Neurotisierung des Brustwarzenareolarkomplexes zur Wiederherstellung der Empfindung bei Patientinnen mit Brustkrebs, die sich einer nippelschonenden Mastektomie und Rekonstruktion unterziehen
Randomisierte Machbarkeitsstudie zur Bestimmung der Machbarkeit einer Neurotisierung des Brustwarzenareolarkomplexes zum Zeitpunkt einer nippelschonenden Mastektomie und einer prothetischen 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.
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Detaillierte Beschreibung
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.
Studientyp
Studientyp
Einschreibung (Geschätzt)
Einschreibung
Phase
Phase
- Phase 2
Kontakte und Standorte
Studienkontakt
Studienkontakt
- Name: Clinical Trials Referral Office
- Telefonnummer: 855-776-0015
- E-Mail: mayocliniccancerstudies@mayo.edu
Studienorte
-
-
Florida
-
Jacksonville, Florida, Vereinigte Staaten, 32224-9980
- Rekrutierung
- Mayo Clinic in Florida
-
Kontakt:
- Clinical Trials Referral Office
- Telefonnummer: 855-776-0015
- E-Mail: mayocliniccancerstudies@mayo.edu
-
Hauptermittler:
- James W. Jakub, M.D.
-
Hauptermittler:
- Olivia S. Ho, M.D., M.S.
-
-
Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Inclusion Criteria:
-
Female patients age >= 18
-
Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2
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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
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Keine (Offenes Etikett)
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
|---|---|
|
Aktiver Komparator: ARM I (control)
Patients undergo standard of care NSM on study. |
Ancillary studies Undergo standard of care NSM
Andere Namen:
|
|
Experimental: ARM II (neurotization)
Patients undergo neurotization during standard of care NSM on study. |
Ancillary studies Undergo standard of care NSM
Andere Namen:
Undergo placement of nerve graft
Andere Namen:
|
Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Percentage of patients undergoing nipple sparing mastectomy (NSM) to enroll in a randomized trial of NSM with or without neurotization
Zeitfenster: 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
|
Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Chest physical well-being
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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)
Zeitfenster: 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
Zeitfenster: 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
|
Mitarbeiter und Ermittler
Sponsor
Sponsor
Ermittler
Ermittler
- Hauptermittler: James W. Jakub, M.D., Mayo Clinic
- Hauptermittler: Olivia S. Ho, M.D., M.S., Mayo Clinic
Publikationen und hilfreiche Links
Nützliche Links
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Studienbeginn
Primärer Abschluss (Geschätzt)
Primärer Abschluss
Studienabschluss (Geschätzt)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Zusätzliche relevante MeSH-Bedingungen
- Neubildungen nach Standort
- Neubildungen
- Neubildungen nach histologischem Typ
- Neubildungen, Drüsen und Epithelien
- Hautkrankheiten
- Brusterkrankungen
- Karzinom
- Neoplasien der Brust
- Karzinom in situ
- Haut- und Bindegewebserkrankungen
- Brustkrebs in situ
- Chirurgische Eingriffe, operativ
- Mastektomie
- Mastektomie, subkutan
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- MC230302
- MC230302 (Andere Kennung: Mayo Clinic)
- NCI-2023-09574 (Registrierungskennung: CTRP (Clinical Trial Reporting Program))
- 23-004411 (Andere Kennung: Mayo Clinic Institutional Review Board)
Arzneimittel- und Geräteinformationen, Studienunterlagen
Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt
Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt
Produkt, das in den USA hergestellt und aus den USA exportiert wird
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