No Sentinel Node Biopsy for Breast Cancer

PM
AO
Overseen ByAmy Oppenheim
Age: 65+
Sex: Female
Trial Phase: Academic
Sponsor: Cedars-Sinai Medical Center
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Approved in 5 JurisdictionsThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores the safety and effectiveness of skipping a sentinel node biopsy (a test for cancer spread) in women aged 65 and older with clinically node-negative breast cancer. Participants will undergo a lumpectomy, which removes the tumor, followed by standard treatments like radiation and hormone therapy. Suitable candidates have been diagnosed with specific types of breast cancer (ER+, HER2-negative) and either have had or plan to have a lumpectomy without a sentinel node biopsy. As an unphased trial, this study provides an opportunity to contribute to research that could simplify treatment for future patients.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that lumpectomy without sentinel node biopsy is safe for women with clinically node-negative breast cancer?

Research has shown that lumpectomy, a surgery to remove a breast tumor, is a safe treatment for breast cancer. Studies have found that breast-conserving surgeries like lumpectomy, followed by radiation, are generally well-tolerated. Large trials have demonstrated that these surgeries are safe compared to more extensive surgeries like mastectomy, which removes the entire breast.

In this trial, lumpectomy is performed without checking the lymph nodes for cancer spread, a procedure known as sentinel node biopsy. Research suggests that omitting this step may be safe for certain patients, such as those with small tumors that haven't spread to the lymph nodes. After surgery, patients receive standard radiation and hormonal therapy, which are common and well-known treatments.

Overall, evidence supports the safety of lumpectomy without sentinel node biopsy for women with breast cancer that hasn't spread to the lymph nodes.12345

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores a new approach to treating breast cancer that might simplify the surgical process. Typically, breast cancer treatment includes a procedure called a sentinel node biopsy to check if cancer has spread to the lymph nodes. However, this trial investigates the possibility of skipping this biopsy during a lumpectomy, while still providing standard radiation and hormonal therapy afterward. By potentially eliminating the need for this additional surgical step, the approach may reduce surgery time and associated risks, making the treatment less invasive and possibly more comfortable for patients.

What evidence suggests that lumpectomy without sentinel node biopsy is effective for clinically node-negative breast cancer?

Research has shown that a lumpectomy, which involves removing just the tumor and a small amount of nearby tissue, is as effective as a mastectomy (removal of the whole breast) for early-stage breast cancer in terms of survival. Studies have found that this breast-conserving surgery is safe and has low rates of cancer recurrence. For older women with early-stage breast cancer, long-term results are similar whether they choose a lumpectomy or a mastectomy. When followed by radiation, a lumpectomy offers survival rates comparable to a mastectomy, effectively treating the cancer while preserving more of the breast.

In this trial, participants will undergo a lumpectomy without a sentinel node biopsy, followed by standard care radiation and hormonal therapy.678910

Who Is on the Research Team?

Alice P. Chung, MD | Cedars-Sinai

Alice Chung, MD

Principal Investigator

Cedars-Sinal Medical Center

Are You a Good Fit for This Trial?

This trial is for women aged 65 or older with estrogen-positive, HER2-negative breast cancer that hasn't spread to lymph nodes. They should be planning a lumpectomy or have had one recently without sentinel node biopsy. Women with advanced cancer stages, those who've had mastectomy, inflammatory breast cancer, or prior treatments like chemotherapy for the current cancer are not eligible.

Inclusion Criteria

I have early-stage, ER+ & HER2- invasive breast cancer, diagnosed before surgery.
My breast cancer was early stage, ER positive, HER2 negative, and possibly had DCIS or LCIS.
I plan to have or had a lumpectomy recently without a sentinel node biopsy.
See 2 more

Exclusion Criteria

I have had chemotherapy before surgery for my current breast cancer.
I am planning to have or have had a mastectomy on one side.
I have had breast cancer or DCIS in the same breast before.
See 3 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Surgery

Participants undergo standard of care lumpectomy without sentinel node biopsy

1 day

Radiation and Hormonal Therapy

Participants receive standard of care radiation on the affected breast and hormonal therapy

6-8 weeks

Follow-up

Participants are monitored for regional recurrence with physical exams every six months for the first two years and then yearly for the last three years

6 years
Physical exams every 6 months for 2 years, then yearly for 3 years

What Are the Treatments Tested in This Trial?

Interventions

  • Lumpectomy
Trial Overview The study is testing the safety and effectiveness of performing a lumpectomy (surgery to remove a breast tumor) without checking the nearby lymph nodes (sentinel node biopsy) in older women with certain types of early-stage breast cancer.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: Lumpectomy without sentinel node biopsyExperimental Treatment1 Intervention

Lumpectomy is already approved in European Union, United States, Canada, Japan for the following indications:

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Approved in European Union as Lumpectomy for:
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Approved in United States as Lumpectomy for:
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Approved in Canada as Lumpectomy for:
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Approved in Japan as Lumpectomy for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

Cedars-Sinai Medical Center

Lead Sponsor

Trials
523
Recruited
165,000+

Published Research Related to This Trial

Partial mastectomy, which includes procedures like lumpectomy and wide excision, is effective for tumors smaller than 4 cm, and ensuring clear resection margins can significantly reduce the risk of local recurrence.
This surgical approach offers psychological benefits for patients, but it requires careful execution to prevent unacceptable changes in breast shape, and axillary dissection should be performed through a separate incision.
[Techniques of breast-conserving therapy in breast carcinoma].Mosny, D.[2008]

Citations

Comparative Effectiveness Analysis of Lumpectomy and ...In data analysis, our main finding is that lumpectomy and mastectomy have comparable long-term overall survival for early-stage elderly female breast cancer ...
Overall survival after mastectomy versus breast-conserving ...The pooled HR was 0.72 (95% c.i. 0.68 to 0.75, P < 0.001), demonstrating improved overall survival for patients undergoing breast-conserving ...
Breast-conserving surgery is a safe and effective treatment ...Research from Mayo Clinic finds breast-conserving surgery yields a low five-year recurrence rate for women with multiple ipsilateral breast ...
Oncological outcomes of breast-conserving surgery versus ...More deaths occurred in the mastectomy group (8.5% versus 3%; p = 0.03). Ten-year LR-free survival was higher in the BCS group (98.5% versus 95 ...
Lumpectomy vs Mastectomy: How to ChooseFor early stage breast cancer, there is absolutely NO difference in survival between a mastectomy and a lumpectomy with radiation.
The prognostic differences between breast-conserving ...The study investigates the prognostic differences between breast-conserving surgery (BCS) and mastectomy in patients with invasive ductal ...
Survival comparison of breast conserving therapy and ...Cohort studies have suggested that breast-conserving therapy (BCT) offers better survival outcomes compared to mastectomy in patients with ...
Total Lumpectomy vs Nipple-Sparing LumpectomyAvailable data show that NSL provides oncologic safety comparable to traditional lumpectomy, with no significant differences in survival or ...
20-year results of EORTC 10801Large multicenter clinical trials have demonstrated the safety of breast conserving surgery and radiation (BCT) compared to modified radical mastectomy ...
Long-Term Oncologic Outcome of Breast-Conserving ...The rates of LRR and DR were 4.9% and 9.0%, respectively, and 35 patients (6.3%) died during the follow-up period. Among patients who did not ...
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