ClinicalTrials.gg
RecruitingNCT03909282NORDISUpdated Oct 7, 2026

Surgical Excision vs Neoadjuvant Radiotherapy+Delayed Surgical Excision of Ductal Carcinoma

An interventional study of Lumpectomy and Partial breast irradiation prior to surgery in Ductal Breast Carcinoma in Situ, sponsored by Stanford University. Recruiting at 1 site in United States. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-10-07.

Sponsored by Stanford University · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Mar 2019; still recruiting 7 years 7 months later.
Updated Oct 7, 2026Study contact changedGo to Updates ↓
Phase
Not applicable
Study type
Interventional
Enrollment
50
Allocation
Randomized
Ages
18 Years and older
Sex
Female
01

Study summary

The purpose of this pilot study is to compare by pathological findings surgical excision versus neoadjuvant radiotherapy followed by delayed surgical excision of ductal carcinoma in situ (DCIS)

Read the detailed description

There will be measurable histopathological treatment effects identified in Arm 2 cases receiving pre-operative radiation. Results found are expected to assist in designing a more definitive study. Compare pathological findings in individuals with ductal carcinoma in situ (DCIS) who have surgical excision versus neoadjuvant radiotherapy followed by delayed surgical excision.

It is noted that "phase 2" is formally associated with drug studies. Nonetheless, it is however part of the time of this study.

02

Conditions studied

  • Ductal Breast Carcinoma in Situ

Keywords

  • Ductal Breast Carcinoma
03

In context

Carcinoma, Intraductal, Noninfiltrating

285 studies on the registry are indexed under Carcinoma, Intraductal, Noninfiltrating; 54 are open to participants now.

This study's planned enrollment of 50 is below the median of 66 across 207 interventional studies indexed under Carcinoma, Intraductal, Noninfiltrating.

Browse Carcinoma, Intraductal, Noninfiltrating studies →

Lead sponsor

Stanford University is the lead sponsor of 2,168 studies on the registry; 431 are open to participants now.

Of its 267 completed or terminated interventional studies of FDA-regulated products, 207 (78%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Core needle demonstrating DCIS (ductal carcinoma in situ) of non-palpable, image-detected breast abnormality
  • Signed and dated IRB-approved written
  • Women 18 years of age or older
  • Mammographic calcifications or MRI non-mass enhancement measuring 4 cm or less in greatest dimension, including multifocal disease
  • Estrogen receptor positive or negative, progesterone receptor positive, negative or unknown; positive, negative or unknown DCIS is allowed
  • Diagnostic needle biopsy within 16 weeks of randomization
  • Patients must have a biopsy marker placed within the tumor bed confirmed on post biopsy imaging.
  • Placement of Savi scout optical reflectance marker in tumor bed area as a wireless guide for surgery and for neoRT treatment planning is preferred but not required if anatomic metallic markers are sufficient for radiation planning. Placement does not have to occur before randomization. Additionally, wire localization before surgery is permissible.
  • Planned lumpectomy. Mastectomy will be acceptable if lumpectomy fails by virtue of involved margins or size of lesion, or patient chooses this approach after randomization
  • Radiation Oncologist to ascertain feasibility of PBI prior to randomization - based on their estimation that 30% or less of the breast volume will be encompassed in the radiation fields
  • Patients who had a prior contralateral invasive or non-invasive (DCIS) cancer are eligible
  • performance status 0, 1, or 2
  • Concurrent foci of atypia or lobular carcinoma in situ in the ipsilateral or contralateral breast are allowed

Exclusion criteria

Exclusion Criteria

  • Invasive carcinoma on core needle , including microinvasive carcinoma
  • Radiographic extent of DCIS >4.0 cm
  • Mass lesion on breast imaging or palpable tumor
  • No residual radiographic lesion after diagnostic percutaneous core needle biopsy
  • Prior history of ipsilateral invasive or noninvasive breast cancer
  • Pregnant or breastfeeding
  • Prior ipsilateral breast or chest irradiation
  • Multicentric or multifocal DCIS, if extent is > 4cm
  • Synchronous contralateral invasive or noninvasive breast cancer
  • Pagets' disease of the breast
  • Active collagen vascular disease
  • Positive axillary lymph nodes
  • Not meeting the described criteria for partial breast irradiation during initial clinical evaluation.
  • Psychiatric or addictive disorders or other condition, that, in the opinion of the investigator, would preclude the patient from meeting the study requirements or interfere with the interpretation of study results
  • Endocrine therapy is not allowed from the time of study randomization to the completion of surgery unless the endocrine therapy is being continued for a contralateral cancer
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

HER2

HER2 is a protein, made from the ERBB2 gene, that drives the growth of some cancers. A study may look for a level of the protein, extra copies of the gene, or a particular change in it.

