NCT07532096

Extended Sentinel Lymph Node Biopsy With Methylene Blue Single Tracer Post-Neoadjuvant Therapy for Node-Positive Breast Cancer

A Multicenter, Single-Arm, Open-Label Study of Extended Sentinel Lymph Node Biopsy Using Methylene Blue as a Single Tracer After Neoadjuvant Therapy in Patients With Axillary Node-Positive Breast Cancer

• Status: Not Yet Recruiting
• Phase: N/A
• Study type: Interventional
• Enrollment: 240 (estimated)
• Sponsor: Xijing Hospital · Academic / Other
• Sex: Female
• Age: 18 Years – 70 Years
• Healthy volunteers: Not accepted

Summary

The goal of this clinical trial is to evaluate the safety and feasibility of methylene blue single tracer-based extensive sentinel lymph node biopsy (ESLNB) and provide evidence for simplifying surgical procedures on the basis of ensuring axillary safety, as well as clarify the incidence of postoperative upper limb lymphedema in female patients with axillary node-positive breast cancer who achieve clinical axillary node negativity after neoadjuvant therapy. The main questions it aims to answer are: * What is the false negative rate of methylene blue single tracer-based extensive sentinel lymph node biopsy in the above-mentioned breast cancer patients? * What are the false negative rate and detection rate of methylene blue single tracer-based conventional sentinel lymph node biopsy * What is the incidence of upper limb lymphedema within 2 years after surgery in these patients? Participants will: * Undergo strict screening to confirm eligibility for the trial and sign an informed consent form * Receive a complete standard neoadjuvant therapy for 6 or 8 cycles as required * Undergo personalized breast surgery combined with methylene blue single tracer-based ESLNB plus axillary lymph node dissection * Accept pathological evaluation of the number of lymph nodes and metastatic lymph nodes in each resected part after surgery * Receive adjuvant therapies such as targeted therapy, endocrine therapy or local radiotherapy in accordance with clinical guidelines * Complete regular follow-up for 2 years after surgery (once every 6 months), including physical sign checks, surgical site evaluations, and upper limb circumference measurements to assess lymphedema

Detailed description

Participants will: * Receive a full course of standard neoadjuvant therapy for 6 or 8 cycles as clinically indicated * Undergo preoperative screening assessments to confirm clinical axillary node negativity after neoadjuvant therapy * Have 0.5ml of methylene blue injected into the areola before surgery and then receive personalized breast surgery combined with extensive sentinel lymph node biopsy plus axillary lymph node dissection * Undergo pathological testing to count the total number of resected lymph nodes and metastatic lymph nodes in different axillary regions * Receive adjuvant treatments like targeted therapy, endocrine therapy or local radiotherapy following clinical practice guidelines * Attend clinic follow-up visits every 6 months for 2 years after surgery, including physical exams, surgical site checks and upper limb circumference measurements * Allow their clinical, surgical, pathological and follow-up data to be collected and entered into a dedicated research database Report any physical discomfort or adverse events that occur during the study period to the research medical team in a timely manner

Conditions

• Breast Cancer

Interventions

Type	Name	Description
PROCEDURE	ESLNB	First, personalized breast surgery is performed in accordance with the patient's breast tumor condition (e.g., breast-conserving surgery, modified radical mastectomy). Next, blue-stained lymphatic vessels are dissected and identified to locate and resect the primary sentinel lymph nodes (SLNs). Subsequently, the lymphoid tissue in the extensive sentinel lymph node region (2-3cm around the resected SLNs) is completely excised (defined as ESLNB in this study). Finally, systematic dissection and clearance of the remaining axillary lymph node regions are conducted to complete ALND. Post-surgical wound management: The surgical wound is rinsed and soaked successively with sterile distilled water and normal saline for hemostasis; a drainage tube is placed, and the skin is sutured layer by layer in accordance with standard surgical protocols.

Timeline

• Start date: 2026-04-25
• Primary completion: 2027-05-01
• Completion: 2028-05-15
• First posted: 2026-04-15
• Last updated: 2026-04-15

Locations

1 site across 1 country: China