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Surgery

Early Surgery for Newly Diagnosed Stage IV Breast Cancer

Early Surgery or Standard Palliative Therapy in Treating Patients With Stage IV Breast Cancer (NCT01242800)

Summary

Approximately 3 to 4 percent of patients with newly diagnosed breast cancer have stage IV (metastatic) disease. When this occurs, the tumor is not usually removed unless it is causing symptoms such as ulceration or pain. (This is called palliative surgery.) It is not known whether removing the breast tumor before it causes problems (called early surgery) may help to extend survival. The goal of this trial is to compare early surgery with standard palliative surgery in individuals with metastatic disease who have a tumor in the breast. To be eligible, participants must have an intact primary (not recurrent) tumor in their breast.
This is a Phase III trial

A New Way to Assess Tumor Margins During Surgery

A Phase 0/1, Open-Label, Single Center Study of the Imaging Potential of Indocyanine Green in Subject Undergoing Breast Cancer Surgery (NCT01796041)

Summary

Studies suggest that up to 70 percent of women who choose to have a lumpectomy need a second operation (a re-excision) because the initial surgery did not result in a clean margin--an area around the tumor that is cancer-free. Currently surgeons feel the breast tissue to determine whether they have obtained a clean margin. This trial is looking at whether an imaging technique that can be performed during surgery makes it easier to identify tumor margins and decreases the need for a second operation. To be eligible, participants must be planning on having a lumpectomy.
This is a Phase O trial

Cryoablation (Freezing) Instead of Surgery & Radiation for Older Women with Small Tumors

Freezing Alone Instead of Resection and Radiotherapy Of Small Breast Tumors: A Study of Cryoablation in the Management of Prognostically Favorable Early Stage Breast Cancer in Elderly Women (NCT01992250)

Summary

Cryoablation uses extreme cold to destroy cancerous tumors. The procedure involves using an ultrasound to pass a thin metal probe through the center of the tumor and then cooling the probe to an extremely low temperatures (-276°F) to freeze and kill the breast tumor. The procedure does not leave any significant scarring. The researchers believe that cryoablation can successfully destroy a small tumor (no greater than 2.0 cm). This study is looking at how well cryoablation works to prevent local recurrence in women 70 and older who would have otherwise had surgery and radiation to treat an early-stage invasive breast cancer. To be eligible for this study, a woman must have a tumor that is classified as Luminal A on a core needle biopsy.
This is a Phase II-III trial

Regional Anesthesia and Breast Cancer Recurrence

Regional Anesthesia and Breast Cancer Recurrence (NCT00418457)

Summary

Surgery is the primary and most effective breast cancer treatment. The goal of surgery is to remove all of the cancer. However, scattered micrometastases and/or a few tumor cells are almost always missed. While a variety of factors determine whether a woman will go on to have a breast cancer recurrence, recent animal and human studies suggest that replacing general anesthesia/analgesia with regional anesthesia/analgesia results in a lower incidence of breast cancer metastases. This trial will help determine whether the risk of recurrence differs between women who receive regional anesthesia/analgesia compared to those who receive general anesthesia/analgesia.
This is a Phase III trial

Radiation During Lumpectomy Surgery for Stage I-III Breast Cancer

Lumpectomy Followed By Intraoperative Electron Radiation Therapy (IOERT) As A Single, Full Dose Partial Breast Irradiation For Early Stage, Node Negative, Invasive Breast Cancer (NCT01960803)

Summary

Researchers are studying new ways to give radiation therapy during or after breast cancer surgery. Intraoperative Electron Radiation Treatment (IOERT) is a radiation treatment that delivers a concentrated beam of radiation directly to the tumor bed. This study is investigating the feasibility and tolerability of giving a single dose of IOERT at the time of breast conserving surgery to patients with early stage breast cancer. To be eligible, patients must be scheduled to have a lumpectomy for stage I, II or III breast cancer.

Lumpectomy and Radiofrequency Ablation

ABLATE Registry: Radiofrequency Ablation After Breast Lumpectomy (eRFA) Added To Extend Intraoperative Margins in the Treatment of Breast Cancer (NCT01153035)

Summary

During a lumpectomy, the surgeon removes the tumor as well as some tissue surrounding the tumor. After the surgery, if the pathologist finds that there were cancer cells near the edges (margin) of the removed tissue, a second operation may be needed to remove more tissue. Radiofrequency ablation is a procedure that uses heat generated by an electrical current to destroy tumor tissue. Researchers believe that radiofrequency ablation given during a lumpectomy may help to ensure that no cancer remains in the margins. This may reduce the need for a second surgery. It also may reduce the chance of a local recurrence. The purpose of this trial is to see if lumpectomy followed by radiofrequency ablation reduces the need for a second surgery. To be eligible, participants must be planning to receive a lumpectomy.

