Ignite Creation Date:
2025-12-25 @ 1:14 AM
Ignite Modification Date:
2025-12-27 @ 3:11 AM
Study NCT ID:
NCT00072293
Status:
COMPLETED
Last Update Posted:
2018-01-23
First Post:
2003-11-04
Is NOT Gene Therapy:
True
Has Adverse Events:
True
Brief Title:
Surgical Resection With or Without Axillary Lymph Node Dissection in Treating Women With Node-Negative Breast Cancer and Sentinel Lymph Node Micrometastases
Sponsor:
Organization:
Raw JSON
{'hasResults': True, 'derivedSection': {'miscInfoModule': {'versionHolder': '2025-12-24'}, 'conditionBrowseModule': {'meshes': [{'id': 'D001943', 'term': 'Breast Neoplasms'}], 'ancestors': [{'id': 'D009371', 'term': 'Neoplasms by Site'}, {'id': 'D009369', 'term': 'Neoplasms'}, {'id': 'D001941', 'term': 'Breast Diseases'}, {'id': 'D012871', 'term': 'Skin Diseases'}, {'id': 'D017437', 'term': 'Skin and Connective Tissue Diseases'}]}}, 'resultsSection': {'moreInfoModule': {'pointOfContact': {'email': 'rudolf.maibach@ibcsg.org', 'phone': '+41 31 389 91 96', 'title': 'Rudolf Maibach, Executive Officer for International Trial Activities', 'organization': 'IBCSG'}, 'certainAgreement': {'piSponsorEmployee': False, 'restrictiveAgreement': False}}, 'adverseEventsModule': {'timeFrame': '5-years. Treating physician assessed and reported long-term surgical events (sensory neuropathy, lymphoedema and motor neuropathy) at every follow-up visit (every 4 months from date of randomization for the first year and every six months from years 2-5).', 'description': 'Analysis population excludes 31 patients (17 in Axillary Dissection group/14 in No Axillary Dissection group) who did not receive the randomly-assigned treatment.', 'eventGroups': [{'id': 'EG000', 'title': 'Axillary Dissection', 'description': 'Patients undergo surgical resection of the primary tumor with axillary lymph node dissection following sentinel lymph node assessment.\n\nAxillary lymph node dissection: Axillary lymph node dissection', 'otherNumAtRisk': 447, 'otherNumAffected': 178, 'seriousNumAtRisk': 447, 'seriousNumAffected': 1}, {'id': 'EG001', 'title': 'No Axillary Dissection', 'description': 'Patients undergo surgical resection of the primary tumor with no axillary lymph node dissection following sentinel lymph node assessment.\n\nNo axillary lymph node dissection: Therapeutic conventional surgery', 'otherNumAtRisk': 453, 'otherNumAffected': 83, 'seriousNumAtRisk': 453, 'seriousNumAffected': 0}], 'otherEvents': [{'term': 'Sensory neuropathy', 'stats': [{'groupId': 'EG000', 'numAtRisk': 447, 'numAffected': 82}, {'groupId': 'EG001', 'numAtRisk': 453, 'numAffected': 55}], 'organSystem': 'Nervous system disorders', 'assessmentType': 'SYSTEMATIC_ASSESSMENT', 'sourceVocabulary': 'CTCAE (2.0)'}, {'term': 'Lymphedema', 'stats': [{'groupId': 'EG000', 'numAtRisk': 447, 'numAffected': 59}, {'groupId': 'EG001', 'numAtRisk': 453, 'numAffected': 15}], 'organSystem': 'Vascular disorders', 'assessmentType': 'SYSTEMATIC_ASSESSMENT', 'sourceVocabulary': 'CTCAE (2.0)'}, {'term': 'Motor neuropathy', 'stats': [{'groupId': 'EG000', 'numAtRisk': 447, 'numAffected': 37}, {'groupId': 'EG001', 'numAtRisk': 453, 'numAffected': 13}], 'organSystem': 'Nervous system disorders', 'assessmentType': 'SYSTEMATIC_ASSESSMENT', 'sourceVocabulary': 'CTCAE (2.0)'}], 'seriousEvents': [{'term': 'Post-operative infection (L.axilla)', 'stats': [{'groupId': 'EG000', 'numAtRisk': 447, 'numAffected': 