A Phase II Study Evaluating the Role of Sentinel Lymph Node Surgery and Axillary Lymph Node Dissection Following Preoperative Chemotherapy in Women With Node Positive Breast Cancer (T1-4, N1-2, M0) at Initial Diagnosis
Phase 2
18 Years
N/A
18 Years
N/A
Not Enrolling
Female
Breast Cancer
Female
Breast Cancer
Trial Information
A Phase II Study Evaluating the Role of Sentinel Lymph Node Surgery and Axillary Lymph Node Dissection Following Preoperative Chemotherapy in Women With Node Positive Breast Cancer (T1-4, N1-2, M0) at Initial Diagnosis
OBJECTIVES:
Primary
- To determine the false negative rate for sentinel lymph node (SLN) surgery in women
with node-positive breast cancer.
Secondary
- To determine how the axillary ultrasound status of the patient upon completion of
neoadjuvant chemotherapy (evidence of residual lymphadenopathy on the ultrasound
examination vs no evidence of lymphadenopathy in the ultrasound examination) affects
the false negative rate of SLN.
- To determine how the axillary ultrasound status of the patient upon completion of
neoadjuvant chemotherapy (sonographic findings) correlates with residual disease on
final pathology.
- To determine the node status of patients after neoadjuvant chemotherapy.
- To determine whether the false-negative rate for SLN surgery after neoadjuvant
chemotherapy is related to the extent of residual cancer burden overall, or separately
in the breast or regional nodal basin.
- To evaluate pathological complete response rates (defined as no invasive disease in
breast or lymph nodes) and disease-free survival rates in node-positive patients
receiving neoadjuvant chemotherapy.
OUTLINE: This is a multicenter study.
Patients receive neoadjuvant chemotherapy at the discretion of the treating physician.
Patients undergo examination for breast and axilla lymph adenopathy and then undergo
ultrasound of the axillary nodes at baseline and after completion of neoadjuvant
chemotherapy. Within 12 weeks of completing neoadjuvant chemotherapy, patients undergo a
mastectomy or lumpectomy including sentinel lymph node and axillary lymph node dissection.
After completion of study treatment, patients are followed every 6 months for 2 years,
yearly for 2 years, then every other year for 6 years.
Inclusion Criteria
DISEASE CHARACTERISTICS:
- Histologically confirmed invasive breast cancer
- Clinical stage II-IIIB (T0-4, N1-2, M0) disease, excluding inflammatory breast
cancer
- Node-positive disease by fine needle aspiration or core needle biopsy of an
axillary node at time of diagnosis and prior to preoperative chemotherapy
- Must have completed or plan to undergo neoadjuvant chemotherapy
- Patients enrolling on studies involving preoperative chemotherapy (through
cooperative groups or institutional studies) may be eligible for this study,
provided sentinel node surgery prior to preoperative chemotherapy was not
required in these studies
PATIENT CHARACTERISTICS:
- ECOG or Zubrod performance status 0-1
- Negative pregnancy test
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- No prior ipsilateral axillary surgery (e.g., excisional biopsy of lymph node[s]) or
treatment of hidradenitis
- No prior sentinel lymph node surgery or excisional lymph node biopsy for pathological
confirmation of axillary status
Type of Study:
Interventional
Study Design:
Masking: Open Label, Primary Purpose: Treatment
Outcome Measure:
