Completed
23-01

Surgical Resection With or Without Axillary Lymph Node Dissection in Treating Women With Node-Negative Breast Cancer and Sentinel Lymph Node Micrometastases

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What is being tested

Axillary lymph node dissection

+ No axillary lymph node dissection
Procedure
Who is being recruted

Breast Cancer

Over 18 Years

See all eligibility criteria

How is the trial designed

Treatment Study

Interventional
Study Start: December 2001

See protocol details

Summary

Principal SponsorETOP IBCSG Partners Foundation
Last updated: January 23, 2018
Sourced from a government-validated database.Claim as a partner
Study start date: December 1, 2001Actual date on which the first participant was enrolled.

RATIONALE: Surgery to remove lymph nodes in the armpit in patients with sentinel lymph node micrometastases may remove cancer cells that have spread from tumors in the breast. It is not yet known whether surgery to remove the primary tumor is more effective with or without axillary lymph node dissection. PURPOSE: This randomized phase III trial is studying surgery and axillary lymph node dissection to see how well they work compared to surgery alone in treating women with node-negative breast cancer and sentinel lymph node micrometastases. OBJECTIVES: * Compare disease-free survival of women with clinically node-negative breast cancer with sentinel lymph node micrometastases treated with surgical resection with or without axillary dissection. * Compare overall survival of patients treated with these regimens. * Assess sites of recurrence, particularly reappearance of disease in the undissected axilla. * Assess long-term surgical complications in patients treated with these regimens. OUTLINE: This is a multicenter study. Patients are stratified according to participating center, menopausal status (pre- vs postmenopausal), and preoperative sentinel node biopsy (yes vs no). Patients are followed every 4 months for 1 year, every 6 months for 4 years, and then annually thereafter.

Official TitleA Randomized Trial Of Axillary Dissection Versus No Axillary Dissection For Patients With Clinically Node Negative Breast Cancer And Micrometastases In The Sentinel Node 
Principal SponsorETOP IBCSG Partners Foundation
Last updated: January 23, 2018
Sourced from a government-validated database.Claim as a partner

Protocol

This section provides details of the study plan, including how the study is designed and what the study is measuring.
Design Details
931 patients to be enrolledTotal number of participants that the clinical trial aims to recruit.
Treatment Study
These studies test new ways to treat a disease, condition, or health issue. The goal is to see if a new drug, therapy, or approach works better or has fewer side effects than existing options.

How participants are assigned to different groups/arms
In this clinical study, participants are placed into groups randomly, like flipping a coin. This ensures that the study is fair and unbiased, making the results more reliable. By assigning participants by chance, researchers can better compare treatments without external influences.

Other Ways to Assign Participants
Non-randomized allocation: Participants are assigned based on specific factors, such as their medical condition or a doctor's decision.
None (Single-arm trial): If the study has only one group, all participants receive the same treatment, and no allocation is needed.

How treatments are given to participants
Participants are divided into different groups, each receiving a specific treatment at the same time. This helps researchers compare how well different treatments work against each other.

Other Ways to Assign Treatments
Single-group assignment: Everyone gets the same treatment.
Cross-over assignment: Participants switch between treatments during the study.
Factorial assignment: Participants receive different combinations of treatments.
Sequential assignment: Participants receive treatments one after another in a specific order, possibly based on individual responses.
Other assignment: Treatment assignment does not follow a standard or predefined design.

How the effectiveness of the treatment is controlled
In a non placebo-controlled study, no participants receive an inert substance (placebo) to compare outcomes. Instead, all participants receive either the experimental treatment or an alternative treatment (often the Standard of Care). This method allows researchers to compare the effects of the experimental treatment with those of a different active intervention, rather than a placebo.

Other Options
Placebo-Controlled: A placebo is used to compare the effects of the experimental treatment with those of an inert substance, isolating the true treatment effect.

How the interventions assigned to participants is kept confidential
Everyone involved in the study knows which treatment is being given. This is typically used when it's not possible or necessary to hide the treatment details from participants or researchers.