1}, {'groupId': 'EG001', 'numAtRisk': 453, 'numAffected': 0}], 'organSystem': 'Infections and infestations', 'assessmentType': 'SYSTEMATIC_ASSESSMENT', 'sourceVocabulary': 'CTCAE (2.0)'}], 'frequencyThreshold': '0'}, 'outcomeMeasuresModule': {'outcomeMeasures': [{'type': 'PRIMARY', 'title': '5-year Disease-Free Survival', 'denoms': [{'units': 'Participants', 'counts': [{'value': '464', 'groupId': 'OG000'}, {'value': '467', 'groupId': 'OG001'}]}], 'groups': [{'id': 'OG000', 'title': 'Axillary Dissection', 'description': 'Patients undergo surgical resection of the primary tumor with axillary lymph node dissection following sentinel lymph node assessment.\n\nAxillary lymph node dissection: Axillary lymph node dissection'}, {'id': 'OG001', 'title': 'No Axillary Dissection', 'description': 'Patients undergo surgical resection of the primary tumor with no axillary lymph node dissection following sentinel lymph node assessment.\n\nNo axillary lymph node dissection: Therapeutic conventional surgery'}], 'classes': [{'categories': [{'measurements': [{'value': '84.4', 'groupId': 'OG000'}, {'value': '87.8', 'groupId': 'OG001'}]}]}], 'analyses': [{'pValue': '0.004', 'groupIds': ['OG000', 'OG001'], 'paramType': 'Hazard Ratio (HR)', 'ciNumSides': 'TWO_SIDED', 'ciPctValue': '95', 'paramValue': '0.78', 'ciLowerLimit': '0.55', 'ciUpperLimit': '1.11', 'pValueComment': 'Test for non-inferiority of no axillary dissection. Stratified logrank test compared groups. HR (no-AD vs AD) estimated from test statistic and variance as HR=exp(\\[O-E\\]/V), compared to 1.25 in 1-sided test of non-inferiority.', 'estimateComment': 'Hazard Ratio is no axillary dissection/axillary dissection.', 'statisticalMethod': '1-sided non-inferiority test', 'nonInferiorityType': 'NON_INFERIORITY_OR_EQUIVALENCE', 'nonInferiorityComment': 'As originally designed, target accrual was 1960 patients with analysis planned after 558 events. These targets were based on having 90% power to detect non-inferiority of no axillary dissection with a one-sided statistical signifi cance level of 10% (ie, α=0·10) under the assumption that 5-year disease-free survival with axillary dissection was 70% and defining non-inferiority as a hazard ratio (HR) of less than 1·25 (no axillary dissection relative to axillary dissection).'}], 'paramType': 'NUMBER', 'timeFrame': '5-year estimate reported after a median follow-up of 60 months', 'description': 'Estimated percentage of patients alive and disease-free at 5 years from randomization, where disease-free survival is defined as the time from randomization to first evidence of invasive relapse at any site, second primary tumor (contralateral or non-breast) or death.', 'unitOfMeasure': 'percentage of participants', 'reportingStatus': 'POSTED', 'populationDescription': 'Intention-to-treat'}, {'type': 'SECONDARY', 'title': '5-year Overall Survival', 'denoms': [{'units': 'Participants', 'counts': [{'value': '464', 'groupId': 'OG000'}, {'value': '467', 'groupId': 'OG001'}]}], 'groups': [{'id': 'OG000', 'title': 'Axillary Dissection', 'description': 'Patients undergo surgical resection of the primary tumor with axillary lymph node dissection following sentinel lymph node assessment.\n\nAxillary lymph node dissection: Axillary lymph node dissection'}, {'id': 'OG001', 'title': 'No Axillary Dissection', 'description': 'Patients undergo surgical resection of the primary tumor with no axillary lymph node dissection following sentinel lymph node assessment.