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RecruitingNCT06362616PAPBI-3Updated Sep 17, 2026

Preoperative Accelerated Partial Breast Irradiation in Patients With Locally Recurrent or Second Primary Breast Cancer

An interventional study of Preoperative accelerated partial breast irradiation and Breast conserving surgery in Breast Cancer, sponsored by The Netherlands Cancer Institute. Recruiting at 1 site in Netherlands. Open to female participants aged 51 Years and older. Per ClinicalTrials.gov, last updated 2026-09-17.

Sponsored by The Netherlands Cancer Institute · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
31
Allocation
Not applicable
Ages
51 Years and older
Sex
Female
01

Study summary

This study evaluates the acute toxicity and feasibility of repeat breast conserving therapy with preoperative accelerated partial breast re-irradiation (PAPBI) in female patients aged 51 years or older with ipsilateral recurrent or second primary low-risk breast cancer or DCIS.

Read the detailed description

Standard treatment for an ipsilateral breast recurrence is a salvage mastectomy. However, repeat breast conserving therapy, involving breast conserving surgery (BCS) and postoperative re-irradiation, is a feasible alternative for a selected group of patients. In the primary setting, accelerated partial breast irradiation (APBI) is an international accepted treatment for a subset of breast cancer patients. Preoperative APBI (PAPBI) leads to low complication rates, limited fibrosis/induration in a small volume and good to excellent cosmetic results compared with results reported after postoperative APBI.

The aim of this study is to asses the acute toxicity and feasibility of repeat breast conserving therapy with PAPBI followed by BCS in patients aged 51 years or older with ipsilateral recurrent or second primary low-risk breast cancer or DCIS.

Patients undergo PAPBI 5 times (5 x 5.2 Gray). One-two weeks after completion of PAPBI, patients undergo BCS.

02

Conditions studied

  • Breast Cancer

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Keywords

  • Recurrent breast cancer
  • Preoperative
  • Partial breast irradiation
03

Who can participate

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

Inclusion criteria

  • Female patients ≥ 51 years
  • Ipsilateral breast cancer; recurrence or second primary
  • Either histologically proven invasive adenocarcinoma (invasive adenocarcinoma with DCIS component is also accepted) or DCIS alone (calcification associated on imaging)
  • Histologically proven estrogen receptor positive
  • HER2neu negative
  • In case of invasive adenocarcinoma: tumor size ≤ 3 cm. In case of DCIS alone: affected area ≤ 2.5 cm
  • Grade I or grade II (biopsy)
  • cN0M0 (No evidence of nodal or distant metastases on axillary ultrasound and, if indicated, positron emission tomography-computed tomography (PET-CT) scan)
  • Unifocal lesions on mammogram and MRI (small satellite lesions adjacent to the tumor are accepted as long as it is suitable for local excision)
  • Interval since completion of local treatment of primary tumor > 12 months
  • Previous radiotherapy (whole breast or partial) of the ipsilateral breast
  • Repeat breast conserving surgery feasible
  • World Health Organization (WHO) performance ≤ 2
  • Written informed consent
  • The patient is legally competent

Exclusion criteria

Exclusion Criteria:

  • ≥ grade 3 radiotherapy toxicity in the breast after treatment of the primary tumor
  • Previous boost radiotherapy is not allowed, UNLESS the protocol tumor lies outside of the original boost area
  • Distant metastases and/or synchronous contralateral invasive or in situ carcinoma
  • Invasive lobular carcinoma (ILC) or pleiomorphic lobular carcinoma in situ (LCIS)
  • ER negative subtype
  • Lymphovascular invasion in biopsy
  • Neoadjuvant systemic treatment for the protocol tumor (except for pre-surgery hormonal therapy ≤ 2 months)
  • (Planned) oncoplastic surgery with major tissue displacement
  • Participation in another clinical trial that interferes with the locoregional treatment of this protocol.
  • It is expected that dosimetric constraints cannot be met, such as lung/heart constraints.
  • Patients with proven BRCA-mutations
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
31 participants (estimated)

