DOI: http://dx.doi.org/10.18203/2349-2902.isj20191881

Clinical presentations of carcinoma breast in rural population of North India: a prospective observational study

Gaurav Gupta, Rohit Dang, Sangeeta Gupta

Abstract


Background: There is an ever increasing incidence in cases of carcinoma breast in developing countries, however no definitive cause is found. Since it presents as painless lump, patients neglect the disease and come to hospital often in late stages. This study was planned to investigate the causes for late presentation of the patients with carcinoma breast in North Indian population.

Methods: This is a prospective observational study; it included fifty cases of carcinoma breast proven by FNAC/Trucut biopsy. All these cases were admitted in the department of general surgery and thoroughly examined and investigated. The details of investigations, management, morbidity & mortality were noted down & results calculated with appropriate statistical analysis.

Results: Most of the female patients were in the age group of 31-60 years. Maximum patients presented with breast lumps, but most of them had lump more than 5 cm (T3) in size with spread to axillary lymph nodes N1 or N2. Surgery in the form of Modified Radical Mastectomy (MRM), adjuvant & neo-adjuvant Chemotherapy as per the stage of the disease and hormonal therapy in the form of Tamoxifen was given.

Conclusions: Poor treatment compliance in the form of irregularity to turn up for chemotherapy cycles has resulted in more number of mastectomies. Numbers of patients lost to follow up were more due to unaffordability of the cost incurred and lack of awareness. True mortality rate and recurrence rate could not be commented upon as a longer period of follow up was required.


Keywords


Carcinoma breast, Mastectomy, Breast lump, Neo adjuvant chemotherapy

Full Text:

PDF

References


Jakesz R. Breast Cancer in developing countries: Challenges for multidisciplinary care. Breast Care. 2008;3:4-5.

Chopra R. The Indian scene. J Clin Oncol. 2001;19:106-11.

Apffelstaedt JP. Locally advanced breast cancer in developing countries: the place of surgery. World J Surg. 2003;27:917-20.

Devita VT, Rosenberg SA. Cancers principles and practice of oncology. 6th ed., Lippincots; 2001: 633-1726.

Siddiqui K, Rasool MI. Pattern of Breast Diseases: Preliminary report of breast clinic. J Coll Physicians Surg Pak. 2001;11(8):497-500.

Chandra A. Problems and prospects of cancer of the breast in India. J Indian Medical Association. 1979;72:43-54.

Dumitrescu R, Cotarla I. Understanding breast cancer risk- where do we stand in 2005? J Cellular Molecular Med. 2005;9:208-21.

Hortobagyi GN, Garza SJ, Pritchard K. The global breast cancer burden: variations in epidemiology and survival. Clin Breast Cancer. 2005;6:391-401.

Anderson BO, Jakesz R. Breast cancer issues in developing countries: An overview of the breast health global initiative. World J Surg. 2008;32:2579-85.

Porter P. Westernizing women’s risks? Breast cancer in lower-income countries. N Engl J Med. 2008;358:213-16.

Green M, Raina V. Epidemiology, screening and diagnosis of breast cancer in the Asia–Pacific region: Current perspectives and important considerations. Asia Pac J Clin Oncol. 2008;4:5-13.

Yeole BB, Kurkure A. An epidemiological assessment of increasing incidence and trends in breast cancer in Mumbai and other sites in India, during the last two decades. Asian Pac J Cancer Prev. 2003;4:51-66.

Agarwal G, Pradeep PV, Aggarwal V, Yip CH, Cheung PS. Spectrum of breast cancer in Asian women. World J Surg. 2007;31:1031-40.

Boyle P, Ferlay J. Cancer incidence and mortality in Europe. Ann Oncol. 2005;16:481-88.

Gang RK, Bothra VC, Pande K. Cancer of the breast. Ind J Sur. 1982;43(6):347-50.

Hadi N, Sadeghi A, Talei A. Assessment of breast cancer screening programme in shiraz, Islamic republic of Iran. East Mediterranean Health. 2002;8:388-91.

Walker ARP, Adam FI, Walker BF. Breast cancer in black african women: a changing situation. J R Soc Health. 2004;124:81-5.

Bray F, McCarron P, Parkin DM. The changing global pattern of female breast cancer incidence and mortality. Breasts Can Res. 2004;6:229-34.

Nasser AH, Huda OB. Trends of breast cancer and its management in the last twenty years in aden and adjacent governorates Yemen. Asian Pacific J Cancer Prev. 2012;13:4347-51.

Tewari M, Pradhan S, Kumar M, Shukla HS. Effect of prevailing local treatment options of breast cancer on survival outside controlled clinical trials: experience of a specialist breast unit in North India. World J Surg. 2006;30:1794-801.

Fisher B, Anderson S, Bryant J. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347:1233-41.