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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT03514654
Other study ID # 17/0048
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date November 1, 2017
Est. completion date October 31, 2020

Study information

Verified date May 2021
Source University College, London
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Sometimes women have more than one breast cancer in the same breast at the same time. These women are usually offered a mastectomy (removal of that breast) and breast reconstruction. It may be possible to treat these patients by removing each cancer using breast-saving surgery (lumpectomies), used for women with only one breast cancer. Databases show that women who had lumpectomies did well, but they may have been healthier before the surgery than those who had a mastectomy. The investigators need to be sure that lumpectomy is effective, safe, and acceptable for this patient group before making it universally available.


Description:

The investigators will run a small study to evaluate whether a sufficient number of eligible patients can be identified and are willing to accept randomisation of the interventions in question. Recruitment and compliance rates of which will inform the feasibility and design of a larger trial. This will comprise a multi-centre randomised controlled trial in women with Multiple Ipsilateral Breast cancer (MIBC) requiring surgery. Participants will receive either Therapeutic Mammoplasty (TM) following excision of each cancer focus or mastectomy (+/- reconstruction). Patients will be randomised (1:1) into either intervention or control group.Therapeutic mammoplasty is an operation to remove breast cancer(s) whilst also significantly reducing the size of the breast. Therapeutic mammoplasty can be used to remove more than one cancer in the breast using separate lumpectomies. Both skin and breast tissue are removed, leaving scars similar to those seen after a standard breast reduction. Each patient is followed up for 12 months post treatment with a total of 50 patients recruited. Timings of the follow-up visits are aligned with standard of care practice for this patient population with quality of life questionnaires and clinical photographs completed before and after surgery. Twenty women will also be invited to an optional semi-structured interview at twelve months.


Recruitment information / eligibility

Status Completed
Enrollment 4
Est. completion date October 31, 2020
Est. primary completion date October 31, 2020
Accepts healthy volunteers No
Gender Female
Age group 40 Years and older
Eligibility Inclusion Criteria: 1. >40 years with MIBC, with the largest clinical cancer measuring 50mm as part of multifocal or multicentric "disease sites". 50mm may include the size of a single cancer and its surrounding small satellite cancers (6, 7). Clinically diagnosed (ultrasound and biopsy) either axillary lymph node negative or positive where axillary treatment depends on local policy 2. Two disease foci with a minimum of one invasive focus of breast cancer as defined within a "disease site" 3. Suitable for TM (best practice) using one large lumpectomy (multifocal) or any number of "distant" lumpectomies (multicentric) to excise "disease sites" 4. Fit for adjuvant therapy as per pre-operative evaluations (ECG, Chest X-ray, blood biochemistry) 5. Willing and able to provide written informed consent Exclusion Criteria: 1. Neo-adjuvant therapy 2. Women considered high risk by local centre or known to have BRCA1/2 gene mutation 3. Ductal Carcinoma in situ (DCIS) only, and extensive DCIS 4. Bilateral breast cancers 5. Previous breast cancer (invasive or DCIS in either breast) 6. Pregnancy as confirmed on blood tests or ultrasound examination 7. Metastatic disease 8. Any previous type of breast radiotherapy 9. Significant other clinical risk factors and co-morbidities at the discretion of the treating clinicians 10. Previous or concomitant malignancy except adequately treated: non-melanomatous skin cancer; in situ carcinoma of the cervix and in situ melanoma

Study Design


Related Conditions & MeSH terms


Intervention

Procedure:
Mastectomy
Removal of the whole breast.
Therapeutic Mammoplasty
Excision via lumpectomy of multifocal or multicentric cancers with breast volume displacement techniques to maximise cosmetic outcomes.

Locations

Country Name City State
United Kingdom Addenbrooke's Hospital Cambridge
United Kingdom South Glasgow Hospitals - New Victoria Hospital / Gartnavel General Hospital Glasgow
United Kingdom Ipswich Hospital Ipswich
United Kingdom St. George's Hospital London
United Kingdom Manchester University NHS Foundation Trust Manchester
United Kingdom Royal Cornwall Hospital Truro
United Kingdom Royal Hampshire Hospital Winchester

Sponsors (2)

Lead Sponsor Collaborator
University College, London National Institute for Health Research, United Kingdom

Country where clinical trial is conducted

United Kingdom, 

Outcome

Type Measure Description Time frame Safety issue
Primary Number of women screened Numbers of women with more than one cancer in the same breast (MIBC) screened for the trial 36 Months
Primary Number of women eligible for the trial Numbers of eligible women based on trial criteria and suitable for therapeutic mammoplasty 36 Months
Primary Consent rate The proportion of women eligible for the trial who provide written informed consent 36 Months
Primary Compliance with trial procedures Rate of compliance with allocated treatment and reason for deviation 36 Months
Secondary Reasons why patients accept or decline randomisation Tabulation of reasons why patients accept or decline randomisation (assessed from patient-completed Qualitative Study questionnaire) 36 Months
Secondary Qualitative research (clinical staff) Tabulation of views of clinical staff following qualitative interviews 36 Months
Secondary Qualitative research (patients) Tabulation of views of participating patients following qualitative interviews 36 Months