The main purpose of follow-up in asymptomatic breast cancer patients during and after adjuvant treatment is to detect breast cancer recurrence and metastatic disease.The aim of this trial is to verify if, in asymptomatic patients, the serial measurement of serum CEA and CA 15.3, with diagnostic imaging procedures (18FDG-PET) performed only in case of a critical increase of serum CEA and CA 15.3 level, can anticipate the diagnosis of breast cancer local and distant recurrence compared to the usual follow-up practice.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
1,507
Tumor markers assessment every three months through the study or until disease recurrence
Azienda Sanitaria dell'Alto Adige - Ospedale di Bressanone
Brixen, Bolzano, Italy
Azienda Sanitaria dell'Alto Adige - Ospedale di Merano
Merano, Bolzano, Italy
ASL13 - Presidio Ospedaliero Mirano, U.O.C. Oncologia ed Ematologia Oncologica
Mirano, Venezia, Italy
Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, SSD Oncologia Medica Addarii
Bologna, Italy
Azienda Sanitaria dell'Alto Adige - Ospedale Centrale di Bolzano
Bolzano, Italy
Azienda Ospedaliero-Universitaria di Ferrara
Ferrara, Italy
IRCCS Azienda Ospedaliera S. Maria Nuova di Reggio Emilia
Reggio Emilia, Italy
Time interval between date of randomization and date of diagnosis of disease distant recurrence
Primary objective of the study is to verify if the experimental arm (serial measurement of serum CEA and CA 15.3 with diagnostic imaging procedures - i.e. 18FDG-PET- performed only in case of critical increase of serum markers level) can anticipate the diagnosis of breast cancer loco-regional (except for in-breast recurrence) or distant metastases compared to the control arm (usual follow-up practice).
Time frame: Participants will be followed from date of randomization until the date of first documented disease distant recurrence or date of death from any cause, whichever came first, assessed up to 60 months
Predefined critical difference of CEA and CA15-3
Secondary objective is to evaluate the Positive Predictive Value (PPV) and the Negative Predictive Value (NPV) of CEA and CA15.3 dynamic changes in the diagnosis of breast cancer loco-regional (except for in-breast recurrence) or distant metastases.
Time frame: Participants will be followed from date of randomization until the date of first documented disease distant recurrence or date of death from any cause, whichever came first, assessed up to 60 months
Exploratory analysis in the different subtypes
Secondary objective is to perform an exploratory analysis on diagnostic anticipation in the different subtypes (ER and HER2 status)
Time frame: Participants will be followed from date of randomization until the date of first documented disease distant recurrence or date of death from any cause, whichever came first, assessed up to 60 months
Imaging diagnostic tests evaluation
Secondary objective is to measure how many imaging diagnostic tests will be avoided in the experimental arm compared to the control arm
Time frame: Participants will be followed from date of randomization until the date of first documented disease distant recurrence or date of death from any cause, whichever came first, assessed up to 60 months
Patient quality of life evaluation
Secondary objective is to compare the quality of life in the two arms
Time frame: Participants will be followed from date of randomization until the date of first documented disease distant recurrence or date of death from any cause, whichever came first, assessed up to 60 months
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