NIH Clinical Research Studies

Protocol Number: 01-C-0009

Active Accrual, Protocols Recruiting New Patients

Title:
Breast Imaging Studies in Women at High Genetic Risk of Breast Cancer: Annual Follow-up Study
Number:
01-C-0009
Summary:
This study will explore new screening methods for early detection of breast and ovarian cancer in women at high risk for these diseases, because they have an altered breast cancer 1 (BRCA1) or breast cancer 2 (BRCA2) gene. It will also try to determine if breast tissue characteristics in women with a BRCA1 or BRCA2 mutation differ from those in women with a normal gene.

Premenopausal women between 25 and 45 years of age who have participated in National Cancer Institute studies for families or individuals at high genetic risk of cancer (78-C-0039 or 99-C-0081) and who have at least a 50 percent probability of carrying an altered BRCA1 or BRCA2 gene may be eligible for this study.

At the first visit, participants will have from 4 to 24 tablespoons of blood drawn and will be interviewed about breast and ovarian cancer risk factors, family and personal history of cancer, history of pregnancies, use of oral contraceptives and other hormones and drugs, and previous surgery on the breasts and ovaries. In addition, they will undergo the following procedures:

Routine breast and ovarian cancer screening for high-risk women, including a mammogram, breast and pelvic exam, instruction in breast self-examination, CA 125 blood test and transvaginal ultrasound of the ovaries.

Magnetic Resonance Imaging (MRI) of the breast- MRI uses a strong magnetic field to show structural and chemical changes in tissues.

Breast Duct Lavage-In this procedure samples of fluid and cells from the lining of the breast milk ducts are collected to look for cancerous or pre-cancerous cell changes.

Positron Emission Tomography (PET) scan-PET scanning will be done only in participants whose mammogram or MRI findings require additional evaluation. This diagnostic test is based on differences in how cells take up and use glucose (sugar), one of the body's main fuels.

Annual follow-up visits will be scheduled for 3 years and will include routine high-risk screening as described above, blood draw, update of family history and risk factors, breast MRI, breast duct lavage and, if there are changes on the MRI or mammogram that need further evaluation, the PET will be repeated.

Sponsoring Institute:
National Cancer Institute (NCI)
Recruitment Detail
Type: Active Accrual Of New Subjects
Gender: Female
Referral Letter Required: Yes
Population Exclusion(s): Male

Children

Eligibility Criteria:
INCLUSION CRITERIA - Annual Follow-up Study:

To participate in the Annual Follow-up Study, a woman must:

Be at least 25 years of age (or 5 years younger than the age at diagnosis of the youngest family member with a tumor associated with the Breast-Ovarian Cancer Syndrome) and less than 56 years of age.

Must be:

A known BRCA1 or BRCA2 deleterious mutation carrier

OR

A first- or second- degree relative of an individual known to carry a deleterious BRCA1 or BRCA2 mutation

OR

A first- or second- degree relative of an individual with a tumor associated with the Breast-Ovarian Cancer Syndrome in a family with a known BRCA mutation.

Have undergone genetic counseling and risk assessment.

Agree to release of genetic test result for stratification purposes, whether or not she has chosen to receive individual test results for clinical decision-making.

Have an ECOG performance status of 0-1.

Have a normal fasting blood glucose (for PET studies only).

Be able to provide informed consent.

Have at least one non-irradiated breast.

EXCLUSION CRITERIA - Annual Follow-up Study:

Pregnancy or lactation within 6 months of enrollment.

Abnormal CA-125 level.

Bilateral breast cancer, ovarian (any stage) or breast cancer (Stage IIB or worse) unless relapse free for 5 years prior to the time of enrollment.

Patients with DCIS, Stage I and Stage II breast cancer are eligible provided that it has been at least 6 months from the completion of primary therapy (surgery, radiation, and chemotherapy as applicable). Tamoxifen and aromatase inhibitor adjuvant therapy is allowed.

Patients with DCIS, Stage I and Stage II breast cancer who have had a local relapse after primary treatment are not eligible unless they have been relapse free for 5 years prior to the time of enrollment.

History of other invasive cancer unless relapse free for 5 years prior to the time of enrollment. Non-Melanoma skin cancer or cervical carcinoma in situ are excepted.

History of diabetes (excluded from PET studies only).

Creatinine greater than 2.

Previous bilateral mastectomy or bilateral radiation therapy.

Weigh over 136 kilograms.

Allergy to gadolinium.

Allergy to lidocaine or Marcaine (bupivacaine). (excluded from breast duct lavage only).

Subareolar or other surgery of the breast to be studied which might disrupt the ductal systems. For example, papilloma resection, biopsy or fine needle aspirations (FNAs) within 2 cm of the nipple might disrupt the ductal systems. Biopsies or FNAs greater than 2 cm from the nipple are acceptable. (Excluded from ductal lavage only)

A breast implant or prior silicone injections in the breast to be studied. (Exclude from breast ductal lavage only)

Active infections or inflammation in a breast to be studied. (breast ductal lavage only)

Medical or psychiatric disorder which, in the opinion of the Principal Investigator, would preclude informed consent or ability to participate in clinical research.

Special Instructions: Currently Not Provided
Keywords:
BRCA1/2
Cancer Detection
MRI
PET
Screening
Recruitment Keywords:
None
Conditions:
Breast Neoplasm
Investigational Drug(s):
2-Fluorodeoxyglucose
Investigational Device(s):
None

Contacts:
CSSC
Clinical Studies Support Center/NCI
164 Rollins Avenue
2nd FLoor
Rockville, MD 20852
Phone: (888) 624-1937
Fax: (301) 881-8239
Electronic Address: ncicssc@mail.nih.gov

Citations:
Easton DF, Ford D, Bishop DT. Breast and ovarian cancer incidence in BRCA1-mutation carriers. Breast Cancer Linkage Consortium. Am J Hum Genet. 1995 Jan;56(1):265-71.

PMID: 7825587

Wooster R, Neuhausen SL, Mangion J, Quirk Y, Ford D, Collins N, Nguyen K, Seal S, Tran T, Averill D Localization of a breast cancer susceptibility gene, BRCA2, to chromosome 13q12-13.

Science. 1994 Sep 30;265(5181):2088-90. PMID: 8091231

Struewing JP, Hartge P, Wacholder S, Baker SM, Berlin M, McAdams M, Timmerman MM, Brody LC, Tucker MA. The risk of cancer associated with specific mutations of BRCA1 and BRCA2 among Ashkenazi Jews. N Engl J Med. 1997 May 15;336(20):1401-8. PMID: 9145676

Active Accrual, Protocols Recruiting New Patients

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