\n\nNo axillary lymph node dissection: Therapeutic conventional surgery'}], 'classes': [{'categories': [{'measurements': [{'value': '97.6', 'groupId': 'OG000'}, {'value': '97.5', 'groupId': 'OG001'}]}]}], 'analyses': [{'pValue': '0.73', 'groupIds': ['OG000', 'OG001'], 'paramType': 'Hazard Ratio (HR)', 'ciNumSides': 'TWO_SIDED', 'ciPctValue': '90', 'paramValue': '0.89', 'ciLowerLimit': '0.52', 'ciUpperLimit': '1.54', 'estimateComment': 'Hazard Ratio is no axillary dissection/axillary dissection.', 'statisticalMethod': 'Log Rank', 'nonInferiorityType': 'SUPERIORITY_OR_OTHER'}], 'paramType': 'NUMBER', 'timeFrame': '5-year estimate reported after a median follow-up of 60 months', 'description': 'Estimated percentage of patients alive and disease-free at 5 years from randomization, where overall survival is defined as the time from randomization to death of any cause.', 'unitOfMeasure': 'percentage of participants', 'reportingStatus': 'POSTED', 'populationDescription': 'Intention-to-treat'}, {'type': 'SECONDARY', 'title': 'Site of Recurrence', 'denoms': [{'units': 'Participants', 'counts': [{'value': '464', 'groupId': 'OG000'}, {'value': '467', 'groupId': 'OG001'}]}], 'groups': [{'id': 'OG000', 'title': 'Axillary Dissection', 'description': 'Patients undergo surgical resection of the primary tumor with axillary lymph node dissection following sentinel lymph node assessment.\n\nAxillary lymph node dissection: Axillary lymph node dissection'}, {'id': 'OG001', 'title': 'No Axillary Dissection', 'description': 'Patients undergo surgical resection of the primary tumor with no axillary lymph node dissection following sentinel lymph node assessment.\n\nNo axillary lymph node dissection: Therapeutic conventional surgery'}], 'classes': [{'title': 'Local recurrence', 'categories': [{'measurements': [{'value': '10', 'groupId': 'OG000'}, {'value': '8', 'groupId': 'OG001'}]}]}, {'title': 'Regional recurrence', 'categories': [{'measurements': [{'value': '1', 'groupId': 'OG000'}, {'value': '5', 'groupId': 'OG001'}]}]}, {'title': 'Contralateral breast cancer', 'categories': [{'measurements': [{'value': '3', 'groupId': 'OG000'}, {'value': '9', 'groupId': 'OG001'}]}]}, {'title': 'Distant recurrence', 'categories': [{'measurements': [{'value': '34', 'groupId': 'OG000'}, {'value': '25', 'groupId': 'OG001'}]}]}, {'title': 'Second (non-breast) primary', 'categories': [{'measurements': [{'value': '20', 'groupId': 'OG000'}, {'value': '6', 'groupId': 'OG001'}]}]}, {'title': 'Death without cancer event', 'categories': [{'measurements': [{'value': '1', 'groupId': 'OG000'}, {'value': '2', 'groupId': 'OG001'}]}]}], 'paramType': 'NUMBER', 'timeFrame': 'Reported after a median follow-up of 60 months', 'description': 'Site of recurrence of breast cancer', 'unitOfMeasure': 'participants', 'reportingStatus': 'POSTED', 'populationDescription': 'Intention-to-treat'}]}, 'participantFlowModule': {'groups': [{'id': 'FG000', 'title': 'Axillary Dissection', 'description': 'Patients undergo surgical resection of the primary tumor with axillary lymph node dissection following sentinel lymph node assessment.\n\nAxillary lymph node dissection: Axillary lymph node dissection'}, {'id': 'FG001', 'title': 'No Axillary Dissection', 'description': 'Patients undergo surgical resection of the primary tumor with no axillary lymph node dissection following sentinel lymph node assessment.