Sometimes women have more than one breast cancer in the same breast at the same time. These women are usually offered a mastectomy (removal of that breast) and breast reconstruction. It may be possible to treat these patients by removing each cancer using breast-saving surgery (lumpectomies), used for women with only one breast cancer. Databases show that women who had lumpectomies did well, but they may have been healthier before the surgery than those who had a mastectomy. The investigators need to be sure that lumpectomy is effective, safe, and acceptable for this patient group before making it universally available.
The investigators will run a small study to evaluate whether a sufficient number of eligible patients can be identified and are willing to accept randomisation of the interventions in question. Recruitment and compliance rates of which will inform the feasibility and design of a larger trial. This will comprise a multi-centre randomised controlled trial in women with Multiple Ipsilateral Breast cancer (MIBC) requiring surgery. Participants will receive either Therapeutic Mammoplasty (TM) following excision of each cancer focus or mastectomy (+/- reconstruction). Patients will be randomised (1:1) into either intervention or control group.Therapeutic mammoplasty is an operation to remove breast cancer(s) whilst also significantly reducing the size of the breast. Therapeutic mammoplasty can be used to remove more than one cancer in the breast using separate lumpectomies. Both skin and breast tissue are removed, leaving scars similar to those seen after a standard breast reduction. Each patient is followed up for 12 months post treatment with a total of 50 patients recruited. Timings of the follow-up visits are aligned with standard of care practice for this patient population with quality of life questionnaires and clinical photographs completed before and after surgery. Twenty women will also be invited to an optional semi-structured interview at twelve months.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Removal of the whole breast.
Excision via lumpectomy of multifocal or multicentric cancers with breast volume displacement techniques to maximise cosmetic outcomes.
Addenbrooke's Hospital
Cambridge, United Kingdom
South Glasgow Hospitals - New Victoria Hospital / Gartnavel General Hospital
Glasgow, United Kingdom
Ipswich Hospital
Ipswich, United Kingdom
St. George's Hospital
London, United Kingdom
Number of women screened
Numbers of women with more than one cancer in the same breast (MIBC) screened for the trial
Time frame: 36 Months
Number of women eligible for the trial
Numbers of eligible women based on trial criteria and suitable for therapeutic mammoplasty
Time frame: 36 Months
Consent rate
The proportion of women eligible for the trial who provide written informed consent
Time frame: 36 Months
Compliance with trial procedures
Rate of compliance with allocated treatment and reason for deviation
Time frame: 36 Months
Reasons why patients accept or decline randomisation
Tabulation of reasons why patients accept or decline randomisation (assessed from patient-completed Qualitative Study questionnaire)
Time frame: 36 Months
Qualitative research (clinical staff)
Tabulation of views of clinical staff following qualitative interviews
Time frame: 36 Months
Qualitative research (patients)
Tabulation of views of participating patients following qualitative interviews
Time frame: 36 Months
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Enrollment
4
Manchester University NHS Foundation Trust
Manchester, United Kingdom
Royal Cornwall Hospital
Truro, United Kingdom
Royal Hampshire Hospital
Winchester, United Kingdom