Can axillary surgery be tailored dependent on response to chemotherapy
Research type
Research Study
Full title
Can axillary lymph node malignancy be sufficiently determined by contrast enhanced ultrasound and axillary node biopsy to allow patients who have had an apparent successful response to primary chemotherapy avoid extensive axillary surgery
IRAS ID
180433
Contact name
Nisha Sharma
Contact email
Duration of Study in the UK
1 years, 11 months, 30 days
Research summary
Upfront chemotherapy is offered prior to breast cancer surgery to reduce the magnitude of surgical procedure and monitor tumour response. Tumour shrinkage may allow partial breast excision rather than total breast excision.
30-40% of patients have spread of the breast cancer to their armpit lymph nodes. Current treatment protocols allow a diminution in breast surgery if there is breast tumour shrinkage but no decrease in the armpit surgery. There is significant morbidity associated with axillary armpit clearance of lymph nodes, such as lymphoedema, which is physically disabling. There is also the longterm psychological upset that despite trying to return to normal life and not to be identified as a "breast cancer victim" the presence of arm swelling and diminished shoulder mobility is evident to all. It affects their quality of life and can lead to psycho-social problems including depression. To date there has been no reliable imaging modality that can accurately assess malignancy in the armpit lymph nodes following chemotherapy. Contrast enhanced ultrasound may identify the first lymph node that drains the breast in just over 90% of cases. This project describes innovative, state of the art armpit node imaging using contrast enhanced ultrasound and pathological assessment methods before and after chemotherapy to determine those patients where armpit nodal spread has resolved with chemotherapy and enable tailoring of treatment of the axilla with a decrease from the current extensive excision to a minimal approach.
This proposed pathway may reduce the number of women requiring axillary node clearance thereby resulting in a better quality of life for patients.REC name
Yorkshire & The Humber - Leeds East Research Ethics Committee
REC reference
15/YH/0374
Date of REC Opinion
6 Oct 2015
REC opinion
Further Information Favourable Opinion