Precision Breast Conserving Surgery With Guidance.

NCT05708664 | Completed

• 1 other identifier: PBCST
• Study Type: interventional
• Target: 92
• Locations: 1 country
• Sites: 1

Brief Summary

From 2021 to 2022, 31 patients with unifocal breast cancer were enrolled for precision breast conserving surgery (PBCS) guided by wire guided localization (WGL) combined with CT guided 3D reconstruction. Surrounded WGL was performed under local anesthesia, followed by an immediate contrast enhanced CT scan. PBCS guided by CT guided 3D reconstruction was performed one day after the localization. Women who underwent palpation guided breast conserving surgery (BCS) were included as control. Two-sided Student t test, Fisher's exact test and chi-square test was applied.

Conditions

Breast Cancer

Keywords

breast cancer; precision breast conserving surgery; wire-guided localization; 3-dimensional image reconstruction

Outcome Measures

Primary Outcomes (1)

• The sum of located margin resection widths

  The sum of the resection widths of located superior, inferior, lateral and interior margins

  1 month post operation

Secondary Outcomes (4)

• The specimen diameter

  1 month post operation

• the largest margin resection width

  1 month post operation

• Operation time

  intraoperative

• Patients reported outcomes

  participants completed the scale at baseline (before surgery), 1 month post operation and 6 months post radiotherapy (RT)

Study Arms (2)

PBCS

EXPERIMENTAL

patients enrolled in the PBCS group underwent precision breast conserving surgery guided by wire guided localization combined with MDCT guided 3D reconstruction.

Procedure: precision breast conserving surgery guided by wire guided localization combined with MDCT guided 3D reconstruction

Control

NO INTERVENTION

patients enrolled in the Control group underwent palpation guided breast conserving surgery

Interventions

precision breast conserving surgery guided by wire guided localization combined with MDCT guided 3D reconstruction PROCEDURE

Local anesthesia was induced by using 1% lidocaine before wire location. The wire (localization set, PAJUNK) was placed in the superior, inferior, lateral and interior edge of the tumor through a 20-gauge needle using US guidance one day before BCS, respectively. Then, the patient underwent an immediate supine contrast enhanced CT (Philips Brilliance iCT) scan of the breast. The radiologist performed 3D reconstruction of CT images prior to surgery. Finally, the surgical procedures were performed by experienced breast surgeons combing 3D reconstruction of CT images and wire localizations one day after the localization.

PBCS

Eligibility Criteria

• Age: 18 Years+
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• women with T1/T2 invasive breast cancer confirmed by core biopsy
• be suitable for BCS
• the tumor should be unilateral and unifocal which is clearly visible with US

You may not qualify if:

• patients with an extensive intraductal component in invasive cancer
• patients who were pregnant or breast-feeding
• patients receiving neoadjuvant therapies.

Sponsors & Collaborators

• The First Affiliated Hospital with Nanjing Medical University: lead

Study Sites (1)

The First Affiliated Hospital with Nanjing Medical University

Nanjing, Jiangsu, 210000, China

Location

Related Publications (12)

• Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, Jeong JH, Wolmark N. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002 Oct 17;347(16):1233-41. doi: 10.1056/NEJMoa022152.

  PMID: 12393820 BACKGROUND

• Wrubel E, Natwick R, Wright GP. Breast-Conserving Therapy is Associated with Improved Survival Compared with Mastectomy for Early-Stage Breast Cancer: A Propensity Score Matched Comparison Using the National Cancer Database. Ann Surg Oncol. 2021 Feb;28(2):914-919. doi: 10.1245/s10434-020-08829-4. Epub 2020 Jul 13.

  PMID: 32661849 BACKGROUND

• Kim H, Lee SB, Nam SJ, Lee ES, Park BW, Park HY, Lee HJ, Kim J, Chung Y, Kim HJ, Ko BS, Lee JW, Son BH, Ahn SH. Survival of Breast-Conserving Surgery Plus Radiotherapy versus Total Mastectomy in Early Breast Cancer. Ann Surg Oncol. 2021 Sep;28(9):5039-5047. doi: 10.1245/s10434-021-09591-x. Epub 2021 Jan 25.