\n\nNo axillary lymph node dissection: Therapeutic conventional surgery'}], 'periods': [{'title': 'Overall Study', 'milestones': [{'type': 'STARTED', 'achievements': [{'groupId': 'FG000', 'numSubjects': '465'}, {'groupId': 'FG001', 'numSubjects': '469'}]}, {'type': 'COMPLETED', 'achievements': [{'groupId': 'FG000', 'numSubjects': '464'}, {'groupId': 'FG001', 'numSubjects': '467'}]}, {'type': 'NOT COMPLETED', 'achievements': [{'groupId': 'FG000', 'numSubjects': '1'}, {'groupId': 'FG001', 'numSubjects': '2'}]}], 'dropWithdraws': [{'type': 'Lost to Follow-up', 'reasons': [{'groupId': 'FG000', 'numSubjects': '1'}, {'groupId': 'FG001', 'numSubjects': '1'}]}, {'type': 'Withdrawal by Subject', 'reasons': [{'groupId': 'FG000', 'numSubjects': '0'}, {'groupId': 'FG001', 'numSubjects': '1'}]}]}], 'recruitmentDetails': 'Accrual began April 1, 2001 and closed February 28, 2010, after 934 patients from 27 centers in Europe, South America and Australia were randomized.'}, 'baselineCharacteristicsModule': {'denoms': [{'units': 'Participants', 'counts': [{'value': '464', 'groupId': 'BG000'}, {'value': '467', 'groupId': 'BG001'}, {'value': '931', 'groupId': 'BG002'}]}], 'groups': [{'id': 'BG000', 'title': 'Axillary Dissection', 'description': 'Patients undergo surgical resection of the primary tumor with axillary lymph node dissection following sentinel lymph node assessment.\n\nAxillary lymph node dissection: Axillary lymph node dissection'}, {'id': 'BG001', 'title': 'No Axillary Dissection', 'description': 'Patients undergo surgical resection of the primary tumor with no axillary lymph node dissection following sentinel lymph node assessment.\n\nNo axillary lymph node dissection: Therapeutic conventional surgery'}, {'id': 'BG002', 'title': 'Total', 'description': 'Total of all reporting groups'}], 'measures': [{'title': 'Age, Continuous', 'classes': [{'categories': [{'measurements': [{'value': '53', 'groupId': 'BG000', 'lowerLimit': '28', 'upperLimit': '81'}, {'value': '54', 'groupId': 'BG001', 'lowerLimit': '26', 'upperLimit': '81'}, {'value': '54', 'groupId': 'BG002', 'lowerLimit': '26', 'upperLimit': '81'}]}]}], 'paramType': 'MEDIAN', 'unitOfMeasure': 'years', 'dispersionType': 'INTER_QUARTILE_RANGE'}, {'title': 'Sex: Female, Male', 'classes': [{'categories': [{'title': 'Female', 'measurements': [{'value': '464', 'groupId': 'BG000'}, {'value': '467', 'groupId': 'BG001'}, {'value': '931', 'groupId': 'BG002'}]}, {'title': 'Male', 'measurements': [{'value': '0', 'groupId': 'BG000'}, {'value': '0', 'groupId': 'BG001'}, {'value': '0', 'groupId': 'BG002'}]}]}], 'paramType': 'COUNT_OF_PARTICIPANTS', 'unitOfMeasure': 'Participants'}], 'populationDescription': 'Intention-to-treat'}}, 'protocolSection': {'designModule': {'phases': ['NA'], 'studyType': 'INTERVENTIONAL', 'designInfo': {'allocation': 'RANDOMIZED', 'maskingInfo': {'masking': 'NONE'}, 'primaryPurpose': 'TREATMENT', 'interventionModel': 'PARALLEL'}, 'enrollmentInfo': {'type': 'ACTUAL', 'count': 931}}, 'statusModule': {'overallStatus': 'COMPLETED', 'startDateStruct': {'date': '2001-12'}, 'expandedAccessInfo': {'hasExpandedAccess': False}, 'statusVerifiedDate': '2017-12', 'completionDateStruct': {'date': '2017-03-31', 'type': 'ACTUAL'}, 'lastUpdateSubmitDate': '2017-12-22', 'studyFirstSubmitDate': '2003-11-04', 'resultsFirstSubmitDate': '2016-02-26', 