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RecruitingNCT03941756Updated May 26, 2026

Lymphovenous Bypass Procedure Before Underarm Lymph Node Surgery in Preventing Lymphedema in Patients With Inflammatory or Locally Advanced Non-inflammatory Breast Cancer or Melanoma

An interventional study of Indocyanine Green and Lymphangiography in Anatomic Stage III Breast Cancer AJCC v8, Breast Inflammatory Carcinoma and Locally Advanced Breast Carcinoma, sponsored by M.D. Anderson Cancer Center. Recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-05-26.

Sponsored by M.D. Anderson Cancer Center · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
252
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This pilot trial studies whether a procedure called lymphovenous bypass would prevent lymphedema (arm swelling) in patients with inflammatory breast cancer or non-inflammatory breast cancer that has spread to nearby tissues or lymph nodes or melanoma. The lymphovenous bypass procedure creates a path for lymphatic fluid to flow away from the arms. It is usually done after a diagnosis of lymphedema. In this study, giving lymphovenous bypass before underarm lymph node surgery may help prevent lymphedema from forming.

Read the detailed description

PRIMARY OBJECTIVES:

I. To evaluate the protective benefit to performing standard of care lymphovenous bypass (LVB) surgery at the time of standard of care axillary lymph node dissection (ALND) for patients that are high risk for developing breast-cancer related lymphedema (LE) of the upper extremity.

SECONDARY OBJECTIVES:

I. Compare the medical outcomes for patients that received the LVB surgery with those receiving standard surgery in whom the intervention could not be performed.

OUTLINE: Patients are randomized to 1 of 2 groups.

GROUP I: Patients receive indocyanine green intravenously (IV) and undergo lymphangiography, then undergo LVB at the time of ALND.

GROUP II: Patients do not receive indocyanine green, undergo lymphangiography, nor undergo LVB at the time of ALND.

After completion of study, patients are followed up at 2 weeks, and then at 6, 12, and 18 months.

02

Conditions studied

  • Anatomic Stage III Breast Cancer AJCC v8
  • Breast Inflammatory Carcinoma
  • Locally Advanced Breast Carcinoma
  • Melanoma
03

Who can participate

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

Inclusion criteria

  • Patients greater than or equal to 18 years of age.
  • Patients willing to participate.
  • Patients able to complete informed consent.
  • Patients will be eligible for inclusion if they fall into one for two groups:

    • Patients with inflammatory breast cancer, and those with locally advanced non-inflammatory breast cancer that are undergoing ALND and are anticipated to receive radiation therapy
    • Or: Patients with a diagnosis of melanoma (including unknown primary) that will undergo ALND will also be eligible for inclusion in the study as a comparator group.

Exclusion criteria

Exclusion Criteria:

  • Patients taking anticoagulants within 7 days prior to surgery.
  • Patients that are known to be pregnant at the time of surgery.
  • Patients are available for follow-up less than 18 months or do not undergo measurements within the scheduled period.
  • Patients with body mass index (BMI) greater than 50.0.
04

Study design

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

Study arms

  • Experimental
    Group I (LVB)

    Patients receive indocyanine green IV and undergo lymphangiography, then undergo LVB at the time of ALND.

    Drug: Indocyanine Green · Procedure: Lymphangiography · Procedure: Lymphovenous Bypass

  • No intervention
    Group II (no intervention)

    Patients do not receive indocyanine green, undergo lymphangiography, nor undergo LVB at the time of ALND.

Interventions

  • DrugIndocyanine Green

    Given IV

    Also known as: ICG

  • ProcedureLymphangiography

    Undergo lymphangiography

    Also known as: Lymphography

  • ProcedureLymphovenous Bypass

    Undergo LVB

    Also known as: Lymphovenous Anastomosis

05

What researchers measure

Primary outcomes

  1. Volumetric diagnosis of lymphedema

    If the limb volume change, meets the criteria for a diagnosis of lymphedema at any time (5 percent, change), then the patient receives a diagnosis of lymphedema.

    Time frame: 18 months

  2. Incidence of lymphedema

    Will compare the incidence of lymphedema after mastectomy and axillary lymph node dissection surgery between two surgical techniques.

    Time frame: 18 months

06

Study locations

1 of 1 sites recruiting
  • M D Anderson Cancer Center
    Houston, Texas 77030, United States
    Recruiting
07

Registry details

Key details

Study ID
NCT03941756
Lead sponsor
M.D. Anderson Cancer Center
Collaborators
National Cancer Institute (NCI)
Responsible party
Sponsor
First posted
May 8, 2019
Start date
Aug 14, 2018
Primary completion
Jan 1, 2027 (estimated)
Completion
Dec 1, 2027 (estimated)
Last update
May 26, 2026

Study contacts

Mark Schaverien
principal investigator · M.D. Anderson Cancer Center

Oversight

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

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