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Neurotisering af brystvortens areolarkompleks for at genoprette følelsen for patienter med brystkræft, der gennemgår brystvortesparende mastektomi og genopbygning

29. september 2026 opdateret af: Mayo Clinic

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

Rekruttering

Betingelser

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

Interventionel

Tilmelding (Anslået)

45

Fase

  • Fase 2

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

    • Florida
      • Jacksonville, Florida, Forenede Stater, 32224-9980
        • Rekruttering
        • Mayo Clinic in Florida
        • Kontakt:
        • Ledende efterforsker:
          • James W. Jakub, M.D.
        • Ledende efterforsker:
          • Olivia S. Ho, M.D., M.S.

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Kvinde

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

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: ARM I (control)

Patients undergo standard of care NSM on study.

Ancillary studies

Undergo standard of care NSM

Andre navne:
  • Brystvortebesparende mastektomi
Eksperimentel: ARM II (neurotization)

Patients undergo neurotization during standard of care NSM on study.

Ancillary studies

Undergo standard of care NSM

Andre navne:
  • Brystvortebesparende mastektomi

Undergo placement of nerve graft

Andre navne:
  • Procedure for nerveregenerering

Hvad måler undersøgelsen?

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

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

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

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

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

5. december 2023

Primær færdiggørelse (Anslået)

19. juli 2028

Studieafslutning (Anslået)

19. juli 2028

Datoer for studieregistrering

Først indsendt

22. november 2023

Først indsendt, der opfyldte QC-kriterier

30. november 2023

Først opslået (Faktiske)

1. december 2023

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

2. oktober 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

29. september 2026

Sidst verificeret

1. september 2026

Mere information

Begreber relateret til denne undersøgelse

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)

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