False negative rate defined as number of patients with no positive lymph nodes after SLN surgery and ≥ 1 positive lymph node by axillary lymph node dissection (ALND) divided by number of patients with ≥ 1 positive lymph node by ALND
Safety Issue:
No
Principal Investigator
Judy Boughey, MD
Investigator Role:
Study Chair
Investigator Affiliation:
Mayo Clinic
Authority:
United States: Federal Government
Study ID:
CDR0000640100
NCT ID:
NCT00881361
Start Date:
July 2009
Completion Date:
Related Keywords:
- Breast Cancer
- stage II breast cancer
- stage IIIA breast cancer
- stage IIIB breast cancer
- Breast Neoplasms
Name | Location |
|---|---|
| Roswell Park Cancer Institute | Buffalo, New York 14263 |
| University of Michigan Comprehensive Cancer Center | Ann Arbor, Michigan 48109-0752 |
| Mayo Clinic Cancer Center | Rochester, Minnesota 55905 |
| Cardinal Bernardin Cancer Center at Loyola University Medical Center | Maywood, Illinois 60153-5500 |
| Barbara Ann Karmanos Cancer Institute | Detroit, Michigan 48201 |
| Duke Comprehensive Cancer Center | Durham, North Carolina 27710 |
| CCOP - Wichita | Wichita, Kansas 67214-3882 |
| CCOP - Mount Sinai Medical Center | Miami Beach, Florida 33140 |
| CCOP - Illinois Oncology Research Association | Peoria, Illinois 61602 |
| CCOP - Iowa Oncology Research Association | Des Moines, Iowa 50309-1016 |
| Mercy Medical Center - Sioux City | Sioux City, Iowa 51104 |
| Siouxland Hematology-Oncology Associates, LLP | Sioux City, Iowa 51101 |
| St. Luke's Regional Medical Center | Sioux City, Iowa 51104 |
| Hennepin County Medical Center - Minneapolis | Minneapolis, Minnesota 55415 |
| Natalie Warren Bryant Cancer Center at St. Francis Hospital | Tulsa, Oklahoma 74136 |
| Geisinger Medical Group - Scenery Park | State College, Pennsylvania 16801 |
| Frank M. and Dorothea Henry Cancer Center at Geisinger Wyoming Valley Medical Center | Wilkes-Barre, Pennsylvania 18711 |
| Avera Cancer Institute | Sioux Falls, South Dakota 57105 |
| University of Wisconsin Paul P. Carbone Comprehensive Cancer Center | Madison, Wisconsin 53792-6164 |
| Medical College of Wisconsin Cancer Center | Milwaukee, Wisconsin 53226 |
| CCOP - Bay Area Tumor Institute | Oakland, California 94609-3305 |
| Bridgeport Hospital | Bridgeport, Connecticut 06610 |
| Methodist Medical Center of Illinois | Peoria, Illinois 61636 |
| Memorial Hospital of South Bend | South Bend, Indiana 46601 |
| CCOP - Cancer Research for the Ozarks | Springfield, Missouri 65807 |
| CCOP - Montana Cancer Consortium | Billings, Montana 59101 |
| CCOP - Columbus | Columbus, Ohio 43206 |
| Joe Arrington Cancer Research and Treatment Center | Lubbock, Texas 79410-1894 |
| CCOP - Northern Indiana CR Consortium | South Bend, Indiana 46601 |
| Saint Joseph Regional Medical Center | South Bend, Indiana 46617 |
| Holden Comprehensive Cancer Center at University of Iowa | Iowa City, Iowa 52242-1002 |
| CCOP - Grand Rapids | Grand Rapids, Michigan 49503 |
| Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill | Chapel Hill, North Carolina 27599-7570 |
| CCOP - Columbia River Oncology Program | Portland, Oregon 97225 |
| Kimmel Cancer Center at Thomas Jefferson University - Philadelphia | Philadelphia, Pennsylvania 19107 |
| USC/Norris Comprehensive Cancer Center and Hospital | Los Angeles, California 90033-0804 |
| CCOP - St. Louis-Cape Girardeau | Saint Louis, Missouri 63141 |
| Peninsula Regional Medical Center | Salisbury, Maryland 21801 |