'studyFirstSubmitQcDate': '2003-11-05', 'lastUpdatePostDateStruct': {'date': '2018-01-23', 'type': 'ACTUAL'}, 'resultsFirstSubmitQcDate': '2016-04-12', 'studyFirstPostDateStruct': {'date': '2003-11-06', 'type': 'ESTIMATED'}, 'resultsFirstPostDateStruct': {'date': '2016-05-18', 'type': 'ESTIMATED'}, 'primaryCompletionDateStruct': {'date': '2012-09', 'type': 'ACTUAL'}}, 'outcomesModule': {'primaryOutcomes': [{'measure': '5-year Disease-Free Survival', 'timeFrame': '5-year estimate reported after a median follow-up of 60 months', 'description': 'Estimated percentage of patients alive and disease-free at 5 years from randomization, where disease-free survival is defined as the time from randomization to first evidence of invasive relapse at any site, second primary tumor (contralateral or non-breast) or death.'}], 'secondaryOutcomes': [{'measure': '5-year Overall Survival', 'timeFrame': '5-year estimate reported after a median follow-up of 60 months', 'description': 'Estimated percentage of patients alive and disease-free at 5 years from randomization, where overall survival is defined as the time from randomization to death of any cause.'}, {'measure': 'Site of Recurrence', 'timeFrame': 'Reported after a median follow-up of 60 months', 'description': 'Site of recurrence of breast cancer'}]}, 'oversightModule': {'oversightHasDmc': True}, 'conditionsModule': {'keywords': ['stage IA breast cancer', 'stage IB breast cancer', 'stage II breast cancer', 'estrogen receptor-negative breast cancer', 'estrogen receptor-positive breast cancer', 'progesterone receptor-negative breast cancer', 'progesterone receptor-positive breast cancer'], 'conditions': ['Breast Cancer']}, 'referencesModule': {'references': [{'pmid': '30196031', 'type': 'DERIVED', 'citation': 'Galimberti V, Cole BF, Viale G, Veronesi P, Vicini E, Intra M, Mazzarol G, Massarut S, Zgajnar J, Taffurelli M, Littlejohn D, Knauer M, Tondini C, Di Leo A, Colleoni M, Regan MM, Coates AS, Gelber RD, Goldhirsch A; International Breast Cancer Study Group Trial 23-01. Axillary dissection versus no axillary dissection in patients with breast cancer and sentinel-node micrometastases (IBCSG 23-01): 10-year follow-up of a randomised, controlled phase 3 trial. Lancet Oncol. 2018 Oct;19(10):1385-1393. doi: 10.1016/S1470-2045(18)30380-2. Epub 2018 Sep 5.'}, {'pmid': '23491275', 'type': 'DERIVED', 'citation': 'Galimberti V, Cole BF, Zurrida S, Viale G, Luini A, Veronesi P, Baratella P, Chifu C, Sargenti M, Intra M, Gentilini O, Mastropasqua MG, Mazzarol G, Massarut S, Garbay JR, Zgajnar J, Galatius H, Recalcati A, Littlejohn D, Bamert M, Colleoni M, Price KN, Regan MM, Goldhirsch A, Coates AS, Gelber RD, Veronesi U; International Breast Cancer Study Group Trial 23-01 investigators. Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases (IBCSG 23-01): a phase 3 randomised controlled trial. Lancet Oncol. 2013 Apr;14(4):297-305. doi: 10.1016/S1470-2045(13)70035-4. Epub 2013 Mar 11.'}], 'seeAlsoLinks': [{'url': 'http://www.ncbi.nlm.nih.gov/pubmed/23491275', 'label': 'Abstract from paper published in Lancet Oncology, 2013'}]}, 'descriptionModule': {'briefSummary': 'RATIONALE: Surgery to remove lymph nodes in the armpit in patients with sentinel lymph node micrometastases may remove cancer cells that have spread from tumors in the breast. It is not yet known whether surgery to remove the primary tumor is more effective with or without axillary lymph node dissection.\n\nPURPOSE: This randomized phase III trial is studying surgery and axillary lymph node dissection to see how well they work compared to surgery alone in treating women with node-negative breast cancer and sentinel lymph node micrometastases.', 'detailedDescription': 'OBJECTIVES:\n\n* Compare disease-free survival of women with clinically node-negative breast cancer with sentinel lymph node micrometastases treated with surgical resection with or without axillary dissection.\n* Compare overall survival of patients treated with these regimens.\n* Assess sites of recurrence, particularly reappearance of disease in the undissected axilla.\n* Assess long-term surgical complications in patients treated with these regimens.\n\nOUTLINE: This is a multicenter study. Patients are stratified according to participating center, menopausal status (pre- vs postmenopausal), and preoperative sentinel node biopsy (yes vs no). Patients are followed every 4 months for 1 year, every 6 months for 4 years, and then annually thereafter.'}, 'eligibilityModule': {'sex': 'FEMALE', 'stdAges': ['ADULT', 'OLDER_ADULT'], 'minimumAge': '18 Years', 'healthyVolunteers': False, 'eligibilityCriteria': "DISEASE CHARACTERISTICS:\n\n* Clinical, mammographic, ultrasonographic, or pathologic diagnosis of unicentric and unifocal breast carcinoma\n* Largest tumor lesion ≤ 5 cm\n* Palpable or nonpalpable breast lesion\n\n * Preoperative radioactive occult lesion localization, hook wire, or other method of localization required for nonpalpable lesions\n* Prior (preoperative) or planned (intraoperative) sentinel node biopsy required\n\n * At least 1 micrometastatic (i.e., no greater than 2 mm) sentinel lymph node with no extracapsular extension\n* No clinical evidence of distant metastases\n\n * No suspicious manifestation of metastases that cannot be ruled out by x-ray, MRI, or CT scan, including the following:\n\n * Skeletal pain of unknown cause\n * Elevated alkaline phosphatase\n * Bone scan showing hot spots\n* No palpable axillary lymph node(s)\n* No Paget's disease without invasive cancer\n* Hormone receptor status:\n\n * Estrogen receptor and progesterone receptor known\n\nPATIENT CHARACTERISTICS:\n\nAge\n\n* Any age\n\nSex\n\n* Female\n\nMenopausal status\n\n* Any status\n\nPerformance status\n\n* Not specified\n\nLife expectancy\n\n* Not specified\n\nHematopoietic\n\n* Not specified\n\nHepatic\n\n* See Disease Characteristics\n\nRenal\n\n* Not specified\n\nOther\n\n* Not pregnant or nursing\n* No other prior or concurrent malignancy except the following:\n\n * Adequately treated basal cell or squamous cell skin cancer\n * Adequately treated carcinoma in situ of the cervix\n * Adequately treated in situ melanoma\n * Contralateral or ipsilateral carcinoma in situ of the breast\n* No psychiatric, addictive, or other disorder that may compromise ability to give informed consent\n* Geographically accessible for follow-up\n\nPRIOR CONCURRENT THERAPY:\n\nBiologic therapy\n\n* Not specified\n\nChemotherapy\n\n* Not specified\n\nEndocrine therapy\n\n* Not specified\n\nRadiotherapy\n\n* Not specified\n\nSurgery\n\n* See Disease Characteristics\n\nOther\n\n* No prior systemic therapy for breast cancer\n* More than 1 year since prior chemopreventive agent"}, 'identificationModule': {'nctId': 'NCT00072293', 'acronym': '23-01', 'briefTitle': 'Surgical