|
|
Screening Study of Breast Ultrasound and Mammography in Women at High Risk for Breast Cancer
Alternate Title Basic Trial Information Objectives Entry Criteria Expected Enrollment Outline Published Results Related Publications Trial Contact Information Registry Information
Alternate Title
Breast Ultrasound and Mammography in Screening Women at High Risk for Breast Cancer
Basic Trial Information
|
Phase
|
|
|
|
Type
|
|
|
|
Status
|
|
|
|
Age
|
|
|
|
Sponsor
|
|
|
|
Protocol IDs
|
|
|
|
No phase specified
|
|
|
|
Screening
|
|
|
|
Closed
|
|
|
|
25 and over
|
|
|
|
NCI
|
|
|
|
ACRIN-6666 NCT00072501, ACRIN-6666
|
|
|
Objectives Primary - Determine the diagnostic yield of whole breast bilateral screening ultrasound and mammography for the detection of breast cancer in women at high risk for breast cancer.
- Determine the cancer detection yield of a single contrast-enhanced magnetic resonance imaging (MRI) examination after 3 rounds of annual screening with ultrasound and mammography in these participants. (MRI component of the study)
Secondary - Determine the independent sensitivity and specificity of these screening methods in these participants.
- Correlate performance of these screening methods with selected participant characteristics (e.g., breast density and heterogeneity of the parenchyma).
- Validate the sonographic classification of lesions as "probably benign" and estimate the rate of malignancy in participants screened with these methods.
- Determine the cost effectiveness associated with screening breast ultrasound, in terms of radiologist and resource time performing the exam and the induced cost of screening ultrasound (e.g., follow-up and biopsy).
- Determine the reproducibility of lesion identification, measurement of lesion diameters, and volume and recording of lesion location on ultrasound in these participants.
- Determine the size, type, grade, and nodal status of cancers seen only on MRI in these participants. (MRI component of the study)
- Estimate the rate of benign biopsies and short interval follow-up induced only by MRI in these participants. (MRI component of the study)
- Determine the cost effectiveness of MRI, including induced costs of unnecessary biopsies and follow-up. (MRI component of the study)
- Compare the agreement among multiple examiners in sonographic, mammographic, and MRI feature analysis (using terms from the BI-RADS® lexicon) and final assessment (e.g., estimated probability of malignancy and/or recommendation for biopsy) in the enriched set of diagnostic training cases with consensus and histopathologic reference standards.
Entry Criteria Disease Characteristics:
Prior/Concurrent Therapy:
Biologic therapy Chemotherapy - No concurrent chemotherapy (MRI component of the study)
Endocrine therapy - See Disease Characteristics
- Concurrent chemoprevention with tamoxifen, raloxifene, anastrozole, exemestane or other aromatase inhibitor for participants with a personal history of cancer allowed (MRI component of the study)
Radiotherapy - See Disease Characteristics
Surgery - See Disease Characteristics
- More than 1 year since prior fine needle aspiration, core needle biopsy, or surgical procedure
- No prior bilateral mastectomy (MRI component of the study)
- More than 1 year since prior breast surgery on the study breast(s) (MRI component of the study)
- More than 5 months since prior core biopsy of the study breast(s) (MRI component of the study)
Other - More than 1 year since prior contrast-enhanced MRI of the breast
- More than 1 year (≥ 11 full months) since prior whole breast bilateral ultrasound
- More than 1 year since prior sonographic or mammographic contrast agent injection or tomosynthesis
- More than 2 years since prior screening contrast-enhanced MRI of the study breast(s) (MRI component of the study)
- More than 1 year since prior diagnostic contrast-enhanced MRI of the study breast(s) (MRI component of the study)
- No concurrent participation in any other breast cancer screening trial
- No concurrent participation in any other study involving breast MRI, sonographic or mammographic contrast agents, or tomosynthesis
- No concurrent dialysis
Patient Characteristics:
Age Sex Menopausal status Performance status Life expectancy Hematopoietic Hepatic Renal - Glomerular filtration rate ≥ 30 mL/min
Other - Not pregnant or nursing
- Fertile participants must use effective contraception
- Able to undergo adequate mammography and cooperate with breast ultrasound
- No concurrent medical or psychiatric condition that would preclude biopsy
- No other malignancy within the past 5 years except basal cell or squamous cell skin cancer or carcinoma in situ of the cervix
- No contraindications to MRI (e.g., pacemaker, aneurysm clip, or other implanted magnetic device)*
- No claustrophobia that cannot be controlled by medication with valium, ativan, or other sedative*
- Must have intravenous access*
- Weight < 300 pounds*
- Physically able to tolerate positioning in the MRI scanner*
- Able to undergo contrast-enhanced MRI within 4 weeks after completing both study ultrasound and mammogram at 24-month time point*
- Agrees to undergo follow-up MRI at 6 months and/or MRI-guided vacuum-assisted biopsy or ultrasound-guided core biopsy (if needed)*
[Note: *MRI component of the study] Expected Enrollment A total of 2,808 participants will be accrued for this study within 2 years. Outline This is a randomized, multicenter study. Participants are randomized to 1 of 2 screening arms. - Arm I: Participants undergo physician-performed bilateral whole breast ultrasound (US) followed by mammogram within 2 weeks.