| Vince Lombardi Cancer Clinic at Aurora St. Luke's Medical Center | Milwaukee, Wisconsin 53201-2901 |
| City of Hope Comprehensive Cancer Center | Duarte, California 91010 |
| Medical Center of Central Georgia | Macon, Georgia 31201 |
| Sunrise Hospital and Medical Center | Las Vegas, Nevada 89109-2306 |
| Arkansas Cancer Research Center at University of Arkansas for Medical Sciences | Little Rock, Arkansas 72205 |
| Kansas Masonic Cancer Research Institute at the University of Kansas Medical Center | Kansas City, Kansas 66160-7353 |
| Josephine Ford Cancer Center at Henry Ford Hospital | Detroit, Michigan 48202 |
| Blumenthal Cancer Center at Carolinas Medical Center | Charlotte, North Carolina 28232-2861 |
| Northside Hospital Cancer Center | Atlanta, Georgia 30342-1611 |
| Washington Cancer Institute at Washington Hospital Center | Washington, District of Columbia 20010 |
| Hulston Cancer Center at Cox Medical Center South | Springfield, Missouri 65807 |
| St. John's Regional Health Center | Springfield, Missouri 65804 |
| McDowell Cancer Center at Akron General Medical Center | Akron, Ohio 44307 |
| Women and Infants Hospital of Rhode Island | Providence, Rhode Island 02905 |
| Central Baptist Hospital | Lexington, Kentucky 40503 |
| CCOP - Toledo Community Hospital | Toledo, Ohio 43623-3456 |
| Waukesha Memorial Hospital Regional Cancer Center | Waukesha, Wisconsin 53188 |
| Via Christi Cancer Center at Via Christi Regional Medical Center | Wichita, Kansas 67214 |
| Albert Einstein Cancer Center at Albert Einstein College of Medicine | Bronx, New York 10461 |
| Presbyterian Cancer Center at Presbyterian Hospital | Charlotte, North Carolina 28233-3549 |
| Wake Forest University Comprehensive Cancer Center | Winston-Salem, North Carolina 27157-1096 |
| Medical University of Ohio Cancer Center | Toledo, Ohio 43614 |
| Hollings Cancer Center at Medical University of South Carolina | Charleston, South Carolina 29425 |
| Texas Tech University Health Sciences Center School of Medicine - Amarillo | Amarillo, Texas 79106 |
| Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas | Dallas, Texas 75390 |
| Providence Cancer Center at Sacred Heart Medical Center | Spokane, Washington 99220-2555 |
| Mary Babb Randolph Cancer Center at West Virginia University Hospitals | Morgantown, West Virginia 26506 |
| St. Vincent Hospital Regional Cancer Center | Green Bay, Wisconsin 54307-3508 |
| James P. Wilmot Cancer Center at University of Rochester Medical Center | Rochester, New York 14642 |
| Green Bay Oncology, Limited - Escanaba | Escanaba, Michigan 49431 |
| Dickinson County Healthcare System | Iron Mountain, Michigan 49801 |
| St. Mary's Hospital Medical Center - Green Bay | Green Bay, Wisconsin 54303 |
| Green Bay Oncology, Limited at St. Vincent Hospital Regional Cancer Center | Green Bay, Wisconsin 54301-3526 |
| Green Bay Oncology, Limited at St. Mary's Hospital | Green Bay, Wisconsin 54303 |
| Green Bay Oncology, Limited - Oconto Falls | Oconto Falls, Wisconsin 54154 |
| Green Bay Oncology, Limited - Sturgeon Bay | Sturgeon Bay, Wisconsin 54235 |
| St. Elizabeth Medical Center | Edgewood, Kentucky 41017 |
| Saint Anthony's Hospital at Saint Anthony's Health Center | Alton, Illinois 62002 |
| Good Samaritan Regional Health Center | Mt. Vernon, Illinois 62864 |
| Battle Creek Health System Cancer Care Center | Battle Creek, Michigan 49017 |
| William Beaumont Hospital - Royal Oak Campus | Royal Oak, Michigan 48073 |
