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Delayed-Delayed Breast Reconstruction

2016年7月14日 更新者:M.D. Anderson Cancer Center

A Multidisciplinary Protocol for Planned Skin-Preserving Delayed Breast Reconstruction for Patients With Locally Advanced Breast Cancer Requiring Postmastectomy Radiation Therapy

The goal of this clinical research study is to learn if delayed-delayed breast reconstruction in women who require post-mastectomy radiation therapy will improve cosmetic outcomes and result in fewer complications compared to the standard approach (reconstruction that is not started until radiation treatment is completed).

調査の概要

状態

完了

条件

詳細な説明

Study Visits and Surgeries:

You will be hospitalized 2-4 times for 1-5 days depending on your condition. If you agree to take part in this study, you will be scheduled for a skin-sparing mastectomy. The following tests and procedures will be performed:

Pre-Operative Visit:

  • Your complete medical history will be updated.
  • The doctor will determine what type of reconstructive surgery can be done.
  • You will have photos taken of your breasts. Your face, hair, or jewelry will not be photographed. These photos will be kept in a password-protected computer accessible only by the principle investigator and people directly involved in this study.
  • You will complete a quality of life questionnaire. The questionnaire asks about how satisfied you are with your appearance. The questionnaire will be sent by email, US postal service mail, or in person when you come for your follow up visits. The questionnaire should take about 20 minutes to complete. If sent by US postal service, you will be given a postage-paid envelope to return the questionnaire.

At your Mastectomy Surgery:

  • Your complete medical history will be updated.
  • You will have photos taken of your breasts.
  • During the surgery, a tissue expander will be placed in your breast. Sterile salt water will be added to inflate the expander and a small skin sample (about the size of a pencil eraser) from the breast will be taken to study stretching and scarring of the skin. The tissue will be securely maintained at MD Anderson.
  • You will be monitored for any problems.

Post-Operative Visit - 7 to 10 Days after Mastectomy Surgery:

  • The study staff will look at the results of your surgery.
  • Your complete medical history will be updated.
  • You will complete the quality of life questionnaire.
  • You will be asked about any problems you may be having.

Deflation Visit - Week 5:

  • Your complete medical history will be updated.
  • You will have photos taken of your breasts.
  • The sterile salt water in the expander will be let out, causing the breast to go flat. This is done by inserting a needle into a special port and withdrawing the fluid with a syringe.

Radiation Visit - Week 8:

  • You must have radiation either at M. D. Anderson or an M. D. Anderson-affiliated site.
  • Extra fluid may be added to the tissue expander before radiation.
  • The study staff will look at the results of your surgery.
  • You will be asked about any problems you may be having.
  • You will receive radiation, typically 5 days a week for 6 weeks.

Post-Radiation Visits - About Week 13 and every 2 to 4 Weeks after:

  • Your complete medical history will be updated.
  • The study staff will look at the results of your surgery.
  • You will be asked about any problems you may be having.
  • You will complete the quality of life questionnaire.
  • Your expander will be re-inflated.

Delayed-delayed Reconstruction Surgery - At about Week 23:

  • Your complete medical history will be updated.
  • You will have photos taken of your breasts.
  • During surgery, you will be monitored for any problems. A tissue sample will be collected to study stretching and scarring of the skin from the mastectomy incision and the tissue that is used to form the new breast. The tissue will be securely maintained at MD Anderson.
  • During surgery, you will have tissue moved from your lower abdomen, back, or buttock to be used for reconstruction. A silicone or saline breast implant may or may not be used to help construct the breast. The amount of tissue used for building the breast will depend on your body size and donation site. Your reconstructive surgeon will discuss this with you before surgery.
  • During surgery, the expander will be removed and reconstruction of your breast will occur.

Follow-Up Surgery - At about Week 47:

  • Your complete medical history will be updated.
  • You will have photos taken of your breasts.
  • You will complete the quality of life questionnaire.
  • During surgery, you will be monitored for any problems and a tissue sample will be collected.
  • During this surgery, procedures will be done to improve the appearance of the breast.