- Arm II: Participants undergo mammogram followed by physician-performed bilateral whole breast US within 2 weeks.
In both arms, participants with negative or benign findings are rescreened according to their screening arm at 1 and 2 years. Participants with "probably benign" findings are rescreened at the 6-month follow-up visit. Participants with findings that are suspicious or highly suggestive of malignancy are recommended for biopsy. A subset of participants* in both arms undergo contrast-enhanced breast MRI within 4 weeks after completion of the 2-year screening US and mammogram. Participants with "probably benign" findings seen only on MRI may undergo an additional breast MRI at the 6-month follow-up visit. Participants with additional suspicious lesions seen only on MRI undergo second-look targeted US for biopsy guidance or MRI-guided vacuum-assisted biopsy after completion of any biopsies or additional views prompted by the 2-year screening US and mammogram visit. [Note: *No diagnosis of metastatic cancer of any type since entering this clinical trial.] Participants are followed annually for 3 years. Published ResultsBerg WA, Blume JD, Cormack JB, et al.: Combined screening with ultrasound and mammography vs mammography alone in women at elevated risk of breast cancer. JAMA 299 (18): 2151-63, 2008.[PUBMED Abstract] Related PublicationsBerg WA, Blume JD, Cormack JB, et al.: Lesion detection and characterization in a breast US phantom: results of the ACRIN 6666 Investigators. Radiology 239 (3): 693-702, 2006.[PUBMED Abstract] Madsen EL, Berg WA, Mendelson EB, et al.: Anthropomorphic breast phantoms for qualification of Investigators for ACRIN Protocol 6666. Radiology 239 (3): 869-74, 2006.[PUBMED Abstract] Berg WA: Supplemental screening sonography in dense breasts. Radiol Clin North Am 42 (5): 845-51, vi, 2004.[PUBMED Abstract] Berg WA: Rationale for a trial of screening breast ultrasound: American College of Radiology Imaging Network (ACRIN) 6666. AJR Am J Roentgenol 180 (5): 1225-8, 2003.[PUBMED Abstract]
Trial Contact Information
Trial Lead Organizations American College of Radiology Imaging Network | | | Wendie Berg, MD, PhD, Protocol chair | | | |
Registry Information | | Official Title | | Screening Breast Ultrasound in High-Risk Women | | Trial Start Date | | 2004-04-20 | | Registered in ClinicalTrials.gov | | NCT00072501 | | Date Submitted to PDQ | | 2003-10-01 | | Information Last Verified | | 2006-02-06 | | NCI Grant/Contract Number | | CA080098 |
Note: The purpose of most clinical trials listed in this database is to test new cancer treatments, or new methods of diagnosing, screening, or preventing cancer. Because all potentially harmful side effects are not known before a trial is conducted, dose and schedule modifications may be required for participants if they develop side effects from the treatment or test. The therapy or test described in this clinical trial is intended for use by clinical oncologists in carefully structured settings, and may not prove to be more effective than standard treatment. A responsible investigator associated with this clinical trial should be consulted before using this protocol. Back to Top |
|