Neurotisering af brystvortens areolarkompleks for at genoprette følelsen for patienter med brystkræft, der gennemgår brystvortesparende mastektomi og genopbygning
Randomiseret gennemførlighedsundersøgelse for at bestemme gennemførligheden af neurotisering af brystvortens areolarkompleks på tidspunktet for brystvortesparende mastektomi og protesebaseret rekonstruktion
This phase II trial tests the willingness of patients undergoing nipple sparing mastectomy (NSM) to enroll in a randomized study of NSM with or without neurotization of the nipple areolar complex (NAC). This trial also compares patient reported outcomes, including quality of life and breast and NAC sexual functionality, for patients undergoing NSM with or without neurotization of the NAC. NSM is a standard practice option for patients undergoing preventative mastectomy, but many report dissatisfaction with decreased nipple sensation. Neurotization is a surgical technique using a nerve graft in an attempt to restore NAC sensation. Neurotization during NSM and reconstruction may restore NAC sensation and improve quality of life in breast cancer patients.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
PRIMARY OBJECTIVE:
I. To determine willingness of patients undergoing NSM to enroll in a randomized trial of NSM with or without neurotization.
SECONDARY OBJECTIVES:
I. To compare patient reported outcomes, including quality of life and breast and NAC sexual functionality, for patients undergoing NSM with or without neurotization.
II. To compare NAC sensation at 12 months in patients undergoing NSM with or without neurotization.
III To determine rate of mastectomy skin flap necrosis following NSM via the skin ischemia and necrosis (SKIN) score.
OUTLINE: Patients are randomized to 1 of 2 arms.
ARM I: Patients undergo standard of care NSM on study.
ARM II: Patients undergo neurotization during standard of care NSM on study.
After completion of study intervention, patients are followed at 14 days and at 6, 12 and 24 months postoperatively.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Fase 2
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Clinical Trials Referral Office
- Telefonnummer: 855-776-0015
- E-mail: mayocliniccancerstudies@mayo.edu
Studiesteder
-
-
Florida
-
Jacksonville, Florida, Forenede Stater, 32224-9980
- Rekruttering
- Mayo Clinic in Florida
-
Kontakt:
- Clinical Trials Referral Office
- Telefonnummer: 855-776-0015
- E-mail: mayocliniccancerstudies@mayo.edu
-
Ledende efterforsker:
- James W. Jakub, M.D.
-
Ledende efterforsker:
- Olivia S. Ho, M.D., M.S.
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
-
Female patients age >= 18
-
Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2
-
Planned nipple sparing mastectomy (NSM)
-
Ideal NSM candidates would meet the following criteria:
- Cup size A-C
- BMI <34
- Ptosis grade < 2
- Clinical stage 0 - T2N0
- Final planned implant volume < 400cc
- Inframammary or lateral mammary incision
- Tumor > 0.5cm from the nipple areolar complex (NAC)
- No prior breast reduction, mastopexy, or periareolar incisions on side of planned NSM
- No prior breast radiation on side of planned NSM
- Tumor <0.5cm from NAC (including suspicious calcifications or MRI enhancement)
- No planned post mastectomy radiation (PMRT)
- No nicotine use within 4 weeks of surgical date
Exclusion Criteria:
- Planned autologous reconstruction (immediate or delayed)
- Pregnancy
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Aktiv komparator: ARM I (control)
Patients undergo standard of care NSM on study. |
Ancillary studies Undergo standard of care NSM
Andre navne:
|
|
Eksperimentel: ARM II (neurotization)
Patients undergo neurotization during standard of care NSM on study. |
Ancillary studies Undergo standard of care NSM
Andre navne:
Undergo placement of nerve graft
Andre navne:
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Percentage of patients undergoing nipple sparing mastectomy (NSM) to enroll in a randomized trial of NSM with or without neurotization
Tidsramme: Up to 2 years
|
Will calculate the proportion of eligible patients who opt to take part in the study. Additionally, will descriptively analyze and report the specific factors that influenced patients' decisions to participate, with the aim of identifying and addressing any obstacles encountered. |
Up to 2 years
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Chest physical well-being
Tidsramme: At baseline and up to 12 months
|
Measured using the BREAST-Q© scored on a 3-point Likert scale where 1=None of the time and 3=All of the time. Higher scores indicate poorer chest physical well-being. |
At baseline and up to 12 months
|
|
Psychosocial well-being
Tidsramme: At baseline and up to 12 months
|
Measured using the BREAST-Q© scored on a 5-point Likert scale where 1=None of the time and 5=All of the time. Higher scores indicate poorer psychosocial well-being. |
At baseline and up to 12 months
|
|
Sexual well-being
Tidsramme: At baseline and up to 12 months
|
Measured using the BREAST-Q© scored on a 5-point Likert scale where 1=None of the time and 5=All of the time. Higher scores indicate poorer sexual well-being. |
At baseline and up to 12 months
|
|
Patient reported amount of sensation in nipple areolar complex (NAC) and breast
Tidsramme: At baseline and up to 12 months
|
Patient reported amount of sensation in nipple areolar complex (NAC) and breast will be will be assessed using a 5-item sensation questionnaire with 5 options to answer each question. Examples of answers include a range from Very unpleasant to Very pleasant or Unimportant to Very Important. Results will be reported descriptively. |
At baseline and up to 12 months
|
|
Patient reported significance of breast or NAC for sexuality
Tidsramme: At baseline and up to 12 months
|
Patient reported significance of breast or NAC for sexuality will be assessed using a 5-item Significance of Breast or Nipple Areolar Complex for Sexuality Questionnaire with 5 options to answer each question: Not at all, A little bit, Somewhat, Quite a bit, or Very much. Results will be reported descriptively. |
At baseline and up to 12 months
|
|
Tactile sensitivity scores
Tidsramme: At baseline and up to 12 months
|
Measured using Semmes Weinstein monofilament test. Scores will be averaged for each patient across all breast/ NAC measurements and summarized in terms of mean, standard deviation, median, and range. The ordinal score at each of the sites will also be summarized in terms of median and range. Frequency and type of missing data will be summarized. |
At baseline and up to 12 months
|
|
Incidence of adverse events (AEs)
Tidsramme: At 12 months
|
AEs will be scored using National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) and will be summarized within arms by reporting the number and percentage of patients for each AE. The maximum grade for each type of AEs will be recorded for each patient and frequency tables will be reviewed to determine overall patterns. The frequency and type of solicited AEs experienced in each arm will also be reported. |
At 12 months
|
|
Mastectomy skin flap necrosis
Tidsramme: At 12 months
|
Incidence of mastectomy skin flap necrosis will be assessed using the skin ischemia necrosis (SKIN) score, as recorded by clinical staff. Necrosis is defined as any depth SKIN score of C or D and surface area >1. |
At 12 months
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: James W. Jakub, M.D., Mayo Clinic
- Ledende efterforsker: Olivia S. Ho, M.D., M.S., Mayo Clinic
Publikationer og nyttige links
Hjælpsomme links
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- MC230302
- MC230302 (Anden identifikator: Mayo Clinic)
- NCI-2023-09574 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
- 23-004411 (Anden identifikator: Mayo Clinic Institutional Review Board)
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
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