Clinicopathological study and its prognostic implication in male breast carcinoma.

The aim of the present study is to analyse the cases of male breast carcinoma as regards its incidence, family history, clinical presentation, staging, histopathological grade, hormone receptor status and to identify the prognostic significance of the above factors on the final outcome. Seventy-nine cases of male breast carcinoma were treated in the radiotherapy department of Medical College, Kolkata from 1994-2003 (10 years). The hospital data were used to analyse the epidemiological and clinicopathologic parameters as well as the treatment offered and outcome. Incidence of male breast cancer was 0.6% among all male cancer cases and 2.5% among all breast cases. The median age of presentation was 67 years. Lump in the breast was the commonest presenting feature; 90% had advanced disease at presentation. All patients were treated by mastectomy. Majority received radiotherapy (93%) and chemotherapy (81%) as well. Hormone therapy was given to 83% patients. Five-year disease-free survival was 58% for node negative patients and 47% for node positive patients Two most important prognostic factors that affect the survival were nodal status and tumour size. Male breast carcinoma is a rare disease. Median age of presentation is much higher than the female counterpart. The prognosis and survival is similar but the incidence of positive hormone receptor is much more than breast carcinoma of females. In absence of prospective randomised trial retrospective review data from various centres could provide useful guidelines regarding therapy.

B cell lymphoma with unusual clinical cutaneous presentation.

Cutaneous B cell lymphoma (CBCL) is a lymphoproliferative disorder of neoplastic B cell of the skin. These are rarer than T cell lymphomas. Commonly, the presenting features of CBCL are plaques or nodules. Here is a case report of CBCL with a very unusual presentation of cutaneous horns. The patient was managed by a combination chemotherapy and local radiotherapy only. He is disease-free for about the last five years. The case has been presented because of its rarity and its management protocol.

Role of chemoradiotherapy in advanced carcinoma cervix.

Carcinoma cervix is the commonest female malignancy in India. In advanced stages radiotherapy was the only treatment options available. Recently there is interest in chemotherapy but the combination, dosage and timing are not well standardised. With this background a trial was undertaken to evaluate the role of chemotherapy along with radiotherapy in advanced carcinoma cervix. One hundred and sixty patients of stages II B-IV A carcinoma cervix were randomised into two arms. Patients of radiotherapy alone arm were treated by external radiotherapy of 5000 cGy in conventional fractionation followed by brachytherapy. The second group received the same schedule of radiotherapy plus chemotherapy with injection cisplatin 30 mg/m2 once weekly for 5 weeks during the course of external radiotherapy. Patients were well matched in both the arms. Compliance rate is similar. The complete response rate was 83% with chemoradiotherapy arm while it was 73% with radiotherapy (p-value > 0.1). Neutropenia was the major dose limiting toxicity, the incidence and severity being more in chemoradiotherapy arm (grade 3 neutropenia 12% versus 0%). Radiation proctitis was the commonest late effect observed. In the median follow-up of 54 months, there is an increased overall survival (56% versus 47%); p-value > 0.1) and disease-free survival (51% versus 37%; p-value > 0.05) in the chemoradiotherapy arm.