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This interventional, post-market, multicenter clinical investigation is designed to evaluate the performance of a custom-made medical device, "the Breast Cancer Locator (BCL)" in Subjects with non-palpable breast cancer, in Europe.
The aim of this interventional, post-market, multicenter clinical investigation is to evaluate the performance of a custom-made medical device, the Breast Cancer Locator (BCL) system, in subjects with non-palpable breast cancer. The study will be conducted in European countries. To evaluate the performance of BCL in reducing the positive margin rate, the proportion of patients with positive margins after partial mastectomy with the BCL will be obtained.
Each Subject, after signing an Informed Consent Form (ICF), will enter into a screening phase, during which several assessments (e.g., demographics, medical history, evaluation of available prone MRI and core biopsy pathological results) will be conducted.
At visit 1, the Subject will undergo supine MRI, from which a 3D breast image and BCL will be made.
At visit 2, the patient will undergo Breast Conserving Surgery (BCS) using the BCL system. On the same day, the specimen volume will be determined. The excised specimen will be sent to the pathological lab for analysis. The results, including the positive margin rate (PMR) and specimen mammogram, will be obtained within 14 days.
At visit 3, follow-up assessments (including physical examination, and adverse event review) will be performed.
At the End Of Study visit, adverse events will be assessed and patients will be asked to express their satisfaction with the BREAST-Q.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment with BCL | Experimental | Subjects will undergo breast conserving surgery with the Breast Cancer Locator (BCL) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Breast Cancer Locator Guided Breast Conserving Surgery | Device | Subjects will undergo a contrast-enhanced supine MRI and two marks will be placed on the breast. The MRI images will be transmitted to the sponsor, and the images will be used to build a BCL using 3D printing. Investigators will be provided with a 3D image of the cancer in the breast. Investigators will use a BCL (a patient-specific, plastic, bra-like form that is placed on the breast and allows the investigator to mark the edges of the tumor on the skin and to place wires inside the breast which define the center of the cancer and the tumor edges. The surgeon will then attempt to surgically remove all the tissue inside the wires used to define the tumor edges. |
| Measure | Description | Time Frame |
|---|---|---|
| Positive Margin Rate | To evaluate the performance of BCL in reducing the positive margin rate, the proportion of patients with positive margins after partial mastectomy with the BCL was obtained. | Pathology results from the index procedure available within 14 days from the day of sample arrival at the pathological lab. |
| Measure | Description | Time Frame |
|---|---|---|
| Specimen Volume | To calculate the specimen volume after BCL guided partial mastectomy, the water displacement method (WDM) was used. | Results obtained the same day of surgery. |
| Surgeon's Perception |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Richard J Barth, MD | Cairn Surgical | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Agaplesion Markus Krankenhaus | Frankfurt | Germany | ||||
| Breast Unit Heidelberg, St Elisabeth Hospital |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40478342 | Result | Thill M, Ghilli M, Roncella M, Kelling K, Fansa H, Golatta M, Heil J, Haasteren V, Freitag A, Togawa R, Sagona A, Rooney TB, Fox MJ, Barth RJ Jr. A Multi-institutional Study to Evaluate the Effectiveness and Safety of a Supine MRI-Based Guidance System, the Breast Cancer LocatorTM, for Breast Conserving Surgery in Patients with Nonpalpable Breast Cancer. Ann Surg Oncol. 2025 Jun 6. doi: 10.1245/s10434-025-17513-4. Online ahead of print. |
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There is no plan to share individual participant data to other researchers.
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After signing the informed consent form, each subject entered a screening phase, during which several assessments (e.g., demographics, medical history, evaluation of available prone MRI and core biopsy pathological results) were conducted. Blood samples were also collect. A total of 45 patients were screened; however, 6 patients were excluded due to screening failure and 4 patients because surgery could not be performed with BCL. All remaining 35 patients were treated with BCL.
Adult women with a diagnosis by pre-operative biopsy of non-palpable breast cancer were recruited from patients at participating sites. Patients were recruited from June 2022 to May 2024.
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| ID | Title | Description |
|---|---|---|
| FG000 | Treatment With BCL | Subjects underwent breast conserving surgery with the Breast Cancer Locator (BCL) |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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| ID | Title | Description |
|---|---|---|
| BG000 | Treatment With BCL | Subjects underwent breast conserving surgery with the Breast Cancer Locator (BCL) |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Positive Margin Rate | To evaluate the performance of BCL in reducing the positive margin rate, the proportion of patients with positive margins after partial mastectomy with the BCL was obtained. | Participants analyzed were in the Per Protocol Set (PPS), which included all participants who (a) met all inclusion/exclusion criteria liable to affect the performance assessment, and (b) did not present serious deviations of the protocol that could affect efficacy. Two participants with serious deviations (BCL was not used properly) were not included in this analysis. | Posted | Count of Participants | Participants | Pathology results from the index procedure available within 14 days from the day of sample arrival at the pathological lab. |
|
From supine MRI 10-40 days prior to surgery through 6 weeks +/- 7 days post surgery
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Treatment With BCL | Subjects who underwent breast conserving surgery with the Breast Cancer Locator (BCL) |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Pain | General disorders | MedDRA | Systematic Assessment |
One possible limitation of the study is the single arm design, which does not allow a comparison of the BCL system with the current standard approaches. A second limitation is the short follow-up period (6-weeks post surgery).
