Parameters that influence the prognosis of phyllodes tumour

To evaluate the factors that influence the prognosis of patients with Phyllodes tumour. Interventional case series from April 2002 to April 2006. Setting: Department of Surgery, Surgical Ward-2, Jinnah Postgraduate Medical Centre, Karachi. Patients: Twenty two patients of Phyllodes tumour breast that were operated. Detailed data of all the patients was collected. Diagnosis of Phyllodes tumour was made on good clinical examination, ultrasonography, mammography and trucut biopsy. Primary treatment included wide local excision in 19 cases and mastectomy in three cases. All patients were females with a mean age of 31 years. Left breast was affected more [60%] than the right and a painless lump was the commonest presentation. Patients were divided into three groups after final histopathology report. Ten patients were reported as benign phyllodes who showed no recurrence on follow-up and four patient as borderline phyllodes, who developed recurrence within 12-18 months; while eight patients were reported as malignant phyllodes. The key prognostic factors are status of margins, histological type and the size of the tumour. Trucut biopsy has greater yield of diagnosis and surgery remains the mainstay of treatment for Cystosarcoma Phyllodes

Predicting factors of Seroma formation after Breast cancer surgery

To determine the frequency of seroma formation, and the role of hypertension, diabetes mellitus, neoadjuvant chemotherapy and nodal dissection in the development of seroma after breast surgery. Hospital based prospective study with descriptive design [interventional descriptive] from April 2002 to March 2005. Setting: Department of General Surgery [Ward-2], Jinnah Postgraduate Medical Centre, Karachi. 160 patients of Carcinoma Breast who underwent elective surgery. Patients were divided into two groups viz. those who developed seroma [Group-A] and those who did not [Group-B]. The data was tabulated on SPSS version 10.0. Demographic data was represented in frequencies. The effect of various risk factors [hypertension, diabetes mellitus, nodal status, tumour histology] was calculated and presented as relative risk [RR]. Out of 160 patients, there were 157 females and three males, with a sex ratio of 53F:1M. Their ages ranged from 23 to 100 years. A total of 144 patients underwent modified radical mastectomy and 16 breast conservation. Seroma formed in 28 [17.5%] cases. Out of 36 hypertensive patients 22 developed seroma [RR=12.72], while amongst the 28 diabetics two and amongst the 64 patients that received neoadjuvant chemotherapy 12 developed seroma. The total number of axillary lymph nodes in patients who developed seroma ranged from 4-28 as compared to non-seroma group with 4-30; an average of nine [0-25] positive nodes were seen in both the groups. Seroma formation is a common complication of the modified radical mastectomy. The only factor that appeared to contribute to seroma formation in this series was hypertension. Neoadjuvant chemotherapy marginally increased the risk, but diabetes had no role in seroma formation