- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03505372
Role of Contrast Enhanced Spectral Mammography to Predict Upgrade Rates of Biopsy Proven Atypical Ductal Hyperplasia
This research study is studying whether contrast enhanced mammography can predict if atypical ductal hyperplasia will progress to cancer.
The device involved in this study is:
-Contrast enhanced mammography
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This research study is a Pilot Study, which is the first time investigators are examining this study device for this purpose.
Atypical ductal hyperplasia (ADH) is a common diagnosis after breast biopsy. Although it is not cancer itself, ADH can become breast cancer in some cases. As a result, surgery is performed to remove ADH to make sure it doesn't progress to cancer. In many cases, no cancer is found during the surgery.
Previous studies have shown that breast MRI may be able to predict which areas of ADH will be cancer at the time of surgery. This would help prevent unnecessary surgery in some patients.
Contrast enhanced mammography is a new type of mammogram that is already being used in clinical practice to help find breast cancer. Similar to breast MRI, it uses contrast material combined with the mammogram to highlight areas that might be breast cancer and that could be missed on the mammogram alone. Contrast material is a dye or other substance that helps show abnormal areas within the body.
Studies have shown the contrast enhanced mammography has a similar ability to find breast cancer as breast MRI.
The investigators purpose is to see whether contrast enhanced mammography can predict which areas of ADH will become breast cancer at the time of surgery. The investigators believe this will help prevent unnecessary surgery in many with women with the diagnosis of ADH.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Massachusetts
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Boston, Massachusetts, United States, 02215
- Beth Israel Deaconess Medical Center
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age, Minimum 30 years. CESM is an imaging exam that uses radiation and is not typically employed in women younger than age 30 due to potentially negative biologic effects on glandular breast tissue.
- Participants who had a percutaneous breast biopsy (to include stereotactic, tomosynthesis, or ultrasound guided) that revealed ADH
- Participants will be undergoing surgical excision to remove the ADH.
- Participants must have normal organ and marrow function as defined by a GFR ≥60 mL/min/1.73 m2 to be performed per clinical protocol
- Patients ≥65 years without underlying renal insufficiency get GFR tested within 6 months of the exam.
- Patients < 65 years without underlying renal insufficiency do not require an GFR calculation)
- Patients ≥65 years with known underlying renal insufficiency get GFR tested within 1 month of the exam.
- Patients < 65 years with known renal insufficiency get GFR tested within 1 month of the exam.
- Because of the potential teratogenic effects of radiation, women of child-bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, until the CESM is performed. Should a woman become pregnant or suspect she is pregnant, she should inform the study team prior to getting the CESM.
- Ability to understand and the willingness to sign a written informed consent document
Exclusion Criteria:
- Participants with a core biopsy diagnosis of atypia with associated malignancy (in the same quadrant) will be excluded.
- Participant had a breast MRI that was performed after the diagnosis of ADH but before surgical excision
- Participants who have a known allergy to contrast media.
- Participants who have a known severe allergic response to one or more allergens, as defined by anaphylaxis.
- Participants with persistent asthma as defined by the National Heart, Lung, and Blood Institute.
- Participants with renal insufficiency or failure, as determined by a point of care renal function blood test.
- Participants who are breastfeeding are excluded because there is an unknown but potential risk for adverse events in nursing infants secondary to contrast administration in the mother.
- Participants with the following underlying medical conditions: multiple myeloma, myasthenia gravis, dysproteinemias, severe cardiac disease, aortic stenosis, primary pulmonary hypertension, cardiac arrythmia, or severe cardiomyopathy. These underlying medical conditions may make the participant more likely to develop a contrast reaction. This is based on the ACR contrast manual version 10.3 and hospital policy.
- Participants with thyroid carcinoma or thyroid disease for whom systemic radioactive iodine therapy is part of planned diagnostic work-up or treatment within 2 months following the contrast mammogram study.
- Participants with a concurrent active illness including, but not limited to, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, thyroid storm.
- Pregnant women are excluded from this study because CESM uses radiation with the potential for teratogenic or abortifacient effects. This will be defined by a urine pregnancy test prior to the CESM study.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Contrast enhanced mammography
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Contrast enhanced mammography is a new type of mammogram that uses contrast material combined with the mammogram to highlight areas that might be breast cancer and that could be missed on the mammogram alone.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
CESM's Ability to Predict Upgrade Rates of Biopsy Proven ADH at Surgical Excision
Time Frame: 3 months
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Investigators will evaluate whether enhancement on CESM can predict which cases of ADH upgrade at the time of surgical excision.
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3 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Types of Changes in Surgical Management Based on CESM
Time Frame: 3 months
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Investigators will evaluate how incidental findings seen on CESM impact the surgical management of patients diagnosed with ADH.
The initial surgical management documented in the clinical report (created before CESM performed) will be compared with the surgical management documented in the medical record after the CESM was performed to determine the change.
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3 months
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Jordana Phillips, MD, Beth Israel Deaconess Medical Center
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
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
- 17-694
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
product manufactured in and exported from the U.S.
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.
Clinical Trials on Atypical Ductal Hyperplasia
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National Cancer Institute (NCI)CompletedBreast Atypical Ductal Hyperplasia | Breast Atypical Lobular Hyperplasia | Breast Ductal Carcinoma In Situ | Breast Lobular Carcinoma In Situ | Invasive Breast CarcinomaUnited States
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Yale UniversityCompletedAtypical Ductal Hyperplasia (ADH) of the BreastUnited States
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Ohio State University Comprehensive Cancer CenterNot yet recruitingBreast Carcinoma | Breast Atypical Ductal Hyperplasia | Breast Atypical Lobular Hyperplasia | Breast Lobular Carcinoma In Situ | Breast Sclerosing AdenosisUnited States
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University of WashingtonNational Cancer Institute (NCI); National Institute of Nursing Research (NINR)CompletedDuctal Breast Carcinoma in Situ | BRCA1 Mutation Carrier | BRCA2 Mutation Carrier | Atypical Ductal Breast Hyperplasia | Lobular Breast Carcinoma in Situ | Atypical Lobular Breast HyperplasiaUnited States
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NYU Langone HealthUnited States Department of DefenseCompletedAtypical Ductal Breast Hyperplasia | Lobular Carcinoma in Situ (LCIS) | Atypical Lobular Hyperplasia (ALH) of BreastUnited States
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