Lymph Node Dissection & Radiation after Neoadjuvant Therapy to Treat Positive Node(s)

A Randomized Phase III Trial Evaluating the Role of Axillary Lymph Node Dissection in Breast Cancer Patients (cT1-3 N1) Who Have Positive Sentinel Lymph Node Disease After Neoadjuvant Chemotherapy (NCT01901094)

Summary

Researchers are studying the best way to treat women who have received neoadjuvant therapy (treatment given before surgery) and are found to have a positive sentinel node(s) during surgery. Radiation therapy uses high-energy x-rays to kill tumor cells that remain after surgery. Axillary lymph node dissection (ALND) removes tumor cells that have spread to nearby lymph nodes or other nodes in the axillary (armpit) area. This study is comparing the effectiveness of ALND plus radiation therapy to radiation therapy alone in treating women who had neoadjuvant treatment and were found to have a positive sentinel node(s) during surgery.
This is a Phase III trial

"Rational Dose" Gamma Knife Radiosurgery for Brain Metastases

A Pilot/Phase II Study of Gamma Knife Radiosurgery for Brain Metastases Using 3Tesla MRI and Rational Dose Selection (NCT02005614)

Summary

The purpose of this study is to collect prospective data for use as a comparator for future subsequent studies attempting to increase the efficacy or reduce the toxicity of Gamma Knife® Radiosurgery is a non-surgical procedure that is recognized as the preferred treatment for brain tumors. "Rational dose" is a method that assesses the best dose of radiation by taking into account tumor volume, prior radiation, and the relative resistance of the tumor to radiation. (Some tumors, like melanomas, are considered radioresistant wheres others, like breast cancer, are considered radiosensitive.) This study is evaluating the effectiveness of and side effects associated with using the rational dose method for gamma knife radiosurgery to treat brain metastases. The information will be used to design future studies on gamma knife radiosurgery. This study is enrolling patients with brain metastases from breast cancer as well as other types of cancers.
This is a Phase II trial

Telapristone Before Mastectomy for High-Risk, DCIS or Stage I-II Breast Cancer

Intra-mammary Distribution of Transdermal Telapristone Versus Oral Telapristone: A Randomized Window Trial in Women Undergoing Mastectomy (NCT02314156)

Summary

Telapristone is an anti-progesterone drug. Laboratory studies have found telapristone can prevent tumors from growing. Telapristone can be given as a pill or absorbed into the skin through a patch. Researchers want to see if giving telapristone before surgery can help prevent breast cancer in premenopausal women. This study is comparing the effectiveness of a telapristone pill or patch to a placebo pill or patch for preventing breast cancer in high-risk women and reducing risk of recurrence in women with DCIS or stage I-II breast cancer. To be eligible, a woman must be premenopausal and scheduled to have a unilateral or bilateral mastectomy.
This is a Phase II trial

Studying Tumor-to-Breast Ratio in Patients with DCIS or Early-Stage Breast Cancer

A Prospective Trial to AssessTumor:Breast Ratio and Patient Satisfaction in Following Lumpectomy Versus Mastectomy With Reconstruction (NCT02216136)

Summary

The size of the tumor compared to the size of the breast is referred to as the tumor-to-breast volume ratio. The ratio is a factor in whether a woman has the option of having a lumpectomy. In this study, women who are scheduled to undergo lumpectomy, mastectomy, or mastectomy with immediate reconstruction for ductal carcinoma in situ (DCIS), lobular carcinoma in situ (LCIS), or early stage breast cancer will have a breast MRI that determines their tumor-to-breast volume ratio prior to surgery. After surgery, patients will complete questionnaires designed to assess their quality of life.

Reducing Post-Operative Pain From Breast Reconstruction

A Prospective Randomized Double Blind Trial to Reduce Post-Operative Pain in Implant Based Breast Reconstruction (NCT02044302)

Summary

Opioids and sedatives like diazepam (valium) are the drugs typically used to manage pain in women who are having a mastectomy with breast reconstruction. Opioids are effective, but they can cause side effects like nausea, vomiting, sedation, and constipation. Bupivacaine is a local anesthetic. Botulinum toxin (commonly known as Botox) is a muscle relaxant. Both block the nerve impulses that send pain signals to the brain. This study is investigating whether using bupivacaine and Botox, either alone or together, during surgery will provide better pain control post-surgery and reduce incidences of opioid side effects in women who are having a mastectomy with breast reconstruction.
This is a Phase II trial

Using Regional & General Anesthesia to Reduce Pain & Nausea After Surgery & Reconstruction

Pectoral Nerve Block vs. Standard Anesthesia in Patients Undergoing Mastectomy and Immediate Breast Reconstruction: Impact on Post-operative Pain and Nausea/Vomiting(NCT02913573)

Summary

To take part in this study, you must be scheduled to have a mastectomy followed by immediate breast reconstruction with a tissue expander or implant. General anesthesia is used before breast cancer surgery. A pectoral nerve block is an anesthetic used to numb the chest area. In this study, researchers will see whether women who receive a pectoral nerve block along with general anesthesia immediately before surgery have less pain, nausea and vomiting after surgery and reconstruction than women who receive general anesthesia alone.
This is a Phase II trial