About this trial
This study will prospectively determine the feasibility and oncological safety of sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NACT) in inflammatory breast cancer patients traditionally considered ineligible for SLNB due to locally advanced cancer with skin/chest wall involvement (cT4d) and heavy nodal burden at presentation (cN1/N2). This study will also assess the identification rate of sentinel lymph-node (SLN) (using single tracer mapping) after NACT in this patient population. Finally, the study will determine the long-term outcome of such cohort.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Female patients over 18 years of age with clinically and biopsy-proven stage IIIB cT4d cN0-2 M0 breast cancer as assessed by clinical exam and imaging
Patients receiving NACT and having a nodal complete clinical response (ycN0) as assessed by physical exam and imaging (ultrasound and PET)
Ability to understand and willingness to sign informed consent document and comply with study procedures
Disqualifiers
Patients with cN3 stage at diagnosis
Participants with stage IV (metastatic) breast cancer
Participants with positive contralateral axillary nodes identified on standard imaging studies (mammograpy, MRI, ultrasound) and cito-histologically ascertained
Patients with a prior history of ipsilateral breast cancer
Trial design
Parallel
Treatments tested in this trial
SLN identification using technetium-99m
Procedure/SurgerySLN Biopsy after pre-surgery positive SLN visualization.
SLN intra-operatory identification with radioguided surgery
Procedure/SurgerySLN biopsy after no pre-surgery SLN visualization using technetium-99m and intra-surgery SLN identification.
Axillary Limph Node Dissection (ALND)
Procedure/SurgeryAxillary Limph Node Dissection (ALND) after no pre-surgery SLN visualization using technetium-99m and no intra-surgery SLN identification.
Treatment groups
Trial outcomes
Primary outcomes
intraoperative SLN identification rate.
Evaluation of the feasibility of SLNB in a selected cohort of IBC patients operated who responded to systemic NACT in the axillary nodes, achieving complete clinical response (ycN0). The feasibility of SLNB, defined as the intraoperative SLN identification rate, will be calculated as the proportion of patients with successfully identified intraoperative SLNs among the enrolled patients.
Secondary outcomes
Disease-free survival (DFS)
DFS will be defined as the time from surgery to loco-regional recurrence, metastasis, other primary non-breast carcinomas, or death, whichever occurs first.
Distant recurrence-free survival (DRFS)
DRFS will be defined as the time from surgery to distant recurrence or death from any cause, whichever occurs first.
Breast cancer-specific survival (BCSS)
BCSS will be defined as the time from surgery to death due to breast cancer.
Overall survival (OS)
OS will be defined as the time from surgery to death from any cause.
Sponsors and contacts
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