Reverse Axillary Mapping as a Lymphedema Prevention Strategy in Breast Radiation Treatment Planning
- De novo presentation of post-operative (lumpectomy or mastectomy) female breast cancer patients to receive radiation to the whole breast or chest wall and the regional nodes. Patients who have received a sentinel lymph node (SLN) biopsy or an axillary lymph node dissection (ALND) will be eligible
- Informed consent obtained
- Patients with metastatic breast cancer
- Documented allergy to iodinated contrast
- Prior breast or axillary surgeries or radiation
- Pregnant women
- Patients with contraindications for iodinated contrast
I. To investigate whether axillary reverse mapping (ARM) can be used to delineate the upper extremity lymphatic (UEL) during the radiation treatment planning process.
I. To evaluate the maximum dose in units of gray delivered to the UEL (Dmax), minimum dose delivered to the UEL (Dmin), mean dose delivered to the UEL (Dmean), minimum dose delivered to 25% of the UEL (D25%), and minimum dose delivered to 75% of the UELD (D75%) delivered to the UEL during routine radiation treatment planning and whether there is any relationship to lymphedema rates at the pre-specified time points.
II. To determine whether it is hypothetically possible to safely modify radiation fields to reduce the dose (e.g. Dmin, Dmean, and Dmax) to the UELs while maintaining targeting coverage.
Patients receive iodinated contrast via injection after standard computed tomography (CT) simulation. Patients then undergo a second CT simulation 3 minutes after injection. Patients also undergo measurement of the circumference of upper and lower arms at 6, 12, 24, 36, and 60 months after treatment.
Trial Phase Phase NA
Trial Type Screening
UNC Lineberger Comprehensive Cancer Center
Dana Lynne Casey
- Primary ID LCCC1934
- Secondary IDs NCI-2020-08327
- Clinicaltrials.gov ID NCT04292860