Clinical predictors of axillary lymph node metastasis in early breast cancer in Indian patients

Background: Surgical dissection is the accepted mode of staging the axilla in breast cancer. Proper prediction of axillary node positivity can help towards stratifying patients. The primary objective of the study was to assess the clinical factors influencing pathological axillary lymph node positivity in early carcinoma breast.Methods: This was a retrospective study, conducted at a tertiary cancer centre. Case records of all the patients with invasive breast cancer which are clinical T1 and T2 and either N0 or NI, from January 2011 to October 2014 were analysed. Clinical profile of the patient including age, BMI, comorbid, menstrual history, family history, symptoms, site of the lesion, size, single or multi centric origin were analysed.Results: Total of 608 patients of early breast cancer analysed of which 248 had pathological nodal positivity. The age group of 51 to 75 years, BMI ≥30, pre-menopausal patients had significant positive predictive value when compared to post-menopausal. Tumours in lower outer quadrant, central sector and multiple tumours also had positive predictive value. Clinical T2 when compared to clinical T1 stage and MRM when compared to BCS had significant positive predictive value.Conclusions: To conclude in present study age of the patient and clinical location of the tumour and surgery performed emerged as significant independent predictive factors of positive lymph node. Prospective studies are required to further prove the significance of these factors.

Bleeding Jejunal Metastases Arising From Primary Alveolar Soft Part Sarcoma Of Thigh

Alveolar soft part sarcoma (ASPS) is a rare tumor (0.5–1% of sarcomas) of unknown etiology with a highly characteristic morphology. It tends to occur more often in the younger age group with a predilection for the female sex. Prognosis is generally poor and it often presents with late metastases. Here, we report the case of a 48-year-old female, who presented to the emergency department with a complaint of giddiness and melena. She was a known case of sarcoma ASPS left thigh with pulmonary secondaries. On evaluation, a bleeding tumor in the upper jejunum was found on upper GI endoscopy. As the patient’s hemodynamics were unstable, she had to be operated without further imaging. Post-operative period was uneventful

Gastrointestinal Mixed Neuroendocrine Carcinoma: Case Reports And Review Of Literature

Mixed adenoneuroendocrine carcinoma (MANEC) is a rare and relatively newer entity and classified into a separate category by the WHO 2010 Classification of Tumors. Accordingly, due to its rarity of diagnosis, further oncologic management is a challenge. They contain an adenocarcinoma part and a neuroendocrine part and are further classified based on grades. We present case series with a histological diagnosis of MANEC, its management, and clinical behavior in the follow-up period. Optimum mode of the management of these tumors is yet to be proposed, as these groups of tumors are highly aggressive and associated with poor prognosis.