In breast cancer, protein tests are read as HER2-positive, HER2-low or HER2-negative; other cancers use their own rules. Check which test result the study requires.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
50 participants (estimated)

Study arms

  • Active comparator
    Surgical Excision

    Surgical excision of ductal carcinoma

    Procedure: Lumpectomy

  • Experimental
    Neoadjuvant partial breast irradiation

    Partial breast irradiation will be delivered once a day for 5 days before surgery. The planned daily dose is 6 Gy.

    Procedure: Lumpectomy · Radiation: Partial breast irradiation prior to surgery

Interventions

  • ProcedureLumpectomy

    Standard of Care surgery for DCIS (either lumpectomy or mastectomy)

    Also known as: Mastectomy

  • RadiationPartial breast irradiation prior to surgery

    Partial breast irradiation (PBI) will be delivered once aday for 5 days. The planned daily dose is 6 Gy prior to surgery (neo adjuvant)

06

What researchers measure

Primary outcomes

  1. Rate of ductal carcinoma in situ (DCIS) pathologic complete response

    A DCIS pathologic complete response will be defined as the absence of in situ carcinoma in the surgical resection specimen. The rate of DCIS pathologic complete response (pCR) will be calculated for Arm 1 and Arm 2.

    Time frame: 12 weeks

Secondary outcomes

  1. Correlation of ductal carcinoma in situ (DCIS) subtypes with rate of DCIS pathologic complete response to neoadjuvant partial breast irradiation (PBI)

    Molecular subtypes based on gene expression profiling with therapy response will be corelated. • DCIS subtypes will be defined based on grade, estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) status as follows: * Low/intermediate grade versus high grade * ER/PR-negative versus ER/PR-positive * HER2-positive versus HER2-negative

    Time frame: 12 weeks

  2. Tumor grade comparison of radiation-induced treatment effect pathologically pre- versus post-therapy

    Tumor grade (grade 1, 2, 3) will be compared pre- and post-therapy.

    Time frame: 12 weeks

  3. Nuclear atypia comparison of radiation-induced treatment effect pathologically pre- versus post-therapy

    Degree of nuclear atypia (low, intermediate, high) will be compared pre- and post-therapy.

    Time frame: 12 weeks

  4. Percent tumor necrosis comparison of radiation-induced treatment effect pathologically pre- versus post-therapy

    Percent tumor necrosis (0-100%) will be quantified on the basis of percentage of overall residual tumor area and compared pre- and post-treatment.

    Time frame: 12 weeks

  5. Tumor cellularity comparison of radiation-induced treatment effect pathologically pre- versus post-therapy

    Tumor cellularity (0-100%) will be quantified on the basis of percentage of overall residual tumor area and compared pre- and post-treatment.

    Time frame: 12 weeks

  6. Proportion of subjects experiencing a wound complication on Arm 1 compared to Arm 2

    Wound complications and healing will be monitored in both arms.The following events will be considered wound complications: wound dehiscence, hematoma requiring intervention, seroma requiring drainage, skin necrosis requiring resection, cellulitis requiring antibiotic therapy.

    Time frame: 12 weeks

  7. Correlation of post-radiation imaging characteristics with pathologic findings

    Mammography obtained prior to surgical resection in Arm 2 patients will be assessed for the presence or absence of a residual mammographic abnormality, the size in mm of the residual mammographic abnormality and the longest span in mm of residual calcification and will be compared to the pathologic presence or absence of residual tumor, size in mm of the pathologic residual DCIS and whether the residual calcification is associated with pathologic residual DCIS.

    Time frame: 12 weeks

  8. Rate of invasive carcinoma comparison in Arm 1 to Arm 2

    Rate of pathologic residual invasive carcinoma will be assessed in Arm 1 and Arm 2.

    Time frame: 12 weeks

07

Study locations

1 of 1 sites recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

1 registry update since Sep 25, 2026
Contact
Study contact changed: s•••@stanford.edu · •••4485→v•••@stanford.edu · •••7489. See the current contact
Oct 7, 2026
Site contacts
Changed at 1 site. See the sites
Show the site
  • Stanford University · Stanford, United StatesContact s•••@stanford.edu · •••4485→v•••@stanford.edu · •••7489
Oct 7, 2026
Show all 1 update
  1. Oct 7, 2026
    Contact Study contact changed: s•••@stanford.edu · •••4485→v•••@stanford.edu · •••7489. See the current contact
    Site contacts Changed at 1 site. See the sites
    Show the site
    • Stanford University · Stanford, United StatesContact s•••@stanford.edu · •••4485→v•••@stanford.edu · •••7489
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT03909282
Responsible party
Sponsor
First posted
Apr 10, 2019
Start date
Mar 22, 2019
Primary completion
Dec 2026 (estimated)
Completion
Dec 2026 (estimated)
Last update
Oct 7, 2026

Study contacts

Vishal Joshi
Contact
vishalj4@stanford.edu
650-725-7489
Irene Wapnir, MD
principal investigator · Stanford University

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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