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Study Assessing The Interest of Indocyanine Green Fluorescence Imaging With Radioisotope Method For Sentinel Lymph Node Biopsy in Patients With Breast Cancer

Phase 3
Completed
Conditions
Breast Neoplasms
Interventions
Registration Number
NCT02279108
Lead Sponsor
Centre Hospitalier Universitaire de Saint Etienne
Brief Summary

The sentinel node has a fundamental role in the management of early breast cancer.

Currently, the double detection of blue and radioisotope is recommended. A radioactive material requires the presence of a nuclear medicine department and the approval of health authorities. In many centers, this technique is not available. The use of blue is easier to implement technique. However, allergic reactions and prolonged breast tattoo led many teams to stop the practice.

So in common practice, many center use a single method. However, with a single detection, the risk of false negatives and the identification failure rate increased to a significant extent and the number of sentinel lymph node detected and removed is not enough.

Under these conditions, find another method of detection seems crucial. According to the literature, the fluorescence method (ICG) is a technique that seems safe and reliable.

The investigators therefore propose a prospective, randomized study to investigate the interest of fluorescence associated with the isotopic method.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
99
Inclusion Criteria
  • Histologically proved infiltrating breast cancer (ductal, lobular carcinoma...) or a carcinoma in-situ with an elevated risk of micro-invasion. (High grade with necrosis, radiologically evaluated size more than 40mm, or immediate mastectomy...)
  • Unifocal or multifocal but in same quarter
  • Size < 5cm clinically palpable or not
  • Clinically or ultrasound axillary N0
  • Isotopic sentinel node detection
  • Adult patient
  • Signed informed consent by patient or legally responsable authority
  • Patient registered to a social security system
  • No surgical contra-indication
Exclusion Criteria
  • Mammary carcinoma recurrence
  • Previous same side mammary reduction
  • Previous lumpectomy
  • Contra-indication to surgery
  • Pregnant or breast feeding patient
  • Denial of participation

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
isotope detection aloneisotopeintradermal injection of 20 MBq of technetium 99 before breast surgery
double detection Indocyanine + isotopeisotopeintradermal injection of 2.5 milligrams of indocyanine green and 20 MBq of technetium 99 before breast surgery
double detection Indocyanine + isotopeindocyanine greenintradermal injection of 2.5 milligrams of indocyanine green and 20 MBq of technetium 99 before breast surgery
Primary Outcome Measures
NameTimeMethod
Number of Patients With Less Than Two Lymph Nodes Detectedperoperative

Number of patients with less than two lymph nodes detected by indocyanine (ICG) + isotope versus isotope detection alone

Secondary Outcome Measures
NameTimeMethod
Number of Lymph Nodes ICG Positive and Tc PositivePeroperative

Number of lymph nodes Indocyanine green (ICG) positive and Tc (Technetium)positive

Comparison Between Groups of the Time of the SurgeryPeroperative

time from incision to wound closure

Comparison Between Groups of Time Surgery NodePeroperative

time from incision time to the last node surgery

Number of Patients With ICG AllergyMonth 2

allergy is : redness, edema, itching, larynges edema and/or allergic shock

Number of Lymph Nodes ICG Positive and Tc NegativePeroperative

Number of lymph nodes Indocyanine green (ICG) positive and Tc (Technetium) negative

Comparison Between Groups of Anesthesia TimePeroperative

time from the injection of anesthesic to the waking

Number of Lymph Nodes ICG Negative and Tc PositivePeroperative

Number of lymph nodes Indocyanine green (ICG) negative and Tc (Technetium) positive

Time From Injection of One Dose ICG Injection to Incision TimePeroperative

time from injection of one dose ICG injection to incision time

Trial Locations

Locations (1)

Centre Hospitalier Universitaire de Saint-Etienne

🇫🇷

Saint-Etienne, France

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