Feasibility of Ultrasound Microbubble Contrast-Enhanced (CEUS) Sentinel Lymph Node Imaging With Guided Biopsy in Breast Cancer Patients

M.D. Anderson Cancer Center

Status: Completed

Conditions: Breast Cancer

Treatments: Behavioral: Phone Call; Device: Contrast-Enhanced Ultrasound (CEUS); Procedure: Biopsy + Radioactive Seed Placement; Drug: Perflutren Protein-Type A Microspheres Injectable Suspension

Study type: Interventional

Funder types: Other; Industry

Identifiers

NCT02321527

2014-0611

NCI-2015-00066 (Registry Identifier)

Details and patient eligibility

About

The goal of this clinical research is to learn if an ultrasound contrast agent called OPTISON (perflutren protein type A) is effective in finding sentinel lymph nodes before surgery. Contrast agents can help make ultrasound images more accurate. The sentinel lymph node is the first node that may be the target of cancer cells that spread from the tumor.

Full description

Study Procedures:

If you agree and are eligible to take part, you will receive perflutren protein type A by injection under the skin near the nipple. After you receive the injection, the radiologist will take more ultrasound images and videos of the tumor and lymph nodes in the underarm area.

You will have a biopsy of the sentinel lymph node that was identified in the ultrasound and a titanium clip marker will be inserted into the node. The clip helps distinguish the biopsied node from other nodes. You will be told the results of biopsy. After the biopsy, a radioactive seed may be inserted into the node to allow the surgeon to find and remove it during your surgery, an extra node may be removed at that time.

You will still have standard of care sentinel lymph node biopsy during your already scheduled surgery. You will sign a separate surgical consent form that explains this procedure and its risks.

You will be called by phone 30 days after the seed is removed to check for any side effects. This phone call should take about 10 minutes.

Length of Study:

Your active participation in this study will be over the follow up phone call.

This is an investigational study. Perflutren protein type A is FDA approved and commercially available for use in contrast-enhanced echocardiograms. Its use in this study is investigational.

Up to 21 patients will take part in this study. All will be enrolled at MD Anderson.

Enrollment: 21 patients

Sex: Female

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. 18 years or older.
2. Ipsilateral biopsy-proven invasive breast cancer <5 cm in maximal dimension by Ultrasound or Mammography.
3. No abnormal axillary nodes identified on grayscale AUS, or abnormal nodes with benign subsequent FNA biopsy.

Exclusion criteria

1. Pregnant or nursing women
2. Prior SLN dissection
3. Neoadjuvant chemotherapy.
4. Prior axillary lymph node surgery.
5. Prior history of ipsilateral breast cancer.
6. Known or suspected: Cardiac shunts
7. Known or suspected: hypersensitivity to perflutren, blood, blood products or albumin
8. Known or suspected: hypersensitivity to a prior OPTISON administration

Trial design

Primary purpose: Screening

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

---

21 participants in 1 patient group

Perflutren Protein-Type A Microspheres Injectable Suspension

Experimental group

Description:

Participants receive a subdermal periareolar injection of 0.2 - 0.5 cc of microbubble contrast Perflutren Protein-Type A Microspheres Injectable Suspension (OPTISON™). Ultrasound images and videos of tumor and lymph nodes in underarm area taken. Biopsy of sentinel lymph node that was identified in ultrasound performed, and a titanium clip marker inserted into the node. After biopsy, a radioactive seed may be inserted into the node to allow surgeon to find and remove it during surgery. Participant called by phone 30 days after seed is removed to check for any side effects. This phone call should take about 10 minutes.

Treatment:

Drug: Perflutren Protein-Type A Microspheres Injectable Suspension

Behavioral: Phone Call

Procedure: Biopsy + Radioactive Seed Placement

Device: Contrast-Enhanced Ultrasound (CEUS)