| Munson Medical Center | Traverse City, Michigan 49684 |
| David C. Pratt Cancer Center at St. John's Mercy | St. Louis, Missouri 63141 |
| Hematology-Oncology Centers of the Northern Rockies - Billings | Billings, Montana 59101 |
| St. Peter's Hospital | Helena, Montana 59601 |
| Glacier Oncology, PLLC | Kalispell, Montana 59901 |
| Montana Cancer Center at St. Patrick Hospital and Health Sciences Center | Missoula, Montana 59802 |
| Montana Cancer Specialists at Montana Cancer Center | Missoula, Montana 59802 |
| Adena Regional Medical Center | Chillicothe, Ohio 54601 |
| Doctors Hospital at Ohio Health | Columbus, Ohio 43228 |
| Grady Memorial Hospital | Delaware, Ohio 43015 |
| Fairfield Medical Center | Lancaster, Ohio 43130 |
| Strecker Cancer Center at Marietta Memorial Hospital | Marietta, Ohio 45750 |
| Licking Memorial Cancer Care Program at Licking Memorial Hospital | Newark, Ohio 43055 |
| Community Hospital of Springfield and Clark County | Springfield, Ohio 45505 |
| University of South Alabama Mitchell Cancer Institute | Mobile, Alabama 36604 |
| Lombardi Comprehensive Cancer Center at Georgetown University Medical Center | Washington, District of Columbia 20007 |
| Indiana University Melvin and Bren Simon Cancer Center | Indianapolis, Indiana 46202-5289 |
| Dana-Farber/Harvard Cancer Center at Dana-Farber Cancer Institute | Boston, Massachusetts 02115 |
| Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis | St. Louis, Missouri 63110 |
| CCOP - Nevada Cancer Research Foundation | Las Vegas, Nevada 89109-2306 |
| University of New Mexico Cancer Center | Albuquerque, New Mexico 87131-5636 |
| Beth Israel Medical Center - Petrie Division | New York, New York 10003-3803 |
| Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center | New York, New York 10032 |
| St. Luke's - Roosevelt Hospital Center - St.Luke's Division | New York, New York 10027 |
| Geisinger Cancer Institute at Geisinger Health | Danville, Pennsylvania 17822-0001 |
| M. D. Anderson Cancer Center at University of Texas | Houston, Texas 77030-4009 |
| Virginia Commonwealth University Massey Cancer Center | Richmond, Virginia 23298-0037 |
| Gundersen Lutheran Center for Cancer and Blood | La Crosse, Wisconsin 54601 |
| Chao Family Comprehensive Cancer Center at University of California Irvine Medical Center | Orange, California 92868 |
| Huntsman Cancer Institute at University of Utah | Salt Lake City, Utah 84112 |
| Todd Cancer Institute at Long Beach Memorial Medical Center | Long Beach, California 90801 |
| Elkhart General Hospital | Elkhart, Indiana 46515 |
| Howard Community Hospital | Kokomo, Indiana 46904 |
| Maine Medical Center - Bramhall Campus | Portland, Maine 04102 |
| Lakeland Regional Cancer Care Center - St. Joseph | St. Joseph, Michigan 49085 |
| Fox Chase Virtua Health Cancer Program at Virtua Memorial Hospital Marlton | Marlton, New Jersey 08053 |
| Fox Chase Virtua Health Cancer Program at Virtua West Jersey | Voorhees, New Jersey 08043 |
| Mount Carmel Health - West Hospital | Columbus, Ohio 43222 |
| Morgan Cancer Center at Lehigh Valley Hospital - Cedar Crest | Allentown, Pennsylvania 18105 |
| UPMC Cancer Centers | Pittsburgh, Pennsylvania 15232 |
| John Muir/Mt. Diablo Comprehensive Cancer Center | Walnut Creek, California 94598 |
| Ella Milbank Foshay Cancer Center at Jupiter Medical Center | Jupiter, Florida 33458 |
| Piedmont Hospital | Atlanta, Georgia 30309 |
