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CompletedNCT04951245UltraCarsUpdated Jan 28, 2022

Ultrasound-assisted CNSs Mapping Versus Dual-tracer-guided Sentinel Lymph Node Biopsy

A Phase 3 interventional study of UC group: ultrasound-assisted CNSs guided and GC group: CNSs plus ICG dual-tracer-guided in Breast Cancer, sponsored by Guangdong Provincial People's Hospital. Completed at 1 site in China. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2022-01-28.

Sponsored by Guangdong Provincial People's Hospital · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
330
Allocation
Randomized
Ages
18 Years and older
Sex
Female
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Study summary

The investigators suggested ultrasound-assisted Carbon nanoparticle suspensions (CNSs) mapping had great clinical value in clinical application and might serve as a useful alternative to the dual-tracer-guided SLNB. The investigators designed this prospective, randomized controlled phase 3 trial, to compare the feasibility and diagnostic performance of ultrasound-assisted carbon nanoparticle suspensions mapping versus dual-tracer-guided sentinel lymph node biopsy in patients with early breast cancer.

Read the detailed description

The study was a single-center, open-label, randomized controlled, non-inferiority, phase 3 trial. Eligible participants were 18 year's of age or older and had histologically confirmed primary invasive breast cancer, or ductal carcinoma in situ scheduled for mastectomy, without clinical or radiological nodal involvement (cN0) or with clinical positive lymph nodes (cN1) that were downstaged to cN0 following neoadjuvant chemotherapy (NCT); and had an Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1. Participants were randomly assigned (1:1) using a permuted block randomization scheme to receive either ultrasound-assisted CNSs (UC group) or CNSs plus ICG dual-tracer-guided (GC group) SLN mapping.

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Conditions studied

  • Breast Cancer

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03

In context

Breast Neoplasms

12,547 studies on the registry are indexed under Breast Neoplasms; 2,892 are open to participants now.

This study's enrollment of 330 is above the median of 72 across 9,305 interventional studies indexed under Breast Neoplasms.

Browse Breast Neoplasms studies →

Lead sponsor

Guangdong Provincial People's Hospital is the lead sponsor of 231 studies on the registry; 101 are open to participants now.

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

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Who can participate

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

Inclusion criteria

  1. The participants must be female and 18 years of age or older.
  2. Resectable invasive adenocarcinoma of the breast, confirmed histologically.
  3. Ductal carcinoma in situ confirmed histologically.
  4. The participants must be a preoperative clinical Tis, T1, T2, T3 as well as clinical M0 breast cancer.
  5. Without clinical or radiological nodal involvement (cN0): No positive ipsilateral axillary lymph nodes; No prior removal of ipsilateral axillary lymph nodes; No suspicious palpable nodes in the contralateral axilla or palpable supraclavicular or infraclavicular nodes, unless proven nonmalignant by biopsy.
  6. With clinical positive lymph nodes (cN1) (including any abnormal or enlarged clinically palpable lymph nodes or core biopsy/surgical biopsy/FNA evidence of malignant cell within any lymph nodes) that was downstaged to cN0 following neoadjuvant therapy.
  7. The participants must have an ECOG performance status of Grade 0-1.
  8. The participants must provide written informed consent before participating in the study.

Exclusion criteria

Exclusion criteria:

  1. The breast has ulceration, erythema, infiltration of the skin or underlying chest wall (complete fixation), peau d'orange, or skin edema of any magnitude. Tethering or dimpling of the skin or nipple inversion allowed.
  2. The participants has a known hypersensitivity to tracers planned for use during SLNB.
  3. Other prior breast malignancy except lobular carcinoma in situ.
  4. The participants has had prior breast implants.
  5. The participants has had prior breast reduction surgery.
  6. The participants has had other prior surgery in the upper, outer quadrant, areola, or axilla to the indicated breast.
  7. The participants has a positive pregnancy test or is lactating.
  8. The participants has participated in another investigational drug study during the 30 days prior to signing informed consent.
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Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
330 participants (actual)

