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Upper Extremity Lymphatic Mapping for Breast Cancer Patients

This study has been completed.
Information provided by (Responsible Party):
Memorial Sloan Kettering Cancer Center Identifier:
First received: July 16, 2008
Last updated: October 19, 2015
Last verified: October 2015
This study is being done to see if lymph nodes that drain the arm also drain the breast. An axillary lymph node dissection removes lymph nodes under the arm. It is done to help prevent cancer cells from spreading to the rest of the body. Usually, about 12 to 15 nodes are removed. They are then examined to see if they have cancer cells. Removing these lymph nodes has some side effects. The most common is lymphedema. This is the build-up of fluid in the arm. This study will tell us if it may be possible in the future to identify lymph nodes that just drain the arm. Leaving those nodes may help to reduce the rate of lymphedema for future patients.

Condition Intervention
Breast Cancer Axillary Lymph Node Dissection Radiation: isosulfan blue dye

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Diagnostic
Official Title: Upper Extremity Lymphatic Mapping for Breast Cancer Patients: A Pilot Study

Resource links provided by NLM:

Further study details as provided by Memorial Sloan Kettering Cancer Center:

Primary Outcome Measures:
  • Number and Prevalence of Metastases of Blue Nodes in the ALND Specimen (Nodes Draining the Breast). [ Time Frame: 2 years ]

Enrollment: 13
Study Start Date: June 2008
Study Completion Date: October 2009
Primary Completion Date: October 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: 1
Patients with documented axillary metastases (Stage II breast cancer) will undergo subdermal injection of technetium sulfur colloid (TSC) into the ipsilateral upper extremity approximately 3 hours before surgery.
Radiation: isosulfan blue dye
At the time of surgery, each patient will undergo a subareolar injection of isosulfan blue dye into the ipsilateral breast as routinely performed during a sentinel lymph node mapping for breast cancer. The surgeon will then perform an axillary lymph node dissection in the usual, routine manner. The above differs from standard of care in that patients scheduled for an upfront axillary dissection do not routinely undergo sentinel lymph node mapping- therefore these patients would not normally get any isotope or TSC injections since they already need an ALND. Second, standard sentinel lymph node mapping involves injection of TSC into the affected breast the day prior to surgery or 3 hours before surgery versus injection of TSC into the ipsilateral upper extremity. The protocol specifies "day of" mapping for patient convenience.
Other Names:
  • Once the specimen is removed from the patient, the axillary nodes will be
  • dissected from the specimen and categorized: "blue only"; "radioactive only";
  • "blue and radioactive"; and "neither." The number of axillary nodes which are
  • "radioactive only" will indicate the nodes which drain the ipsilateral upper
  • extremity. The "blue and radioactive" nodes will indicate the sentinel lymph
  • nodes from the breast, which are also nodes that drain the ipstilateral upper
  • extremity. The prevalence of positive "radioactive only" and /or "blue and
  • radioactive", "blue only" and nodes with "neither" will be noted.


Ages Eligible for Study:   21 Years and older   (Adult, Senior)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Females with Stage II invasive breast cancer and documented axillary metastases by core biopsy, clinical examination, or fine-needle aspiration who are scheduled to undergo an ALND.
  • Females > 21 years of age

Exclusion Criteria:

  • Prior ipsilateral axillary surgery
  • Prior ipsilateral axillary radiation
  • Prior ipsilateral breast cancer
  • Prior ipsilateral breast radiation
  • Allergy to isosulfan blue dye
  • History of ipsilateral upper extremity lymphedema
  • Prior history of surgical excision of the upper outer quadrant of the ipsilateral breast
  • Prior history of neoadjuvant chemotherapy for current breast cancer
  • Bulky axillary disease at presentation (N2)
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00717886

United States, New York
Memorial Sloan Kettering Cancer Center
New York, New York, United States, 10065
Sponsors and Collaborators
Memorial Sloan Kettering Cancer Center
Principal Investigator: Leslie Montgomery, MD Memorial Sloan Kettering Cancer Center
  More Information

Additional Information:
Responsible Party: Memorial Sloan Kettering Cancer Center Identifier: NCT00717886     History of Changes
Other Study ID Numbers: 08-051
Study First Received: July 16, 2008
Results First Received: October 19, 2015
Last Updated: October 19, 2015

Keywords provided by Memorial Sloan Kettering Cancer Center:
Lymph Nodes

Additional relevant MeSH terms:
Breast Neoplasms
Neoplasms by Site
Breast Diseases
Skin Diseases processed this record on August 16, 2017