Other Ways to Mask Information
Single-blind: Participants do not know which treatment they are receiving, but researchers do.
Double-blind: Neither participants nor researchers know which treatment is given.
Triple-blind: Participants, researchers, and outcome assessors do not know which treatment is given.
Quadruple-blind: Participants, researchers, outcome assessors, and care providers all do not know which treatment is given.

Eligibility

Researchers look for people who fit a certain description, called eligibility criteria: person's general health condition or prior treatments.
Conditions
Criteria
FemaleBiological sex of participants that are eligible to enroll.
Over 18 YearsRange of ages for which participants are eligible to join.
Healthy volunteers not allowedIf individuals who are healthy and do not have the condition being studied can participate.
Conditions
Pathology
Breast Cancer
Criteria

DISEASE CHARACTERISTICS: * Clinical, mammographic, ultrasonographic, or pathologic diagnosis of unicentric and unifocal breast carcinoma * Largest tumor lesion ≤ 5 cm * Palpable or nonpalpable breast lesion * Preoperative radioactive occult lesion localization, hook wire, or other method of localization required for nonpalpable lesions * Prior (preoperative) or planned (intraoperative) sentinel node biopsy required * At least 1 micrometastatic (i.e., no greater than 2 mm) sentinel lymph node with no extracapsular extension * No clinical evidence of distant metastases * No suspicious manifestation of metastases that cannot be ruled out by x-ray, MRI, or CT scan, including the following: * Skeletal pain of unknown cause * Elevated alkaline phosphatase * Bone scan showing hot spots * No palpable axillary lymph node(s) * No Paget's disease without invasive cancer * Hormone receptor status: * Estrogen receptor and progesterone receptor known PATIENT CHARACTERISTICS: Age * Any age Sex * Female Menopausal status * Any status Performance status * Not specified Life expectancy * Not specified Hematopoietic * Not specified Hepatic * See Disease Characteristics Renal * Not specified Other * Not pregnant or nursing * No other prior or concurrent malignancy except the following: * Adequately treated basal cell or squamous cell skin cancer * Adequately treated carcinoma in situ of the cervix * Adequately treated in situ melanoma * Contralateral or ipsilateral carcinoma in situ of the breast * No psychiatric, addictive, or other disorder that may compromise ability to give informed consent * Geographically accessible for follow-up PRIOR CONCURRENT THERAPY: Biologic therapy * Not specified Chemotherapy * Not specified Endocrine therapy * Not specified Radiotherapy * Not specified Surgery * See Disease Characteristics Other * No prior systemic therapy for breast cancer * More than 1 year since prior chemopreventive agent

Study Plan

Find out more about all the medication administered in this study, their detailed description and what they involve.
Treatment Groups
Study Objectives
2 intervention groups 

are designated in this study

This study does not include a placebo group 

Treatment Groups
Group I
Active Comparator
Patients undergo surgical resection of the primary tumor with axillary lymph node dissection following sentinel lymph node assessment.
Group II
Experimental
Patients undergo surgical resection of the primary tumor with no axillary lymph node dissection following sentinel lymph node assessment.
Study Objectives
Primary Objectives

Estimated percentage of patients alive and disease-free at 5 years from randomization, where disease-free survival is defined as the time from randomization to first evidence of invasive relapse at any site, second primary tumor (contralateral or non-breast) or death.
Secondary Objectives

Estimated percentage of patients alive and disease-free at 5 years from randomization, where overall survival is defined as the time from randomization to death of any cause.

Site of recurrence of breast cancer

Study Centers

These are the hospitals, clinics, or research facilities where the trial is being conducted. You can find the location closest to you and its status.
This study has 31 locations
Suspended
Lismore Base HospitalLismore, AustraliaSee the location
Suspended
St Vincents HospitalLismore, Australia
Suspended
Mater Hospital - North SydneyNorth Sydney, Australia
Suspended
Royal North Shore HospitalSt. Leonards, Australia
Completed31 Study Centers