A COMPARATIVE STUDY OF COMPLICATIONS OF MRM (MODIFIED RADICAL MASTECTOMY) VERSUS BCS (BREAST CONSERVATION THERAPY) IN EARLY INVASIVE BREAST CANCER. A RESULT FROM SAVERA CANCER AND MULTISPECIALITY HOSPITAL PATNA, BIHAR.

2021 ◽  
pp. 66-67
Author(s):  
Vijay Pratap Singh ◽  
Akash Singh ◽  
Pranab Kumar Verma ◽  
Vishal Mohan Singh ◽  
Arun Kumar Jha
Keyword(s):  
Breast Cancer ◽  
Statistical Analysis ◽  
Breast Tissue ◽  
Breast Conservation ◽  
Surgical Margin ◽  
Radical Mastectomy ◽  
P Value ◽  
Shoulder Dysfunction ◽  
The Difference

Background: Early breast cancer patients admitted in the surgical oncology department of Savera Cancer and Multispeciality Hospital. Patients were divided in two treatment arms; Arm A and Arm B. Arm A patient went through MRM and Arm B patients went through BCS. This study included prospective cases of 1 year from June 2019 to June 2020. Method: In all MRM group patients all breast tissue, skin, nipple areola complex and level 1, 2, 3 lymph nodes removed. In all BCS group patients lump was removed with an envelope of normal appearing breast tissue. In all resected specimens free surgical margin was ensured via histopathology reports (HPR). Patients were reviewed in early post operative period for complications and follow up done at the end of 1st, 3rd, 6th and 12th month for recurrence. In treatment Arm A (MRM) 08 patients developed arm ede Result: ma; 05 patients developed shoulder dysfunction; 07 patients developed ap necrosis; 07 patients developed arm dysesthesia. Whether in treatment ARM B (BCT) 04 patient had Seroma formation; 13 patients developed wound infection & wound contracture. Complications were reported in 35% of MRM group (35 out of 100 cases), while they were absent in 65% (65 out of 100). However, in the BCS group, complications were reported in 6.66% cases only (15 out of 100 cases), while were absent in 93.33% (75 out of 100). P value by statistical analysis being 0.283, the difference being statistically insignicant. Recurrence were present in 6.66% of MRM group (8/100) while they were absent in 92.34 % (92/100). However in BCS group recurrences were present in 3.33 % (3/100) and were absent in 97.67% (97/100). P value by statistical analysis being 1, the difference being statistically insignicant. Grading of complications has been captured from CTCAE Version 5.0 (Common Terminology Criteria for Adverse Events). Conclusion: There is slight signicant difference in the recurrence rate, whether the patient had undergone BCS or MRM based on our short term follow-up. However a long term follow-up is required.

scholarly journals Is quality of life after mastectomy comparable to that after breast conservation surgery? A 5-year follow up study from Mumbai, India

2019 ◽  
Vol 29 (3) ◽  
pp. 683-692
Author(s):  
K. V. Deepa ◽  
A. Gadgil ◽  
Jenny Löfgren ◽  
S. Mehare ◽  
Prashant Bhandarkar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Breast Conservation ◽  
Radical Mastectomy ◽  
Breast Conservation Surgery ◽  
Breast Cancer Surgery ◽  
Significant Difference ◽  
Domain Scores

Abstract Purpose Breast cancer is the commonest cancer in women worldwide. Surgery is a central part of the treatment. Modified radical mastectomy (MRM) is often replaced by breast conserving therapy (BCT) in high-income countries. MRM is still the standard choice, in low- and middle-income countries (LMICs) as radiotherapy, a mandatory component of BCT is not widely available. It is important to understand whether quality of life (QOL) after MRM is comparable to that after BCT. This has not been studied well in LMICs. We present, 5-year follow-up of QOL scores in breast cancer patients from India. Methods We interviewed women undergoing breast cancer surgery preoperatively, at 6 months after surgery, and at 1 year and 5 years, postoperatively. QOL scores were evaluated using FACT B questionnaire. Average QOL scores of women undergoing BCT were compared with those undergoing MRM. Total scores, domain scores and trends of scores over time were analyzed. Results We interviewed 54 women with a mean age of 53 years (SD 9 ± years). QOL scores in all the women, dipped during the treatment period, in all subscales but improved thereafter and even surpassed the baseline in physical, emotional and breast-specific domains (p < 0.05) at 5 years. At the end of 5 years, there was no statistically significant difference between the MRM and BCT groups in any of the total or domain scores. Conclusion QOL scores in Indian women did not differ significantly between MRM and BCT in the long term. Both options are acceptable in the study setting.