| WellStar Cobb Hospital | Austell, Georgia 30106 |
| Charles B. Eberhart Cancer Center at DeKalb Medical Center | Decatur, Georgia 30033 |
| Gwinnett Medical Center | Lawrenceville, Georgia 30045 |
| Kennestone Cancer Center at Wellstar Kennestone Hospital | Marietta, Georgia 30060 |
| Southern Regional Medical Center | Riverdale, Georgia 30274-2600 |
| St. Joseph Medical Center | Bloomington, Illinois 61701 |
| Graham Hospital | Canton, Illinois 61520 |
| Memorial Hospital | Carthage, Illinois 62321 |
| Eureka Community Hospital | Eureka, Illinois 61530 |
| Mason District Hospital | Havana, Illinois 62644 |
| McDonough District Hospital | Macomb, Illinois 61455 |
| BroMenn Regional Medical Center | Normal, Illinois 61761 |
| Community Cancer Center | Normal, Illinois 61761 |
| Oncology Hematology Associates of Central Illinois, PC - Ottawa | Ottawa, Illinois 61350 |
| Cancer Treatment Center at Pekin Hospital | Pekin, Illinois 61554 |
| Oncology Hematology Associates of Central Illinois, PC - Peoria | Peoria, Illinois 61615 |
| OSF St. Francis Medical Center | Peoria, Illinois 61637 |
| Illinois Valley Community Hospital | Peru, Illinois 61354 |
| Perry Memorial Hospital | Princeton, Illinois 61356 |
| St. Francis Hospital and Health Centers - Beech Grove Campus | Beech Grove, Indiana 46107 |
| Center for Cancer Therapy at LaPorte Hospital and Health Services | La Porte, Indiana 46350 |
| John Stoddard Cancer Center at Iowa Lutheran Hospital | Des Moines, Iowa 50316-2301 |
| Medical Oncology and Hematology Associates at John Stoddard Cancer Center | Des Moines, Iowa 50309 |
| Medical Oncology and Hematology Associates at Mercy Cancer Center | Des Moines, Iowa 50314 |
| Mercy Cancer Center at Mercy Medical Center - Des Moines | Des Moines, Iowa 50314 |
| Medical Oncology and Hematology Associates - West Des Moines | West Des Moines, Iowa 50266 |
| Cancer Center of Kansas, PA - Dodge City | Dodge City, Kansas 67801 |
| Hickman Cancer Center at Bixby Medical Center | Adrian, Michigan 49221 |
| Mecosta County Medical Center | Big Rapids, Michigan 49307 |
| Community Cancer Center of Monroe | Monroe, Michigan 48162 |
| Alexandria, Minnesota 56308 | |
| Coborn Cancer Center | Saint Cloud, Minnesota 56303 |
| CentraCare Clinic - River Campus | St. Cloud, Minnesota 56303 |
| Saint Francis Medical Center | Cape Girardeau, Missouri 63701 |
| Wood County Oncology Center | Bowling Green, Ohio 43402 |
| Samaritan North Cancer Care Center | Dayton, Ohio 45415 |
| David L. Rike Cancer Center at Miami Valley Hospital | Dayton, Ohio 45409 |
| Good Samaritan Hospital | Dayton, Ohio 45406 |
| Blanchard Valley Medical Associates | Findlay, Ohio 45840 |
| Charles F. Kettering Memorial Hospital | Kettering, Ohio 45429 |
| Lima Memorial Hospital | Lima, Ohio 45804 |
| Northwest Ohio Oncology Center | Maumee, Ohio 43537 |
| Middletown Regional Hospital | Middletown, Ohio 45044 |
| Toledo Clinic - Oregon | Oregon, Ohio 43616 |
| St. Charles Mercy Hospital | Oregon, Ohio 43616 |
| North Coast Cancer Care, Incorporated | Sandusky, Ohio 44870 |
| Mercy Hospital of Tiffin | Tiffin, Ohio 44883 |
| UVMC Cancer Care Center at Upper Valley Medical Center | Troy, Ohio 45373-1300 |
| Fulton County Health Center | Wauseon, Ohio 43567 |
| Ruth G. McMillan Cancer Center at Greene Memorial Hospital | Xenia, Ohio 45385 |
| Providence Milwaukie Hospital | Milwaukie, Oregon 97222 |
| Providence Cancer Center at Providence Portland Medical Center | Portland, Oregon 97213-2967 |
