Evaluation of Clinicopathological Findings on 255 cases of Inoperable Locally Advanced Breast Carcinoma: A Tertiary Care Experience.

INTRODUCTION: Breast cancer is the second most common cancer in the Indian female population. LABC and metastatic breast cancer are the most common stages at presentation in most low-resource countries. Although the incidence of LABC has decreased significantly in countries with enhanced resources thanks to widespread education and screening programs, it remains a daily encounter for surgeons and oncologists in low-resource countries. Neoadjuvant therapy has been studied widely for the treatment of LABC and is followed by locoregional therapy. OBJECTIVES: As per our hospital data, breast cancer is also found to be the second leading malignancy in women and locally advanced breast cancer is the most common type of breast cancer. Hence, we undertook this study to evaluate the clinical profile, histopathologic types and grade of the disease in our patients. MATERIALS AND METHODS: This study was undertaken over a period of three years comprising of 255 patients who underwent modified radical mastectomy following neoadjuvant chemotherapy after preliminary diagnosis of carcinoma on histopathological examination of the trucut biopsy specimens. Clinicopathological evaluation was done in all of these cases following standard protocols. RESULTS: The study comprised of 252 female patients and 3 male patients in the age range of 26 to 70 years. Majority (255, 66.6%) of the cases were within the age range of 31­60 years. Three females had bilateral breast cancer. Invasive ductal carcinoma no special type was the most common histopathologic pattern, and was seen in 254 (98.4%) cases. Most tumors were Scarff Bloom Richardson grade II and American Joint Committee on Cancer pathologic stage 3. CONCLUSIONS: The present study has provided information about the clinicopathological aspects of locally advanced breast cancer in patients who are from rural areas. LABC remains a daily encounter and challenge for medical and surgical oncologists in developing low-resource countries. Neoadjuvant chemotherapy is recommended for inoperable LABC at all resource levels.

Liver abscess in the tropics: an experience from Jammu.

OBJECTIVE: To study the various types of liver abscesses. This prospective study was conducted over a period of one year, from November 2011 to October 2012, at the Department of General Surgery in Acharya Shri Chander College of Medical Sciences and Hospital Sidhra, Jammu. MATERIALS AND METHODS: The patients in this study were admitted from the emergency wing, and from indoor and outdoor departments of surgery and medicine over a period of one year (November 2011 to October 2012) to the Department of General Surgery in Acharya Shri Chander College of Medical Sciences and Hospital Sidhra, Jammu. Patients of all age groups and both genders who presented with clinical suspicion of liver abscess, or had already been diagnosed, were included in the study. A definitive diagnosis of liver abscess was made based on compatible clinical features, ultrasonography and aspiration or drainage of pus. Diagnostic criteria for the various types of abscesses were as follows: Amoebic abscess: demonstration of Entamoeba histolytica trophozoites in aspirated pus. Pyogenic abscess: positive cultures of blood or aspirated pus. If both of the above sets of criteria were satisfied, the abscess was considered to be of mixed aetiology. Tuberculous abscess was diagnosed by identifying acid-fast bacilli in aspirated material and polymerase chain reaction. The abscess was classified as indeterminate if none of the above criteria were satisfied. RESULTS: The majority of patients in our study had amoebic liver abscesses (73.33%). Escherichia coli and Klebsiella were the most common organisms cultured from the pyogenic abscesses. The majority of patients with amoebic liver abscesses were treated with drug therapy alone, whereas all pyogenic liver abscesses required some form of drainage.