ABSTRACT
Background: Breast cancer is the most common cause of cancer in women and cancer related mortality all over the world. There is strong evidence that delayed diagnosis of breast cancer is associated with poor survival. At our center most of the patients with breast cancer presented as locally advanced breast cancer (LABC) which drew our attention to find out the reasons of delay and its association with different socio-demographic variables.Methods: We enrolled 50 histologically proven cases of LABC in this study. With help of semi structured interview, questions were asked from each patient which could reflect their understanding about the disease to find likely reasons for their delayed presentation, including socioeconomic status.Results: In present study most of our patients were more than 45 years, married. 88% presented late due to unawareness and ignorance about nature and severity of breast cancer disease, 86% had financial issues, 64% had shyness as reason, 20% wasted time by taking alternative treatment, 52% presented late due to painless lump; 30% had fear of losing breast, 18% didn’t get support from family, 4% presented late due to other reasons.Conclusions: Awareness and knowledge of breast cancer was found to be poor amongst sufferers prior to their diagnosis, making it important reason for delayed presentation. Other significant factors being socioeconomic status and education. The need for increased awareness and use of screening practices was identified to be essential for early diagnosis of the disease and for improved outcomes.
ABSTRACT
Cases of carcinoma breast with TNM stage 3 are considered as locally advanced breast cancer. This study was done to demonstrate the effect of multimodal treatment approach in cases of stage 3 technically inoperable breast cancer. Its effect on clinical response was studied. Methods: This prospective study was carried out in department of general surgery, government Medical College, Amritsar, Punjab. Main part of multimodal approach is neoadjuvant chemotherapy, so in collaboration with department of radiotherapy, relevant data was collected. 25 cases of locally advanced breast carcinoma were studied. These patients were studied on treatment with FAC regimen (as neoadjuvant chemotherapy), then underwent surgical excision (MRM) followed by chemotherapy, radiotherapy and hormonal therapy wherever indicated, and response was assessed. Results: Initially assessment of lump was done after 3 cycle of chemotherapy. 2 patients (8%) have reduction <50%, 22 patients (88%) have reduction in size which ranges between 51- 75% of the initial, remaining 1 patient (4%) has reduction >75% of the initial. Thus making them operable therefore after this they all had undergone modified radical mastectomy. During follow up period no lump was detected clinically, ultrasonographically or radiologically. There was no any loco-regional recurrence in any case. Conclusion: The study demonstrated the effectiveness of neoadjuvant chemotherapy in down staging the tumor enabling definitive surgery with less morbidity.
ABSTRACT
Background: Cases of carcinoma breast with TNM stage 3 are considered as locally advanced breast cancer. This study was done to demonstrate the effect of neoadjuvant chemotherapy in cases of stage 3 technically inoperable breast cancers. As neoadjuvant chemotherapy is an already established form of treatment, its effect on ‘complete clinical response and pathological response’ were studied. Methods: This prospective study was carried out in department of general surgery of Medical college, Thiruvananthapuram after obtaining approval from research ethical committee. Relevant data of chemotherapy was collected from department of Radiotherapy and Histopathological data was collected from department of Pathology. 25 cases of locally advanced breast carcinoma were studied. These patients were started on treatment with FAC regime and the response was assessed. Results: In this study 20% of patients had complete clinical response at the completion of 3 cycles of chemotherapy with FAC regime. 48% had partial response. In 32% of patients, stasis was observed. None showed increase in tumor size during treatment. Conclusion: The study demonstrated the effectiveness of neoadjuvant chemotherapy in downstaging the tumor enabling definitive surgery with less morbidity. It also showed a complete clinical and pathological response in a significant number of patients.