Of A Survey Of Surgeons Performing Breast-conserving Therapy (BCT) In Our Study Patient Population	Reported as the proportion of surgeons answering yes. Surgeon reported answers to surveys asking if the supine MRI helped in the performance of the surgical procedure.	after surgery

Collaborators and Investigators

• Sponsor: Dana-Farber Cancer Institute
• Investigators: Principal Investigator: Tari King, MD, Brigham and Women's Hospital

Study record dates

Study Major Dates

• Study Start (Actual): November 15, 2016
• Primary Completion (Actual): August 1, 2022
• Study Completion (Actual): August 1, 2022

Study Registration Dates

• First Submitted: November 3, 2016
• First Submitted That Met QC Criteria: November 3, 2016
• First Posted (Estimated): November 6, 2016

Study Record Updates

• Last Update Posted (Actual): March 12, 2024
• Last Update Submitted That Met QC Criteria: February 12, 2024
• Last Verified: February 1, 2024

More Information

Terms related to this study

• Keywords: Breast Cancer
• Additional Relevant MeSH Terms: Skin Diseases; Neoplasms; Neoplasms by Site; Breast Diseases; Breast Neoplasms
• Other Study ID Numbers: 16-277

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO