 My name is Dr. Tara Belija. I'm a breast surgeon here at Hackensack University Medical Center. So a clinical trial is a research study that involves volunteer patients who participate in a study that asks questions about the effectiveness of different treatments. So it's interesting to note that every current treatment for breast cancer actually is backed by a clinical trial. Patients in our community should be aware that clinical trials are available that help to push forward our current knowledge of different therapies in medicine. Basically clinical trials are really only available at academic medical centers. This makes Hackensack University Medical Center a unique institution in northern New Jersey. So the Comet study is a clinical trial for low risk DCIS. DCIS are abnormal cells in the lining of the milk duct of the breast and they are not invasive cancer cells but they can turn into invasive cancer cells. Usually the standard of care is to do surgery sometimes radiation and then some years of a medication to reduce the risk of recurrence. There are two different types of DCIS. There's high grade DCIS that we know has a higher chance of going on to becoming invasive cancer but there's also low risk DCIS and many times that low risk DCIS does not turn into invasive cancer. The Comet study takes patients and randomizes them to two arms one where a patient will undergo active observation or active surveillance of their DCIS or they will go on to the standard of care and do surgery and or radiation and other medications and basically we're trying to compare the two groups to see if the outcomes are the same with the hopes that active observation will not be worse than doing standard of care. Our other two randomized clinical trials are involving patients who have breast cancer who have cancer already in their lymph nodes at the time of diagnosis. So the usual treatment pathways that they would go on to do chemotherapy they then have surgery and at the time of surgery we check their lymph nodes to see if they are still positive or if chemo was effective at clearing the cancer from the lymph nodes. So this is where our two trials come in because at the time of surgery when we remove a few of the lymph nodes to see if cancer is still there if the cancer is still present then they can be enrolled in our Alliance A011202 study and that will allow patients to go into two groups. Either they will continue to go on and have the rest of their lymph nodes removed or they will have radiation treatment for their lymph nodes instead and this is to see whether or not radiation is enough and if we can avoid removing lymph nodes at the time of surgery because there's a lot of side effects that are associated with that. So now if at the time of surgery when we remove a few of the lymph nodes and we found that cancer was cleared from the lymph nodes then we stop with the removal of the rest of the lymph nodes. Usually because lymph node positive disease was already present we may still recommend that a patient go on to have radiation but the NSAVP B51 clinical trial is looking at whether or not radiation is really necessary in these patients because a lot of studies have shown that once chemotherapy has cleared cancer from the lymph nodes that those patients go on to have a good prognosis their recurrence rates are lower so is radiation over treatment. So this study allows us to put patients either in no further radiation or radiation and then follow them and see what their outcomes are. So being able to participate in clinical trials gives you access not only to treatments that you wouldn't otherwise have access to but you can also have the added effect of being able to help other people in the future. By the knowledge we gain in clinical trial participation we could actually potentially shift the standard of care and you know change the way that we treat patients in the future. I think the ability to have clinical trials at Hackensack University Medical Center is vitally important and it shows our commitment and dedication to research and advancing medicine.