Individualizing Surveillance Mammography for Older Breast Cancer Survivors

August 1, 2022 updated by: Rachel Freedman, MD, MPH, Dana-Farber Cancer Institute
This research is being conducted to develop consensus on surveillance mammography and follow-up for breast cancer survivors who are age ≥75.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The investigators will develop a communication tool that summarizes recommendations for clinicians and patients for surveillance mammography and follow-up care for breast cancer survivors age ≥75. Developing expert-panel recommendations, examining clinician and patient attitudes towards these recommendations, and testing a strategy for communication of expert recommendations on mammography cessation through direct engagement of specialists, primary care clinicians (PCs), and patients.

This is a multi-step study, the investigators will build on prior steps to develop consensus on surveillance mammography and follow-ups for breast cancer survivors who are age >= 75.

This study includes a physician focus group.

Study Type

Interventional

Enrollment (Actual)

45

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Massachusetts
      • Boston, Massachusetts, United States, 02215
        • Dana-Farber Cancer Institute

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

75 years and older (Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

Female

Description

Inclusion Criteria:

  • Female gender, given that screening guidelines do not exist for men
  • Receiving part or all of their care at DFCI
  • Ages 75-79 (approximately 15 patients)
  • Age ≥80 (approximately 15 patients)
  • History of stage 0-II breast cancer

    -≥1 Charlson comorbidity present72, defined as one of the following:

    • Diabetes
    • Liver disease
    • History of or other active malignancy other than non-melanoma skin cancers
    • HIV or AIDS
    • Chronic kidney disease
    • History of myocardial infarction and/or congestive heart failure
    • Chronic lung disease (emphysema/chronic bronchitis/chronic obstructive pulmonary disease [COPD], interstitial lung disease)
    • Peripheral vascular disease
    • Cerebrovascular disease (history of TIA or stroke)
    • Dementia
    • Hemiplegia/paralysis
    • Connective tissue disorder
  • Underwent breast conserving surgery for treatment of this cancer
  • Completed all active breast cancer therapy >3 months prior to enrollment (i.e. any chemotherapy, trastuzumab, radiation). Ongoing hormonal therapy or enrollment in survivorship clinical trials (aspirin, exercise, etc) is allowed.
  • English-speaking and reading (for this initial work)
  • Aim 1.1. Cognitive testing of the communication tool. The criteria for this are intentionally more flexible than in other aims, as we are simply working to initially test the tool and its readability and understandability. Patients will be eligible to cognitively test the tool if they meet the following criteria:
  • Female gender
  • Previous diagnosis of breast cancer
  • Age ≥75
  • Receive some/all care at Dana-Farber Cancer Institute
  • English speaking-reading
  • Aim 1.2. Pilot testing the communication tool in clinic.
  • Previous diagnosis of stage 0-II breast cancer
  • Receive some/all care at Dana-Farber Cancer Institute (main campus or St. Elizabeth's site)
  • Completed any active breast cancer therapy > 3 months prior to enrollment (i.e. any chemotherapy, trastuzumab, radiation). Ongoing hormonal therapy or enrollment in survivorship clinical trials (aspirin, exercise, etc) is allowed.
  • Age ≥75
  • Had breast-conserving surgery to treat this cancer

    -≥1 the following comorbid conditions72 present, defined as the following:

    • Diabetes
    • Liver disease
    • History of or other active malignancy other than non-melanoma skin cancers
    • HIV or AIDS
    • Chronic kidney disease
    • History of myocardial infarction and/or congestive heart failure
    • Chronic lung disease (COPD, interstitial lung disease)
    • Peripheral vascular disease
    • Cerebrovascular disease (history of TIA or stroke)
    • Dementia
    • Hemiplegia/paralysis
    • Connective tissue disorder
  • Provider does not opt out of the patient's enrollment via email notification
  • Blessed Orientation Memory Concentration (COMC) score is <10 and capacity is met73 (see Appendix A for BOMC scale)
  • Providers of participating patients will be sent a one-time survey but there are no other eligibility for providers to participate in this other than their patient participated
  • English speaking and reading

Exclusion Criteria:

  • Are unable to consent
  • Who do not read and write English (for this initial pilot)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Surveillance Mammography Communication Tool
  • Conduct 30 telephone-based patient interviews
  • 4-6 focus groups with oncologists and primary care providers (PCs) to learn their perceptions and thoughts about when to stop surveillance mammography
  • Perform cognitive testing of the communication tool
Summarizes recommendations for clinicians and patients for surveillance mammography and follow-up care for breast cancer survivors

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Rate of Change in Intentions for Mammography in the Next Year
Time Frame: 2 years
Survey measure on whether mammography will be done or not
2 years

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Rate of Satisfaction
Time Frame: 2 years
Survey asking about satisfaction with the tool
2 years
Preferred Decision-making Role
Time Frame: 2 years
Survey on preferred decision-making style
2 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Rachel Freedman, MD, MPH, Dana-Farber Cancer Institute

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 16, 2019

Primary Completion (Actual)

July 1, 2021

Study Completion (Actual)

July 1, 2021

Study Registration Dates

First Submitted

March 5, 2019

First Submitted That Met QC Criteria

March 5, 2019

First Posted (Actual)

March 7, 2019

Study Record Updates

Last Update Posted (Actual)

August 24, 2022

Last Update Submitted That Met QC Criteria

August 1, 2022

Last Verified

August 1, 2022

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 19-001
  • 1R21CA227615-01A1 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

The Dana-Farber / Harvard Cancer Center encourages and supports the responsible and ethical sharing of data from clinical trials. De-identified participant data from the final research dataset used in the published manuscript may only be shared under the terms of a Data Use Agreement. Requests may be directed to: [contact information for Sponsor Investigator or designee]. The protocol and statistical analysis plan will be made available on Clinicaltrials.gov only as required by federal regulation or as a condition of awards and agreements supporting the research

IPD Sharing Time Frame

Data can be shared no earlier than 1 year following the date of publication.

IPD Sharing Access Criteria

BCH - Contact the Technology & Innovation Development Office at www.childrensinnovations.org or email TIDO@childrens.harvard.edu BIDMC - Contact the Beth Israel Deaconess Medical Center Technology Ventures Office at tvo@bidmc.harvard.edu BWH - Contact the Partners Innovations team at http://www.partners.org/innovation DFCI - Contact the Belfer Office for Dana-Farber Innovations (BODFI) at innovation@dfci.harvard.edu MGH - Contact the Partners Innovations team at http://www.partners.org/innovation

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ICF

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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