Minimal Invasive Axillary Staging and Treatment After Neoadjuvant Systemic Therapy in Node Positive Breast Cancer

  • STATUS
    Recruiting
  • End date
    Jul 1, 2027
  • participants needed
    549
  • sponsor
    Maastricht University Medical Center
Updated on 19 February 2024
cancer
breast cancer
invasive breast cancer
axillary lymph node dissection
lymphadenectomy
systemic therapy

Summary

Today, the majority of clinically node positive (cN+) breast cancer patients is treated with neoadjuvant systemic therapy (NST). Axillary staging and treatment after NST in cN+ patients are areas of controversy. Patients with a pathological complete response (pCR) of the axillary lymph nodes are not expected to benefit from axillary lymph node dissection (ALND). Hence, less invasive axillary staging procedures are being introduced to avoid unnecessary ALND. However, evidence supporting the safety of replacing ALND by less invasive techniques in terms of oncologic safety and impact on quality of life (QoL) is lacking.

Description

The MINIMAX study is a multicenter observational registry study in cN+ breast cancer patients treated with NST (chemotherapy and immunotherapy) in order to gain insight in oncologic safety and impact on QoL of less and more invasive axillary staging and treatment strategies.

Patients who are included in this study will complete Patient Reported Outcome Measures (PROMs) at baseline (time of diagnosis) and 1 and 5 years after diagnosis to assess impact on QoL. A database will be built by the Netherlands Cancer Registry. Data on patient-, tumor-, pre-NST staging-, post-NST staging- and treatment-characteristics are retrieved from patients' records by trained data registrars of the Netherlands Comprehensive Cancer Organisation (IKNL) using electronic case report forms (eCRFs). Five-year survival and recurrence will be evaluated to determine oncologic safety.

The results will be incorporated in the national guidelines. In case of an equilibrium between less and more invasive strategies, the data of this study will at least be extremely suitable to be used in the shared decision making process.

Details
Condition Neoadjuvant Therapy, Breast Cancer, Breast Cancer, Lymph Node Metastases
Age 18-100 years
Clinical Study IdentifierNCT04486495
SponsorMaastricht University Medical Center
Last Modified on19 February 2024

Eligibility

Yes No Not Sure

Inclusion Criteria

Female patient with unilateral invasive breast cancer and cN1-3
Pathologically proven positive axillary lymph node
Planned to undergo NST (chemotherapy and immunotherapy), followed by staging and treatment of the breast and axilla

Exclusion Criteria

Clinically node negative breast cancer before NST
Distant metastases (including oligometastatic disease)
Axillary surgery or radiotherapy before NST (this includes SLNB prior to NST)
History of invasive breast cancer
Other malignancies except for basal/squamous cell skin cancer and in situ carcinoma of the cervix and breast
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