Study of clinico-pathological factors, indications and response to chemotherapy in breast cancer patients in a tertiary care hospital in south India

Mohammad Fazelul Rahman Shoeb

doi:10.18203/2349-2902.isj20173390

Authors

Mohammad Fazelul Rahman Shoeb Department of General Surgery, Gulbarga Institute of Medical Sciences, Gulbarga, Karnataka, India

DOI:

https://doi.org/10.18203/2349-2902.isj20173390

Keywords:

Axillary clearance, Early and locally advanced breast cancer, Simple mastectomy

Abstract

Background: Breast cancer is considered a systemic disease, surgical interventions on most of the patients can reduce the loco regional burden and chemotherapy can reduce systemic burden by reducing chances of metastasis and recurrence and prolong life expectancy. The objective of this study was to assess the clinic-pathological factors of patient presenting with breast cancer and to study the indications and response to chemotherapy for breast cancer.

Methods: A prospective study of fifty patients was carried out at Victoria hospital and Bowring and Lady Curzon Hospital between October 2010 to October 2012 who underwent surgery, chemotherapy, radiotherapy and hormonal therapy.

Results: Most patients presented with palpable axillary lymph nodes (64%) and belonged to stage II disease (50%). Invasive ductal carcinoma was seen in 90% of cases while medullary in 04%, colloid in 2% and Infiltrating lobular was seen in 04% of patients. Totally 64% cases were ER or PR+, and 36% were ER/PR- among the study participants. 70% of the patients operated had positive nodes. All 50 cases received chemotherapy. Chemotherapy was indicated in node positive patients and in patients whose tumour was measuring more than 1 cm. After follow-up of 50 patients for about a period of two years, 3 patients died, 4 patients had metastasis and in the remaining 47 surviving patients none of them had recurrence at the end of second year.

Conclusions: Most cases and belonged to Stage II disease with Invasive ductal carcinoma being most common histological subtype seen in 90% of cases. FNAC is good diagnostic procedure cost effective and reliable as all cases post-operative HPE confirmed malignancy. Patients should be treated by chemotherapy in indicated cases, as carcinoma breast is a systemic disease and chemotherapy can reduce systemic burden by reducing chances of metastasis and recurrence and prolong life expectancy.

Metrics

Metrics Loading ...

References

Aswathy S, Reshma J, Avani D. Epidemiology of cervical cancer with special focus on India. Int J Womens Health. 2015;7:405-14.

Wood WC, MUSS HB, Solin LJ, Olopade OI. Cancer of the Breast. Devita, Cancer: Principles and Practice of Oncology, 7th edition, Lippincott William and Wilkins, Philadelphia; 2005;33:1400-1487.

A guide for women who are considering breast cancer treatment with chemotherapy and/or hormonal therapy before surgery. Available at https://www.bcia.org.au/brochure/neoadjuvant-decision-aid/ANZBCTG%20DOMINO%20AID.pdf. Accessed on 10 May 2017.

Statistics of breast cancer in India. Available at: http://www.breastcancerindia.net/statistics/stat_global.html. Accessed on 10 May 2017.

Trends of breast cancer in India. Available at: http://www.breastcancerindia.net/statistics/trends.html. Accessed on 10 May 2017.

Sen AK, Das Gupta TK. Cancer of breast and its treatment. Ind J Surg. 2009;11:832-47.

Vyas JJ, Desai PB, Sarkar S. Operable breast cancer and axillary tumor burden. Indian J Surg. 1989;109-18.

Bloom BS, Pouvourville N, Chatre S, Jayadevappa R,Weinberg D. Breast Cancer treatment in clinical practice compared to evidence and practical guidelines, Brit J Canc. 2004;90:26-30.

Schaepveld M, Elisabeth GE, Winette TA. The prognostic effect of the number of histologically examined axillary lymph nodes in Breast cancer: Stage migration or age association. Annals of Surgical Oncol. 2006;13:465-74.

Lisa A. Newman. “The Breast” F. Charles Brunicardi, Schwatz Principles of Surgery, 9th Edition, Mc graw hill; 2010: 423-474.

Desai SB, Moonim MT, Gill AK. Punia RS, Naresh KN, Chinoy RF. Hormone receptor status of Breast cancer in India: A Study of 798 tumors. Department of Pathology, Tata Memorial Hospital, Mumbai. Breast. 2000;9(5):267-70.

Chua B, Ung O, Taylor R, Boyages J. Frequency and predictors of Axillary lymph node metastasis in invasive breast cancer. ANZ J Surg. 2002;72(11):786-92.

Pritcherd KI. Surgery for breast cancer patients. The 2nd International Breast cancer research group conference. Cancer. 2003;7:98.

Silverstein MJ, Skinner KA, Lomes TJ. Predicting axillary nodal positivity in 2282 patients with breast crcinoma. World J Surg. 2001;25(6):767-72.

Henderson IC, Berry DA, Demetri GD, Cirrincione CT, Goldstein LJ, Martino S, et al. Improved outcomes from adding sequential Paclitaxel but not from escalating Doxorubicin dose in an adjuvant chemotherapy regimen for patients with node-positive primary breast cancer. J Clin Oncol. 2003;21:976.

Martin M, Pienkowski T, Mackey J, Pawlicki M, Guastalla JP, Weaver C, et al. Adjuvant docetaxel for node-positive breast cancer. N Engl J Med. 2005;352(22):2302-13.