Long-Term Follow-Up Visits - At 6, 12, 24, and 36 Months:

  • Your complete medical history will be updated.
  • You will have photos taken of your breasts.
  • You will be asked about any problems you may be having.
  • At Months 12 and 24, you will complete the quality of life questionnaire.

This is an investigational study. The implants in this study have been FDA approved for skin expansion as a method of breast reconstruction. The use of the implants is investigational in this study.

Up to 200 women will take part in this study. All will be enrolled at M. D. Anderson.

研究の種類

介入

入学 (実際)

40

段階

  • 適用できない

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究場所

    • Texas
      • Houston、Texas、アメリカ、77030
        • University of Texas MD Anderson Cancer Center

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年歳以上 (大人、高齢者)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

女性

説明

Inclusion Criteria:

  1. Patients with invasive breast carcinoma that are scheduled for a mastectomy with planned postmastectomy XRT. This includes, but is not limited to, clinical stage II, III, and IV.
  2. Patient must desire breast reconstruction.
  3. Patients must sign the informed consent form and must be deemed by operative surgeon not to have medical contraindications for delayed-delayed approach.
  4. Patients must be 18 years of age or older.

Exclusion Criteria:

  1. Patients in whom it is not known preoperatively to need postmastectomy radiation therapy.
  2. Patients with inflammatory breast cancer.
  3. Patients in whom the breast skin can not be spared because of involvement with breast cancer.
  4. Any patient deemed by the radiation oncologist during preoperative consultation to be an inappropriate patient for this protocol.
  5. Patients that can not commit to receiving postmastectomy radiation treatment in addition to breast reconstructive procedures at MD Anderson Cancer Center or satellite affiliates.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:処理
  • 割り当て:なし
  • 介入モデル:単一グループの割り当て
  • マスキング:なし(オープンラベル)

武器と介入

参加者グループ / アーム
介入・治療
実験的:Delayed Breast Reconstruction
Approximately 3 months after postmastectomy radiation therapy, the preserved, irradiated, and re-inflated breast skin will be used to perform the delayed breast reconstruction. During the stage 2 reconstruction, the implant or expander will be removed and the definitive reconstruction will be performed with the preserved breast skin utilizing a preference for autologous tissue or autologous tissue with an implant due to the potential for complications with implant-based reconstructions after radiation therapy (XRT).
Approximately 3 months after postmastectomy radiation therapy, the preserved, irradiated, and re-inflated breast skin will be used to perform the delayed breast reconstruction. During the stage 2 reconstruction, the implant or expander will be removed and the definitive reconstruction will be performed with the preserved breast skin utilizing a preference for autologous tissue or autologous tissue with an implant due to the potential for complications with implant-based reconstructions after radiation therapy (XRT).

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Overall Complication Rate
時間枠:6 months
Overall complication defined as any of the following complications post breast reconstruction surgery: seroma, hematoma, wound dehiscence, partial flap loss, total flap loss, infection, flap microvascular thrombosis (arterial or venous), venous congestion of flap, flap fat necrosis, mastectomy skin flap necrosis, exposure breast implant, capsular contracture, and delayed wound healing.
6 months

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

捜査官

  • 主任研究者:Steven J. Kronowitz, MD、M.D. Anderson Cancer Center

出版物と役立つリンク

研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始

2010年12月1日

一次修了 (実際)

2015年9月1日

研究の完了 (実際)

2015年9月1日

試験登録日

最初に提出

2010年12月7日

QC基準を満たした最初の提出物

2010年12月7日

最初の投稿 (見積もり)

2010年12月8日

学習記録の更新

投稿された最後の更新 (見積もり)

2016年7月15日

QC基準を満たした最後の更新が送信されました

2016年7月14日

最終確認日

2016年7月1日

詳しくは

本研究に関する用語

その他の研究ID番号

  • 2010-0053
  • NCI-2011-00270 (レジストリ識別子:NCI CTRP)

この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。

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