| Providence St. Vincent Medical Center | Portland, Oregon 97225 |
| Bryn Mawr Hospital | Bryn Mawr, Pennsylvania 19010 |
| Lankenau Cancer Center at Lankenau Hospital | Wynnewood, Pennsylvania 19096 |
| Doctor's Hospital of Laredo | Laredo, Texas 78041 |
| Southwest Washington Medical Center Cancer Center | Vancouver, Washington 98668 |
| DeCesaris Cancer Institute at Anne Arundel Medical Center | Annapolis, Maryland 21401 |
| Lancaster General Hospital | Lancaster, Pennsylvania 17604-3555 |
| Highland General Hospital | Oakland, California 94602 |
| Palo Alto Medical Foundation | Palo Alto, California 94301 |
| Northeast Georgia Medical Center | Gainesville, Georgia 30501 |
| Saint Luke's Hospital | Chesterfield, Missouri 63017 |
| Allegheny Cancer Center at Allegheny General Hospital | Pittsburgh, Pennsylvania 15212 |
| Stanford Cancer Center | Stanford, California 94305-5824 |
| University of Miami Sylvester Comprehensive Cancer Center - Miami | Miami, Florida 33136 |
| John B. Amos Cancer Center | Columbus, Georgia 31904 |
| Harbin Clinic Cancer Center - Medical Oncology | Rome, Georgia 30165 |
| Evanston Hospital | Evanston, Illinois 60201-1781 |
| Elkhart Clinic, LLC | Elkhart, Indiana 46514-2098 |
| William N. Wishard Memorial Hospital | Indianapolis, Indiana 46202 |
| Michiana Hematology-Oncology, PC - South Bend | Mishawaka, Indiana 46545-1470 |
| Reid Hospital & Health Care Services | Richmond, Indiana 47374 |
| Cancer Center of Kansas, PA - Chanute | Chanute, Kansas 66720 |
| Cancer Center of Kansas, PA - El Dorado | El Dorado, Kansas 67042 |
| Cancer Center of Kansas - Fort Scott | Fort Scott, Kansas 66701 |
| Cancer Center of Kansas-Independence | Independence, Kansas 67301 |
| Cancer Center of Kansas, PA - Kingman | Kingman, Kansas 67068 |
| Lawrence Memorial Hospital | Lawrence, Kansas 66044 |
| Cancer Center of Kansas, PA - Liberal | Liberal, Kansas 67905 |
| Cancer Center of Kansas, PA - Newton | Newton, Kansas 67114 |
| Menorah Medical Center | Overland Park, Kansas 66209 |
| Saint Luke's Hospital - South | Overland Park, Kansas 66213 |
| Cancer Center of Kansas, PA - Parsons | Parsons, Kansas 67357 |
| Cancer Center of Kansas, PA - Pratt | Pratt, Kansas 67124 |
| Cancer Center of Kansas, PA - Salina | Salina, Kansas 67401 |
| Cancer Center of Kansas, PA - Wellington | Wellington, Kansas 67152 |
| Cancer Center of Kansas, PA - Wichita | Wichita, Kansas 67214 |
| Associates in Womens Health, PA - North Review | Wichita, Kansas 67208 |
| Cancer Center of Kansas, PA - Medical Arts Tower | Wichita, Kansas 67208 |
| Cancer Center of Kansas, PA - Winfield | Winfield, Kansas 67156 |
| Haematology-Oncology Associates of Ohio and Michigan, PC | Lambertville, Michigan 48144 |
| Mercy Memorial Hospital - Monroe | Monroe, Michigan 48162 |
| Lakeside Cancer Specialists, PLLC | Saint Joseph, Michigan 49085 |
| Truman Medical Center - Hospital Hill | Kansas City, Missouri 64108 |
| St. Joseph Medical Center | Kansas City, Missouri 64114 |
| North Kansas City Hospital | Kansas City, Missouri 64116 |
| Saint Luke's Cancer Institute at Saint Luke's Hospital | Kansas City, Missouri 64111 |
| Research Medical Center | Kansas City, Missouri 64132 |
| Saint Luke's East - Lee's Summit | Lee's Summit, Missouri 64086 |
| Liberty Hospital | Liberty, Missouri 64068 |
| Heartland Regional Medical Center | Saint Joseph, Missouri 64506 |
