Axillary Radiotherapy or Axillary Lymph Node Dissection in Patients With Clinically Node- Positive Breast Cancer Undergoing Upfront Tailored Axillary Surgery
Recruiting · NCT07140172 · Interventional (participants receive a specific treatment)
View the official record on ClinicalTrials.gov →Interventions studied
Axillary lymph node dissection (ALND)Axillary radiotherapy (ART)
What this trial is about
This trial is to investigate if in patients with clinically node positive breast cancer undergoing upfront surgery, treatment with TAS and ART is superior to ALND in terms of arm-related Quality of Life (QoL) and occurrence of lymphedema two years after randomization.
Who can take part
Age range
18 Years and older
Sex
All (male and female)
Healthy volunteers
No - a diagnosis or condition is required
Phase
Not applicable (e.g. observational or device study)
Study type
Interventional (participants receive a specific treatment)
Inclusion criteria
- at screening:
- Written informed consent according to ICH/GCP regulations prior to any trial specific procedures.
- Patients ≥ 18 years of age.
- Node-positive breast cancer (histologically or cytologically proven both in primary tumor and in lymph node) American Joint Committee on Cancer/ International Union Against Cancer (AJCC/UICC) stage II-III (all molecular subtypes allowed).
- Node-positivity detected by imaging and non-palpable (iN+) and confirmed by pathology.
- Node-positivity palpable (cN1-3) and confirmed by pathology.
- Occult breast cancer is allowed, if biopsy-proven axillary lymphatic metastasis is present.
- Eligible for primary ALND or SLN procedure and either:
- Newly diagnosed.
- Isolated in-breast recurrence or second ipsilateral breast cancer after previous breast conserving surgery and sentinel procedure and at least 3 years disease free and no prior axillary dissection or axillary RT.
- Upfront surgery setting.
- Most suspicious axillary lymph node clipped. (If clipping is not part of the routine, this should be done after consent of the patient as a study procedure.)
- Ability to complete the QoL questionnaires.
- WHO performance status 0-2
- Adequate condition for general anesthesia, breast cancer surgery and radiotherapy.
- Adult patients (≥18 years of age).
- Women of child-bearing potential are using effective contraception (condom, diaphragm, intrauterine device), are not pregnant or lactating and agree not to become pregnant during trial treatment (until end of RT) and thereafter during the time recommended by the guidelines - also for adjuvant systemic therapies. A negative pregnancy test before registration is required for all women of child-bearing potential.
- Men agree not to father a child during trial treatment and for 6 months afterward.
Exclusion criteria
- at screening:
- Stage IV breast cancer.
- Clinical N3c breast cancer without axillary disease (clinical N3a and clinical N3b are allowed).
- Clinical N2b breast cancer (clinical N2a is allowed).
- Contralateral breast cancer within 3 years.
- Prior axillary surgery (except prior sentinel node procedure in case of in-breast recurrence).
- Prior regional radiotherapy.
- Neoadjuvant treatment with the exception of bridging therapy given for less than 3 months.
- History of hematologic or primary solid tumor malignancy, unless in remission for at least 3 years from pre-registration with the exception of adequately treated cervical carcinoma in situ or localized non-melanoma skin cancer.
- Any other serious underlying medical, psychiatric, psychological, familial or geographical condition, which in the judgment of the investigator may interfere with the planned staging, treatment and follow-up, affect patient compliance or place the patient at high risk from treatment-related complications.
- Exclusion criteria at randomization (intraoperatively):
- Absence of clip in the specimen radiography.
- Palpable disease left behind in the axilla after TAS.
- No SLN identified in the axilla.
Where it is running
54 locations listed across 4 US states.
- Walter Reed National Military Medical Center - Bethesda, Maryland, United States
- Duke University/Duke Cancer Center - Durham, North Carolina, United States
- Fox Chase Cancer Center - Philadelphia, Pennsylvania, United States
- Swedish Cancer Institute - Seattle, Washington, United States
- "Alexandra" Hospital, Athens - Athens, Greece
- Kantonsspital Baden - Baden, Switzerland
- Breast Surgery Service, University Hospital Basel - Basel, Switzerland
- University Hospital of Bern (Inselspital) - Bern, Switzerland
- Graubünden Cantonal Hospital - Chur, Switzerland
- Clinique des Grangettes - Chêne-Bougeries, Switzerland
- Cork University Hospital - Cork, Ireland
- KH Dornbirn - Dornbirn, Austria
- Beaumont Hospital Dublin - Dublin, Ireland
- St- Luke's Hospital Dublin - Dublin, Ireland
- St. James's Hospital Dublin - Dublin, Ireland
- St. Vincent's University Hospital - Dublin, Ireland
- LKH Feldkirch - Feldkirch, Austria
- Spital Thurgau - Frauenfeld, Switzerland
- University Hospital Galway - Galway, Ireland
- Hôpitaux Universitaires de Genève - Geneva, Switzerland
- Clinique de Genolier - Genolier, Switzerland
- University Hospital Heidelberg, Women's Clinic - Heidelberg, Germany
- Brustzentrum Heidelberg Klinik St. Elisabeth GmbH - Heidelberg, Germany
- University Hospital of Heraklion - Heraklion, Greece
- MUI - Univ. Klinik f. Frauenheilkunde Innsbruck - Innsbruck, Austria
- İstanbul Bağcılar Training and Research Hospital - Istanbul, Turkey (Türkiye)
- Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital - Istanbul, Turkey (Türkiye)
- University Hospital of Larissa - Larissa, Greece
- Ordensklinikum Linz - Linz, Austria
- Hirslandenklinik St. Anna - Lucerne, Switzerland
- Kantonsspital Luzern - Lucerne, Switzerland
- Centro di Senologia della Svizzera Italiana - Lugano, Switzerland
- Ticino Breast Center - Lugano, Switzerland
- CIUSSS du Centre Ouest-de-l 'Ile-de-Montréal - Montreal, Canada
- Hôpital Neuchâtelois - Neuchâtel, Switzerland
- Breast Center Osnabrück - Osnabrück, Germany
- Istituto Oncologico Veneto IRCCS - Padova, Italy
- Bethesda Hospital Basel - Pratteln, Switzerland
- Pauls Stradiņš Clinical University Hospital - Riga, Latvia
- Breast Centre of Clinical Hospital, Rijeka - Rijeka, Croatia
- Policlinico Universitario "Agostino Gemelli - Rome, Italy
- Kantonsspital St. Gallen - Sankt Gallen, Switzerland
- Tumor-& Brustzentrum Ostschweiz St. Gallen - Sankt Gallen, Switzerland
- Schaffhausen Cantonal Hospital - Schaffhausen, Switzerland
- Spital Limmattal - Schlieren, Switzerland
- Hôpital du Valais, Hôpital de Sion - Sion, Switzerland
- Medical University Vienna, Department of Gynecology - Vienna, Austria
- Medical University Vienna, Department of Surgery - Vienna, Austria
- Kantonsspital Winterthur - Winterthur, Switzerland
- HELIOS Universitätsklinikum Wuppertal - Wuppertal, Germany
- Spital Zollikerberg - Zollikerberg, Switzerland
- Brustzentrum Zürich (Seefeld) - Zurich, Switzerland
- Stadtspital Triemli - Zurich, Switzerland
- University Hospital Zürich - Zurich, Switzerland