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- Ensaio Clínico NCT06153836
Neurotização do complexo areolar do mamilo para restaurar a sensação em pacientes com câncer de mama submetidas a mastectomia e reconstrução com preservação do mamilo
Estudo de viabilidade randomizado para determinar a viabilidade de neurotização do complexo areolar do mamilo no momento da mastectomia preservadora do mamilo e reconstrução baseada em prótese
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.
Visão geral do estudo
Status
Condições
Descrição detalhada
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.
Tipo de estudo
Inscrição (Estimado)
Estágio
- Fase 2
Contactos e Locais
Contato de estudo
- Nome: Clinical Trials Referral Office
- Número de telefone: 855-776-0015
- E-mail: mayocliniccancerstudies@mayo.edu
Locais de estudo
-
-
Florida
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Jacksonville, Florida, Estados Unidos, 32224-9980
- Recrutamento
- Mayo Clinic in Florida
-
Contato:
- Clinical Trials Referral Office
- Número de telefone: 855-776-0015
- E-mail: mayocliniccancerstudies@mayo.edu
-
Investigador principal:
- James W. Jakub, M.D.
-
Investigador principal:
- Olivia S. Ho, M.D., M.S.
-
-
Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
Inclusion Criteria:
-
Female patients age >= 18
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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
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
|
Comparador Ativo: ARM I (control)
Patients undergo standard of care NSM on study. |
Ancillary studies Undergo standard of care NSM
Outros nomes:
|
|
Experimental: ARM II (neurotization)
Patients undergo neurotization during standard of care NSM on study. |
Ancillary studies Undergo standard of care NSM
Outros nomes:
Undergo placement of nerve graft
Outros nomes:
|
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Percentage of patients undergoing nipple sparing mastectomy (NSM) to enroll in a randomized trial of NSM with or without neurotization
Prazo: 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
|
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Chest physical well-being
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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)
Prazo: 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
Prazo: 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
|
Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: James W. Jakub, M.D., Mayo Clinic
- Investigador principal: Olivia S. Ho, M.D., M.S., Mayo Clinic
Publicações e links úteis
Links úteis
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Estimado)
Conclusão do estudo (Estimado)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Termos MeSH relevantes adicionais
- Neoplasias por local
- Neoplasias
- Neoplasias por Tipo Histológico
- Neoplasias Glandulares e Epiteliais
- Doenças de pele
- Doenças da mama
- Carcinoma
- Neoplasias da Mama
- Carcinoma in situ
- Doenças da Pele e do Tecido Conjuntivo
- Carcinoma de Mama In Situ
- Procedimentos cirúrgicos, operatórios
- Mastectomia
- Mastectomia, subcutânea
Outros números de identificação do estudo
- MC230302
- MC230302 (Outro identificador: Mayo Clinic)
- NCI-2023-09574 (Identificador de registro: CTRP (Clinical Trial Reporting Program))
- 23-004411 (Outro identificador: Mayo Clinic Institutional Review Board)
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