  PMID: 33492542 BACKGROUND

• Li P, Li L, Xiu B, Zhang L, Yang B, Chi Y, Xue J, Wu J. The Prognoses of Young Women With Breast Cancer (</=35 years) With Different Surgical Options: A Propensity Score Matching Retrospective Cohort Study. Front Oncol. 2022 Feb 28;12:795023. doi: 10.3389/fonc.2022.795023. eCollection 2022.

  PMID: 35296009 BACKGROUND

• Hanson SE, Lei X, Roubaud MS, DeSnyder SM, Caudle AS, Shaitelman SF, Hoffman KE, Smith GL, Jagsi R, Peterson SK, Smith BD. Long-term Quality of Life in Patients With Breast Cancer After Breast Conservation vs Mastectomy and Reconstruction. JAMA Surg. 2022 Jun 1;157(6):e220631. doi: 10.1001/jamasurg.2022.0631. Epub 2022 Jun 8.

  PMID: 35416926 BACKGROUND

• Moran MS, Schnitt SJ, Giuliano AE, Harris JR, Khan SA, Horton J, Klimberg S, Chavez-MacGregor M, Freedman G, Houssami N, Johnson PL, Morrow M; Society of Surgical Oncology; American Society for Radiation Oncology. Society of Surgical Oncology-American Society for Radiation Oncology consensus guideline on margins for breast-conserving surgery with whole-breast irradiation in stages I and II invasive breast cancer. J Clin Oncol. 2014 May 10;32(14):1507-15. doi: 10.1200/JCO.2013.53.3935. Epub 2014 Feb 10.

  PMID: 24516019 BACKGROUND

• Leiloglou M, Kedrzycki MS, Elson DS, Leff DR. ASO Author Reflections: Towards Fluorescence Guided Tumor Identification for Precision Breast Conserving Surgery. Ann Surg Oncol. 2022 Dec;29(Suppl 3):564-565. doi: 10.1245/s10434-021-10626-6. Epub 2021 Aug 18. No abstract available.

  PMID: 34406539 BACKGROUND

• Hill-Kayser CE, Vachani C, Hampshire MK, Di Lullo GA, Metz JM. Cosmetic outcomes and complications reported by patients having undergone breast-conserving treatment. Int J Radiat Oncol Biol Phys. 2012 Jul 1;83(3):839-44. doi: 10.1016/j.ijrobp.2011.08.013. Epub 2011 Dec 2.

  PMID: 22137022 BACKGROUND

• Ahmed M, Rubio IT, Klaase JM, Douek M. Surgical treatment of nonpalpable primary invasive and in situ breast cancer. Nat Rev Clin Oncol. 2015 Nov;12(11):645-63. doi: 10.1038/nrclinonc.2015.161. Epub 2015 Sep 29.

  PMID: 26416152 BACKGROUND

• O'Connell AM, Karellas A, Vedantham S, Kawakyu-O'Connor DT. Newer Technologies in Breast Cancer Imaging: Dedicated Cone-Beam Breast Computed Tomography. Semin Ultrasound CT MR. 2018 Feb;39(1):106-113. doi: 10.1053/j.sult.2017.09.001. Epub 2017 Sep 5.

  PMID: 29317032 BACKGROUND

• He Z, Chen Z, Tan M, Elingarami S, Liu Y, Li T, Deng Y, He N, Li S, Fu J, Li W. A review on methods for diagnosis of breast cancer cells and tissues. Cell Prolif. 2020 Jul;53(7):e12822. doi: 10.1111/cpr.12822. Epub 2020 Jun 12.

  PMID: 32530560 BACKGROUND

• Doihara H, Fujita T, Takabatake D, Takahashi H, Ogasawara Y, Shimizu N. Clinical significance of multidetector-row computed tomography in breast surgery. Breast J. 2006 Sep-Oct;12(5 Suppl 2):S204-9. doi: 10.1111/j.1075-122X.2006.00323.x.

  PMID: 16959003 BACKGROUND

MeSH Terms

Conditions

Breast Neoplasms

Condition Hierarchy (Ancestors)

Neoplasms by Site; Neoplasms; Breast Diseases; Skin Diseases; Skin and Connective Tissue Diseases

Study Officials

• Hui Xie, Doctor

  The First Affiliated Hospital with Nanjing Medical University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 9, 2023
• First Posted: February 1, 2023
• Study Start: August 1, 2021
• Primary Completion: June 30, 2022
• Study Completion: January 1, 2023
• Last Updated: February 1, 2023

Record last verified: 2023-01

Locations

CN (1)