Study arms

  • Experimental
    UC group

    Ultrasound-assisted CNSs guided SLN mapping

    Procedure: UC group: ultrasound-assisted CNSs guided

  • Active comparator
    GC group

    CNSs plus ICG dual-tracer-guided SLN mapping

    Procedure: GC group: CNSs plus ICG dual-tracer-guided

Interventions

  • ProcedureUC group: ultrasound-assisted CNSs guided

    1ml of CNSs was subcutaneously injected into the areolar area in the upper outer quadrant of the breast. The injection site was massaged for 15 minutes to promote drainage of the tracer to the axilla. During the intraoperative ultrasound-assisted procedure, an ultrasound diagnostic system was used. Before the incision, ultrasound-guided exploration of SLNs was performed by placing the probe on the lateral border of the breast and sliding cranially along the lateral border of the pectoralis major muscle . A sterile skin marker was then used to mark the optimal site of incision over the targeted lymph nodes, and the distance from the skin to the nodes was measured by ultrasound and recorded in millimeters. Blunt dissection was carried out to identify the CNSs-stained nodes around the marked region. Ultrasonography probe was placed repeatedly in or around the wound at different angles for adequate visualization if SLNs could not be localized with further dissection.

  • ProcedureGC group: CNSs plus ICG dual-tracer-guided

    The preparation of CNSs mapping was identical to that of the UC group. 1ml of diluted ICG was subsequently injected into the areolar area in the upper outer quadrant of the breast. A NIR camera was used to visualize the subcutaneous lymph vessels and localized the SLNs. All fluorescent or black-stained lymph nodes along with any palpable suspicious nodes were removed. The remaining surgical field was reexamined to ensure complete resection of fluorescent lymph nodes.

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What researchers measure

Primary outcomes

  1. The identification rate of SLNs

    Defined as the number of patients who at least one SLN were detected divided by the total number of patients included.

    Time frame: within 14 days of SLNB

Secondary outcomes

  1. The mean number of SLNs collected

    Defined as the number of tracer-stained or palpable SLNs divided by the number of patients whose SLNs were identified.

    Time frame: within 14 days of SLNB

  2. Operative time

    Defined as the time from skin incision to resection of the SLNs specimens in patients whose at least one SLN were detected.

    Time frame: within 14 days of SLNB

  3. Intraoperative or postoperative complications

    An adverse event is any untoward, undesired, and/or unplanned clinical event in the form of signs, symptoms, disease, or laboratory testing, or physiological observations occurring in a human participating in a clinical study with a study drug, regardless of causal relationship.

    Time frame: within 30 days of SLNB

Other outcomes

  1. Identification rate of SLNs in post-NCT patients

    Defined as the number of patients who at least one SLN were detected divided by the total number of patients included in NCT subgroup.

    Time frame: within 14 days of SLNB

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Study locations

1 site
  • Guangdong General Hospital
    Guangzhou, China
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References and documents

Publications

  • Zhang L, Cheng M, Lin Y, Zhang J, Shen B, Chen Y, Yang C, Yang M, Zhu T, Gao H, Ji F, Li J, Wang K. Ultrasound-assisted carbon nanoparticle suspension mapping versus dual tracer-guided sentinel lymph node biopsy in patients with early breast cancer (ultraCars): phase III randomized clinical trial. Br J Surg. 2022 Nov 22;109(12):1232-1238. doi: 10.1093/bjs/znac311. PubMed 36074703 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jan 28, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT04951245
Lead sponsor
Guangdong Provincial People's Hospital
Responsible party
Kun Wang (Professor, Guangdong Provincial People's Hospital) — Principal investigator
First posted
Jul 6, 2021
Start date
Dec 1, 2019
Primary completion
Apr 30, 2021
Completion
Jun 1, 2021
Last update
Jan 28, 2022

Study contacts

Kun Wang, MD
study chair · Guangdong Provincial People's Hospital

Oversight

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

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