Breast Neoplasms Clinical Trial
Official title:
Magnetic Occult Lesion Localization and Imaging (MOLLI) for Non-palpable Breast Lesions: a Phase 0 Pilot Feasibility Trial
The proposed trial is a non-randomized, single-arm study examining the technical feasibility and safety of magnetic occult lesion localization and imaging (MOLLI) for Breast Conserving Surgery (BCS), in patients with non-palpable lesions. All patients who have an area of concern in the breast and are identified by their physician as good candidates for BCS are eligible to participate. All patients will undergo standard radioactive seed localization (RSL) for intraoperative surgical guidance concurrently with MOLLI localization. The feasibility trial will take place exclusively at a tertiary care institution (Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada) over a 1-year period. The primary endpoint of this study is to measure the success rate of localizing the MOLLI seed.
BACKGROUND INFORMATION
In contemporary breast cancer management, more than 70% of breast cancer patients are
eligible for - and select - breast-conserving therapy (BCS). However, issues with cosmesis,
patient experience, and treatment workflow efficiency during the therapeutic process have
considerable room for improvement.
BCS consists of a surgical procedure whereby the suspicious tumor and a rim of surrounding
normal tissue are removed. Up to one-third of all diagnosed breast cancers are
non-palpable,and require some form of pre-operative localization to guide precise surgical
excision. Currently, options for localization of non-palpable lesions are suboptimal in terms
of patient experience, healthcare system resource utilization, and cost-effectiveness.
One of the most common approaches is radioactive seed localization (RSL). RSL consists of
insertion of a small radioactive seed under ultrasound guidance to mark the center and/or
borders of the tumor. During the procedure the surgeon uses a hand-held probe to detect the
seed and guide surgical excision of the lesion intra-operatively. While RSL is effective the
use of a radioactive source is and poses many challenges for patients and staff.
WHAT ARE THE INVESTIGATORS DOING?
The investigative team of surgeons and scientists are examining an alternative approach to
BCS called magnetic occult lesion localization and imaging (MOLLI). Analogous to RSL, this
procedure involves implantation of a small passive magnetic seed - under ultrasound imaging
guidance - directly into or surrounding the tumor; during the procedure the surgeon uses a
novel hand-held probe to intra-operatively detect the position of this seed and remove the
tumor.
WHY IS THE STUDY BEING CONDUCTED?
MOLLI offers many of the same benefits as RSL but without any radiation. MOLLI also has the
potential to be more effective and accurate than other localization methods.
WHAT WILL HAPPEN DURING THE STUDY?
As part of this study, researchers will look at how safe the MOLLI system is in finding the
tumor in the participant's breast. The study will also gather information on the
participant's experience of having the MOLLI seed placed. Participants will undergo both
MOLLI as well as the current standard method, RSL, ensuring that the area of concern will be
accurately located and then removed. Approximately 20 women will take part in this study
ARE THERE SIDE EFFECTS?
No side effects are expected from the study treatments. Possible risks associated with using
MOLLI include:
- A small risk of bleeding following both visits
- A remote risk of allergic reaction to nickel contained in the MOLLI seeds
WHAT WILL HAPPEN AFTER THE STUDY?
Participants may be contacted by a study team member up to and including 16 weeks (6.5
months) after your procedure to take part in a short telephone questionnaire. The
questionnaire should take no more than 5 minutes to complete.
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