Study arms

  • Experimental
    Preoperative accelerated partial breast re-irradiation

    Patients receive preoperative accelerated partial breast irradiation of the in situ tumor in the breast followed by repeat breast conserving surgery

    Radiation: Preoperative accelerated partial breast irradiation · Procedure: Breast conserving surgery · Procedure: Sentinel node procedure · Procedure: Biopsy track removal

Interventions

  • RadiationPreoperative accelerated partial breast irradiation

    Patients will be treated with 5 x 5.2 Gray (Gy) preoperative accelerated partial breast irradiation of the in situ tumor in the breast

  • ProcedureBreast conserving surgery

    Patients will be treated with breast conserving surgery.

  • ProcedureSentinel node procedure

    Patients will undergo a (repeat) sentinel node procedure.

  • ProcedureBiopsy track removal

    The biopsy track will be surgically removed.

05

What researchers measure

Primary outcomes

  1. Acute post-treatment toxicity

    Acute post-treatment toxicity from start of local treatment up to 3 months after end of local treatment, assessed by the Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Values range form 0 to 5, with 5 being the worst value. At least grade ≥ 2 toxicity is scored as an event.

    Time frame: 3,5 months

Secondary outcomes

  1. Fibrosis/induration

    Assessment of fibrosis/induration grade at 3 months after end of local treatment, assessed the Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Values range form 0 to 5, with 5 being the worst value.

    Time frame: 3 months

  2. Patient-reported Outcome Measures (PROMS): EORTC Quality of Life Questionnaire (QLQ)-C30

    PROMs will be assessed using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire. All of the scales and single-item measures range in score from 0 to 100. A high score for the functional scales represents a high/healthy level of functioning, whilst a high score for the symptom scales represents a high level of symptomatology or problems.

    Time frame: 3,5 months

  3. Patient-reported Outcome Measures (PROMS): EORTC QLQ-BR23

    PROMs will be assessed using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-BR23 questionnaire. All of the scales and single-item measures range in score from 0 to 100. A high score for the functional scales represents a high/healthy level of functioning, whilst a high score for the symptom scales represents a high level of symptomatology or problems.

    Time frame: 3,5 months

  4. Patient-reported Outcome Measures (PROMS): Patient's Questionnaire Cosmesis

    PROMs will be assessed using the Patient's Questionnaire Cosmesis, adapted from Sneeuw et al. (1992). Patients score their cosmetic outcome by the following outcomes: very satisfied, satisfied, neutral, unsatisfied and very unsatisfied.

    Time frame: 3,5 months

  5. Cosmetic outcome according to the BCCT.core software program

    Cosmetic outcome according to the Breast Cancer Conservative Treatment cosmetic results (BCCT.core) software program. The program returns an overall cosmetic outcome score (excellent, good, fair, or poor) based on the symmetry of the breasts, skin color, and scar visibility.

    Time frame: 3,5 months

06

Study locations

1 of 1 sites recruiting
  • The Netherlands Cancer Institute
    Amsterdam, 1066CX, Netherlands
    Recruiting
07

Registry details

Key details

Study ID
NCT06362616
Lead sponsor
The Netherlands Cancer Institute
Collaborators
Medical Center Haaglanden, Erasmus Medical Center, Albert Schweitzer Hospital
Responsible party
Sponsor
First posted
Apr 12, 2024
Start date
Apr 12, 2024
Primary completion
Oct 11, 2026 (estimated)
Completion
Apr 11, 2027 (estimated)
Last update
Sep 17, 2026

Study contacts

Tess Snellen, MD
Contact
t.snellen@nki.nl
0205129111 ext. 3448
Lisa van den Hengel
Contact
l.vd.hengel@nki.nl
0205129111 ext. 9140
Astrid Scholten, MD PhD
principal investigator · The Netherlands Cancer Institute

Oversight

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

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