Resection With or Without Axillary Lymph Node Dissection in Treating Women With Node-Negative Breast Cancer and Sentinel Lymph Node Micrometastases', 'organization': {'class': 'NETWORK', 'fullName': 'ETOP IBCSG Partners Foundation'}, 'officialTitle': 'A Randomized Trial Of Axillary Dissection Versus No Axillary Dissection For Patients With Clinically Node Negative Breast Cancer And Micrometastases In The Sentinel Node', 'orgStudyIdInfo': {'id': 'CDR0000339581'}, 'secondaryIdInfos': [{'id': 'IBCSG 23-01', 'type': 'OTHER', 'domain': 'IBCSG'}]}, 'armsInterventionsModule': {'armGroups': [{'type': 'ACTIVE_COMPARATOR', 'label': 'Axillary Dissection', 'description': 'Patients undergo surgical resection of the primary tumor with axillary lymph node dissection following sentinel lymph node assessment.', 'interventionNames': ['Procedure: Axillary lymph node dissection']}, {'type': 'EXPERIMENTAL', 'label': 'No Axillary Dissection', 'description': 'Patients undergo surgical resection of the primary tumor with no axillary lymph node dissection following sentinel lymph node assessment.', 'interventionNames': ['Procedure: No axillary lymph node dissection']}], 'interventions': [{'name': 'Axillary lymph node dissection', 'type': 'PROCEDURE', 'description': 'Axillary lymph node dissection', 'armGroupLabels': ['Axillary Dissection']}, {'name': 'No axillary lymph node dissection', 'type': 'PROCEDURE', 'description': 'Therapeutic conventional surgery', 'armGroupLabels': ['No Axillary Dissection']}]}, 'contactsLocationsModule': {'locations': [{'zip': '2480', 'city': 'Lismore', 'state': 'New South Wales', 'country': 'Australia', 'facility': 'Lismore Base Hospital', 'geoPoint': {'lat': -28.81354, 'lon': 153.2773}}, {'zip': '2480', 'city': 'Lismore', 'state': 'New South Wales', 'country': 'Australia', 'facility': 'St Vincents Hospital', 'geoPoint': {'lat': -28.81354, 'lon': 153.2773}}, {'zip': '2060', 'city': 'North Sydney', 'state': 'New South Wales', 'country': 'Australia', 'facility': 'Mater Hospital - North Sydney', 'geoPoint': {'lat': -33.839, 'lon': 151.2072}}, {'zip': '2065', 'city': 'St Leonards', 'state': 'New South Wales', 'country': 'Australia', 'facility': 'Royal North Shore Hospital', 'geoPoint': {'lat': -33.82344, 'lon': 151.19836}}, {'zip': '2050', 'city': 'Sydney', 'state': 'New South Wales', 'country': 'Australia', 'facility': 'Sydney Cancer Centre at Royal Prince Alfred Hospital', 'geoPoint': {'lat': -33.86785, 'lon': 151.20732}}, {'zip': '2650', 'city': 'Wagga Wagga', 'state': 'New South Wales', 'country': 'Australia', 'facility': 'Riverina Cancer Care Centre', 'geoPoint': {'lat': -35.12577, 'lon': 147.35375}}, {'zip': '2145', 'city': 'Westmead', 'state': 'New South Wales', 'country': 'Australia', 'facility': 'Westmead Institute for Cancer Research at Westmead Hospital', 'geoPoint': {'lat': -33.80383, 'lon': 150.98768}}, {'zip': '5000', 'city': 'Adelaide', 'state': 'South Australia', 'country': 'Australia', 'facility': 'Royal Adelaide Hospital Cancer Centre', 'geoPoint': {'lat': -34.92866, 'lon': 138.59863}}, {'zip': '3050', 'city': 'Parkville', 'state': 'Victoria', 'country': 'Australia', 'facility': 'Royal Melbourne Hospital', 'geoPoint': {'lat': -37.78333, 'lon': 144.95}}, {'zip': '6230', 'city': 'Bunbury', 'state': 'Western Australia', 'country': 'Australia', 'facility': 'St. John of God Hospital - 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