| Bozeman Deaconess Cancer Center | Bozeman, Montana 59715 |
| St. James Healthcare Cancer Care | Butte, Montana 59701 |
| Great Falls Clinic - Main Facility | Great Falls, Montana 59405 |
| Sletten Cancer Institute at Benefis Healthcare | Great Falls, Montana 59405 |
| Northern Montana Hospital | Havre, Montana 59501 |
| Kalispell Medical Oncology at KRMC | Kalispell, Montana 59901 |
| Mary Rutan Hospital | Bellefontaine, Ohio 43311 |
| North Coast Cancer Care - Clyde | Clyde, Ohio 43410 |
| Grant Medical Center Cancer Care | Columbus, Ohio 43215 |
| Hematology Oncology Center | Elyria, Ohio 44035 |
| Community Cancer Center | Elyria, Ohio 44035 |
| Wayne Hospital | Greenville, Ohio 45331 |
| Knox Community Hospital | Mount Vernon, Ohio 43050 |
| Fisher-Titus Medical Center | Norwalk, Ohio 44857 |
| St. Anne Mercy Hospital | Toledo, Ohio 43623 |
| Mount Carmel St. Ann's Cancer Center | Westerville, Ohio 43081 |
| Clinton Memorial Hospital | Wilmington, Ohio 45177 |
| Adventist Medical Center | Portland, Oregon 97216 |
| St. Luke's Cancer Network at St. Luke's Hospital | Bethlehem, Pennsylvania 18015 |
| Geisinger Hazleton Cancer Center | Hazleton, Pennsylvania 18201 |
| Penn State Hershey Cancer Institute at Milton S. Hershey Medical Center | Hershey, Pennsylvania 17033-0850 |
| York Cancer Center at Apple Hill Medical Center | York, Pennsylvania 17405 |
| Fredericksburg Oncology, Incorporated | Fredericksburg, Virginia 22401 |
| Community Comprehensive Cancer Center at Camden-Clark Memorial Hospital | Parkersburg, West Virginia 26102 |
| Vince Lombardi Cancer Clinic - Green Bay at Aurora BayCare Medical Center | Green Bay, Wisconsin 54311 |
| Vince Lombardi Cancer Clinic - Marinette | Marinette, Wisconsin 54143 |
| Rocky Mountain Oncology | Casper, Wyoming 82609 |
| Morton Plant Hospital | Clearwater, Florida 33756 |
| John H. Stroger, Jr. Hospital of Cook County | Chicago, Illinois 60612-9985 |
| Sacred Heart Hospital | Allentown, Pennsylvania 18102 |
| Baptist Hospital | Nashville, Tennessee 37236 |
| Aurora Sinai Medical Center | Milwaukee, Wisconsin 53201-0342 |
| Bethesda North Hospital | Cincinnati, Ohio 45242 |
| Gibbs Regional Cancer Center at Spartanburg Regional Medical Center | Spartanburg, South Carolina 29303 |
| Regional Cancer Center at Oconomowoc Memorial Hospital | Oconomowoc, Wisconsin 53066 |
| St. John's Regional Medical Center | Joplin, Missouri 64804 |
| MBCCOP - Meharry Medical College - Nashville | Nashville, Tennessee 37208-3599 |
| Sentara Cancer Institute at Sentara Norfolk General Hospital | Norfolk, Virginia 23507 |
| Providence Cancer Center | Anchorage, Alaska 99508 |
| Lacks Cancer Center at Saint Mary's Health Care | Grand Rapids, Michigan 49503 |
| Metro Health Hospital | Grand Rapids, Michigan 49506 |
| Doctors Medical Center - San Pablo Campus | San Pablo, California 94806 |
| Galesburg Clinic, PC | Galesburg, Illinois 61401 |
| St. Vincent Healthcare Cancer Care Services | Billings, Montana 59101 |
| Good Samaritan Hospital Cancer Treatment Center | Cincinnati, Ohio 45220 |
| Midwest Hematology Oncology Group, Incorporated | Saint Louis, Missouri 63109 |
| East Bay Radiation Oncology Center | Castro Valley, California 94546 |
| Contra Costa Regional Medical Center | Martinez, California 94553-3156 |
| El Camino Hospital Cancer Center | Mountain View, California 94040 |
| Larry G Strieff MD Medical Corporation | Oakland, California 94609 |
| Tom K Lee, Incorporated | Oakland, California 94609 |