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Richard J. Barth, MD | Cairn Surgical, Inc. | 603-650-9479 | richard.j.barth.jr@hitchcock.org |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Nov 25, 2022 | Mar 5, 2026 | Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Nov 26, 2024 | Mar 5, 2026 | SAP_001.pdf |
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| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
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All subjects will undergo breast conserving surgery with the BCL.
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To evaluate the surgeon's perception of the BCL system, a survey asking them if they strongly disagree, somewhat disagree, are undecided, somewhat agree, or strongly agree that the BCL made tumor localization easier, was easy to use, made tumor excision easier, and would be recommended by them, will be used.
| Results will be obtained prior to subject discharge after the study procedure (within approximately 2 days after surgery) |
| Number of Participants With Adverse Events | To evaluate the safety and tolerability of BCL, adverse events will be reported, including frequency, maximum intensity, relation to study treatment, seriousness, action taken, and outcome. Safety data will be handled descriptively. | From supine MRI 10-40 days prior to surgery through 6 weeks +/- 7 days post surgery |
| Patient Satisfaction | To evaluate the patient's satisfaction, the BREAST-Q patient-reported outcome measure will be used. Patient satisfaction scores range from 0-100, with a higher score meaning greater satisfaction or better quality of life. | 6 weeks +/- 7 days post surgery |
| Heidelberg |
| Germany |
| U.O. Senologia, Instituto Clinico Humanitas | Milan | Italy |
| U.O. Senologia Ospedale Santa Chiara, Azienda Ospedaliera Universitaria Pisana | Pisa | Italy |
| Ospedale Regionale di Bellinzona e Valli | Bellinzona | Switzerland |
| Spital Zollikerberg | Zurich | Switzerland |
| years |
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| Sex: Female, Male | Count of Participants | Participants |
|
| Race/Ethnicity, Customized | Count of Participants | Participants |
|
| BREAST-Q Rasch score | The BREAST-Q is a patient-reported outcome measure designed to evaluate outcomes among women undergoing breast surgery. Higher scores reflect a better outcome. Scores range from 0 (worst) to 100 (best). In this study, pre-operative patient satisfaction was measured for: how she looks in the mirror clothed and unclothed, how comfortably her bras fit, and being able to wear more fitted clothing. Post-operative satisfaction was measured for the same variables, plus satisfaction with the lumpectomy breast and how equal in size and same both breasts look. | Three participants did not complete the baseline BREAST-Q Rasch score. | Mean | Standard Deviation | scores on a scale |
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| Secondary | Specimen Volume | To calculate the specimen volume after BCL guided partial mastectomy, the water displacement method (WDM) was used. | Participants analyzed were in the Full Analysis Set (FAS), which included all enrolled patients undergoing surgery with the BCL System. | Posted | Mean | Standard Deviation | ml | Results obtained the same day of surgery. |
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| Secondary | Surgeon's Perception | To evaluate the surgeon's perception of the BCL system, a survey asking them if they strongly disagree, somewhat disagree, are undecided, somewhat agree, or strongly agree that the BCL made tumor localization easier, was easy to use, made tumor excision easier, and would be recommended by them, will be used. | Procedures analyzed were in the Full Analysis Set (FAS), which included all enrolled patients undergoing surgery with the BCL System. | Posted | Number | Percent of surgeon responses | Results will be obtained prior to subject discharge after the study procedure (within approximately 2 days after surgery) |
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| Secondary | Number of Participants With Adverse Events | To evaluate the safety and tolerability of BCL, adverse events will be reported, including frequency, maximum intensity, relation to study treatment, seriousness, action taken, and outcome. Safety data will be handled descriptively. | Participants analyzed were in the Full Analysis Set (FAS)/Safety Analysis Set (SAS), which included all enrolled patients undergoing surgery with the BCL System. | Posted | Count of Participants | Participants | From supine MRI 10-40 days prior to surgery through 6 weeks +/- 7 days post surgery |
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|
|
| Secondary | Patient Satisfaction | To evaluate the patient's satisfaction, the BREAST-Q patient-reported outcome measure will be used. Patient satisfaction scores range from 0-100, with a higher score meaning greater satisfaction or better quality of life. | Participants were in the Full Analysis Set (FAS), which included all enrolled patients undergoing surgery with the BCL System; however, four (4) participants did not complete the BREAST-Q patient reported outcome measure postoperatively. | Posted | Mean | Standard Deviation | scores on a scale | 6 weeks +/- 7 days post surgery |
|
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|
|
| 0 |
| 35 |
| 0 |
| 35 |
| 10 |
| 35 |
| Postoperative wound infection | Infections and infestations | MedDRA | Systematic Assessment |
|
| Seroma | Injury, poisoning and procedural complications | MedDRA | Systematic Assessment |
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| Cancer cells present | Investigations | MedDRA | Systematic Assessment |
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| Anxiety | Psychiatric disorders | MedDRA | Systematic Assessment |
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| Axillary lymphadenectomy | Surgical and medical procedures | MedDRA | Systematic Assessment |
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| D017437 |
| Skin and Connective Tissue Diseases |
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| Surgeon rating BCL device as somewhat or very much speeding up surgery |
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| Surgeon rating the BCL safety as high or very high |
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| Surgeon rating BCL reliability as high or very high |
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| Surgeon rating likely or very like to reuse the BCL devicehe |
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| Surgeon rating likely or very likely to recommend the BCL device to a colleague |
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| Title | Measurements |
|---|---|
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| Participants with at least 1 severe AE |
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