Clinical and Epidemiological Evaluation and Assessment of Various Modes of Therapeutic Management of Locally Advanced Carcinoma of Breast in a Tertiary Care Hospital: An Observational Study
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 6, Issue 5
Abstract
Background: Worldwide breast cancer is the most frequent cancer in women and represents the second leading cause of cancer death among women (after lung cancer). Higher incidence in developing countries is due to lack of active screening, and early detection programs, low awareness of breast cancer, poor access to health care due to poverty, and cultural issues are other contributory factors for late presentation. The locally advanced breast cancer (LABC) is characterized by varying clinical presentations of tumors belonging to Stages IIIA, IIIB, IIIC, and inflammatory breast cancer and the aim of this study is to evaluate the epidemiologic characteristics such as age distribution, clinical presentation, stage at presentation, and various modalities of treatment. Methodology: The present study is a descriptive hospital-based study conducted in the department of general surgery in a tertiary care hospital during the period of November 2013–October 2015. All patients presenting to the hospital with Stage IIIA, IIIB, IIIIC, and inflammatory carcinoma were included in the study. The multimodality treatment approach of LABC commenced in the majority of cases with neoadjuvant chemotherapy (NACT), followed by local therapy in the form of modified radical mastectomy (MRM) (Auchincloss modification). The patients were then subjected to consolidating radiotherapy to locoregional area. Statistical Analysis: Descriptive statistics were done. Data were expressed as absolute numbers and percentage. Results: Observations were made regarding demographics, quadrants involved, menstrual status, tumor size, and fixity to chest wall, lymph node status, stage of the disease, inoperability, chemotherapy regimen, receptor status, and complications of surgery. Conclusion: Patients administered NACT showed a good response with 13.2% and 65.8% of the patients showing clinically complete and partial response, respectively. 92% of inoperable tumors became operable confirming that NACT is an effective method of downstaging the tumor.
Authors and Affiliations
Padmasree Gaddam
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