| Bay Area Breast Surgeons, Incorporated | Oakland, California 94609 |
| Illinois CancerCare - Bloomington | Bloomington%, Illinois 61701 |
| Illinois CancerCare - Canton | Canton, Illinois 61520 |
| Illinois CancerCare - Carthage | Carthage, Illinois 62321 |
| Illinois CancerCare - Eureka | Eureka, Illinois 61530 |
| Illinois CancerCare - Galesburg | Galesburg, Illinois 61401 |
| Illinois CancerCare - Havana | Havana, Illinois 62644 |
| Illinois CancerCare - Kewanee Clinic | Kewanee, Illinois 61443 |
| Illinois CancerCare - Macomb | Macomb, Illinois 61455 |
| OSF Holy Family Medical Center | Monmouth, Illinois 61462 |
| Illinois CancerCare - Monmouth | Monmouth, Illinois 61462 |
| Illinois CancerCare - Community Cancer Center | Normal, Illinois 61761 |
| Illinois CancerCare - Pekin | Pekin, Illinois 61603 |
| Illinois CancerCare - Peru | Peru, Illinois 61354 |
| Illinois CancerCare - Princeton | Princeton, Illinois 61356 |
| Illinois CancerCare - Spring Valley | Spring Valley, Illinois 61362 |
| Mercy General Health Partners | Muskegon, Michigan 49443 |
| Valley Hospital - Ridgewood | Ridgewood, New Jersey 07450 |
| Cancer Center of Paoli Memorial Hospital | Paoli, Pennsylvania 19301-1792 |
| Associates in Hematology-Oncology, PC at Crozer Regional Cancer Center | Upland, Pennsylvania 19013 |
| University of Colorado Cancer Center at UC Health Sciences Center | Aurora, Colorado 80045 |
| Valley Medical Oncology Consultants - Castro Valley | Castro Valley, California 94546 |
| Valley Medical Oncology | Fremont, California 94538 |
| Cancer Care Center at John Muir Health - Concord Campus | Concord, California 94524-4110 |
| Mercy Medical Center | Baltimore, Maryland 21202 |
| Community Hospital of the Monterey Peninsula Comprehensive Cancer Center | Monterey, California 93940 |
| Camino Medical Group - Treatment Center | Mountain View, California 94040 |
| Robert and Carol Weissman Cancer Center at Martin Memorial | Stuart, Florida 34994 |
| Holy Cross Hospital | Silver Spring, Maryland 20910 |
| Cancer Institute at St. Joseph Medical Center | Towson, Maryland 21204 |
| Baylor University Medical Center - Dallas | Dallas, Texas 75246 |
| CCOP - Kansas City | Prairie Village, Kansas 66208 |
| Aurora Women's Pavilion of West Allis Memorial Hospital | West Allis, Wisconsin 53227 |
| Vince Lombardi Cancer Clinic - Oshkosh | Oshkosh, Wisconsin 54904 |
| Piedmont Fayette Hospital | Fayetteville, Georgia 30214 |
| Presbyterian Cancer Treatment Center at Presbyterian Kaseman Hospital | Albuquerque, New Mexico 87110 |
| Clackamas Radiation Oncology Center | Clackamas, Oregon 97015 |
| Providence Newberg Medical Center | Newberg, Oregon 97132 |
| Willamette Falls Hospital | Oregon City, Oregon 97045 |
| Dyson Center for Cancer Care at Vassar Brothers Medical Center | Poughkeepsie, New York 12601-3990 |
| Sharp Memorial Hospital Cancer Center | San Diego, California 92123 |
| Saint Francis Hospital Cancer Center | Poughkeepsie, New York 12601 |
| Surgical Oncology Associates | Newport News, Virginia 23606 |
| Nashville Breast Center | Nashville, Tennessee 37203 |
| Lexington Medical Center | West Columbia, South Carolina 29169 |
| Clarian West Medical Center | Avon, Indiana 46123 |
| Clarian North Medical Center | Carmel, Indiana 46032 |
| Lovelace Women's Hospital | Albuquerque, New Mexico 87109 |
| Hilton Head Regional Medical Center | Hilton Head Island, South Carolina 29926 |
