Clinical Trials Logo

Clinical Trial Summary

The study hypothesis is that the rate of inadequate surgical margins after conservative breast surgery for DICS and the rate of reoperation (re-excision or/and mastectomy) is lower in the group of patients who underwent standard preoperative mammography and CEM to assess the extent of DICS, compared to the group of patients for whom the preoperative assessment of the extent of in situ breast cancer was not performed using one of the imaging techniques with contrast medium such as contrast mammography or magnetic resonance imaging.


Clinical Trial Description

Ductal carcinoma in situ (DCIS) is the earliest form of malignant lesion in the breast, which in most cases is diagnosed by mammography screening, usually in the form of asymptomatic calcifications. The question of whether DCIS is a true malignancy of the breast, which pathological criteria are used for diagnosing and classifying DCIS, but also the questions of the nature of the disease and its overtreatment are controversial. Surgery is still the primary treatment of DCIS, and the status of the surgical margins is of paramount importance. Compared to invasive ductal carcinoma, the re-excision rate in DCIS is relatively high (30-40%), probably because the change is not palpable. Segmental distribution, with areas affected by the disease that are not calcified and therefore not detected, and stricter guidelines for appropriate surgical margins may also contribute to the re-excision rate. Because the diagnosis of DCIS is closely associated with mammographic detection of pathologic calcifications, it was assumed that magnetic resonance (MR) imaging would provide little or no value for their detection and visualization. However, a study conducted by Kuhl et al. showed that breast MRI has a significantly higher sensitivity than mammography in detecting DCIS. In addition, subsequent studies have shown that MRI is more accurate than mammography in assessing the distribution of DCIS. In recent years, mammography with an iodine contrast agent, known as contrast mammography (CEM), has been introduced, which, like MRI, is based on the evaluation of tumor angiogenesis. It is important to emphasize that the sensitivity of CEM in detecting malignant lesions corresponds to the sensitivity of MR. CEM has several advantages over breast MRI, the most important of which are the availability and the shorter imaging time, as well as the shorter time required to analyze the mammogram and read the findings. Numerous studies show that patients tolerate CEM better than MRI. The study hypothesis is that the rate of inadequate surgical margins after conservative breast surgery for DICS and the rate of reoperation (re-excision or/and mastectomy) is lower in the group of patients who underwent standard preoperative mammography and CEM to assess the extent of DICS, compared to the group of patients for whom the preoperative assessment of the extent of in situ breast cancer was not performed using one of the imaging techniques with contrast medium, such as contrast mammography or magnetic resonance imaging. The interventional cohort involves 50 consecutive patients with newly diagnosed DCIS who will undergo surgery at CHC Rijeka in 2024, 2025, and 2026 and who agree to have a CEM performed before surgery as part of the diagnostic work-up in addition to standard mammography and who agree to participate in the trial. Patients diagnosed with ductal in situ carcinoma who underwent surgery at CHC Rijeka in the period from 2019 to 2024 and whose clinical data are available in the prospectively managed clinical register for breast diseases at CHC Rijeka and the Integrated Hospital Informatics System (IBIS), are included in the second (control) cohort. Two clinical radiology specialists with experience in breast radiology will evaluate the morphologic and functional features of standard MMG and CEM by consensus, and assess the extent of disease using the BI-RADS lexicon for imaging with contrast mammography. Demographic and imaging data (morphological and functional characteristics on CME such as background parenchymal enhancement, presence/absence of a lesion, location of the lesion in breast quadrant, type of lesion, size of the lesion in mm and BI-RADS category are analyzed for each lesion) will be recorded. Only one lesion per breast is considered, and if multiple lesions are visible, the overall diameter of the suspicious area will be considered. The above parameters are compared with the grade of the DCIS tumor, i. e. the morphological and functional characteristics of G1 and G2 lesions compared to G3 lesions. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT06217458
Study type Interventional
Source Clinical Hospital Center Rijeka
Contact Petra Valkovic Zujic, PhD
Phone +98598713493
Email petra.valkovic@gmail.com
Status Not yet recruiting
Phase N/A
Start date March 1, 2024
Completion date January 1, 2027

See also
  Status Clinical Trial Phase
Completed NCT00256217 - Chemoprevention Trial - Anastrozole in Ductal Carcinoma In Situ (DCIS) in Postmenopausal Women Phase 2
Completed NCT03931928 - Genotype and Phenotype Guided Supplementation of TAMoxifen Standard Therapy With ENDOXifen in Breast Cancer Patients Phase 2
Terminated NCT03535506 - Preoperative Palbociclib in Patients With DCIS of the Breast That Are Candidates for Surgery Phase 2
Recruiting NCT04797299 - Prospective Evaluation of Breast-Conserving Surgery Alone in Low-Risk Ductal Carcinoma in Situ (DCIS)
Completed NCT02637024 - Trial of Radiation Fractionation Schedules for Once-a-Day Accelerated Partial Breast Irradiation Phase 2
Completed NCT00148655 - Educational Interventions for Patients With DCIS N/A
Suspended NCT03936478 - Real-Time MRI-Guided 3-Fraction Accelerated Partial Breast Irradiation in Early Breast Cancer Phase 2
Recruiting NCT03878342 - Radiotherapy Omission in Low Risk Ductal in Situ Carcinoma Breast N/A
Recruiting NCT03793829 - Neoadjuvant Multi-epitope HER2 Peptide Vaccine in Patients With HER2-expressing DCIS Phase 1/Phase 2
Active, not recruiting NCT04245150 - Assessing the Impact of the Microbiome on Breast Cancer Radiotherapy Toxicity
Recruiting NCT06388304 - THRIVE Study: Positive Affect Training for Endocrine Therapy Medication Adherence N/A
Recruiting NCT04722692 - Delayed Sentinel Lymph Node Biopsy in Ductal Cancer in Situ Phase 3
Enrolling by invitation NCT05868252 - Molecular Analysis of the Sloane Project
Recruiting NCT05912569 - Delayed Selective Sentinel Node Biopsy for Patients Undergoing Mastectomy for DCIS N/A
Recruiting NCT04049214 - Perioperative Mindfulness Proposal N/A
Completed NCT02061332 - DC Vaccine for Patients With Ductal Carcinoma In Situ Phase 1/Phase 2
Recruiting NCT04916808 - The AUS-PREDICT Registry for DCIS Patients With DCISionRT Testing
Withdrawn NCT05436808 - Partial Chest Wall Radiation Therapy After Surgery for Lymph Node Negative Breast Cancer Early Phase 1
Recruiting NCT05900986 - LS301-IT in Partial Mastectomy and Sentinel Lymph Node Biopsy (SLNB) for DCIS or Stage I-II Primary Invasive Breast Cancer Phase 1/Phase 2
Suspended NCT03448926 - The PREDICT Registry for DCIS Patients With DCISionRT Testing