scholarly journals Location and Frequency of Residual Breast Tissue after Mastectomy

Breast Care ◽  
2019 ◽  
Vol 14 (4) ◽  
pp. 212-215
Author(s):  
Ibrahim Ustun ◽  
Kemal Beksac ◽  
Olcay Kandemir ◽  
Ugur Berberoglu
Keyword(s):  
Breast Cancer ◽  
Breast Tissue ◽  
Tissue Sample ◽  
Radical Mastectomy ◽  
Skin Closure ◽  
Breast Cancer Patients ◽  
Tissue Samples ◽  
Positive Biopsy ◽  
Residual Tissue

Introduction: Residual breast tissue after mastectomy is a problem since breast cancer can arise from it. The aim of this study was to investigate the incidence and location of residual breast tissue following modified radical mastectomy. Methods: 111 consecutive breast cancer patients who underwent mastectomy were enrolled in this study. During surgery, after removal of the breast tissue and before skin closure, a 1-cm2 tissue sample was obtained from each quadrant under the skin flaps. These samples were evaluated histopathologically for the presence of any residual breast tissue. Results: Residual breast tissue was detected in the tissue samples of 12/111 (10.8%) patients. 4 of these patients had residual breast tissue in all 4 quadrants. 6 patients had residual tissue in a single quadrant. With 9 positive biopsy results, the upper medial quadrant was the most frequently involved location. The other quadrants had 6 positive biopsy results each. At the end of a median of 20 months of follow-up, none of these patients developed breast cancer recurrences. Conclusion: Mastectomy has a high probability of residual breast tissue being left behind. Physicians should be aware of this and act accordingly when planning surgical or follow-up treatment.

Inappropriate lumpectomy in early breast cancer: Experience from a Tertiary Care Centre in India.

2015 ◽  
Vol 33 (28_suppl) ◽  
pp. 77-77
Author(s):  
Veda Padma Priya Selvakumar ◽  
Rajeev Kumar
Keyword(s):  
Breast Cancer ◽  
Adjuvant Therapy ◽  
Early Breast Cancer ◽  
Residual Disease ◽  
Age Of Onset ◽  
Tertiary Care ◽  
Breast Conservation ◽  
Radical Mastectomy ◽  
Diagnostic Purpose

77 Background: In India the incidence of breast cancer has shown an increasing trend over the past few decades and the majority of patients present with early breast cancer in the cities. A disturbing trend in the present setting is that a substantial proportion of patients are referred for the management of early breast cancer after inappropriate excision as diagnostic procedure in the primary care setup. Methods: The medical records of all patients who underwent surgery for early breast cancer post-lumpectomy status from September 2010 to December 2014 were reviewed retrospectively. The patterns of incision for lumpectomy, the margins of excision, the T stage, pre-operative imaging, the type of surgery and adjuvant therapy, the lapses in lumpectomy and various challenges it poses for further management and how it was combated were scrutinized in detail. Results: About one hundred and fifteen women were found eligible for the study. The mean age of onset was 47.33 years [Range 28-78]. The ratio of Left : Right were 57 : 58. The Margins and T status were known only in seventeen patients. Imaging ruled out any residual disease in breast in twenty eight patients. Twenty-seven patients underwent breast conservation with reconstruction, 82 underwent modified radical mastectomy and six of them underwent only axillary dissection. Only 41 patients had no residual primary disease on final histopathological evaluation. All patients underwent adjuvant therapy based on the approximate T staging. 12 patients were lost to follow up at one month.103 patients are alive and 101 disease free at an average follow up of 13.6 months. Conclusions: In early breast cancer, inappropriate lumpectomy for diagnostic purpose alters the course of surgical and adjuvant management. Hence it should be discouraged and not advocated as standard of care.

Local Recurrence of Breast Cancer after MammoSite® Brachytherapy

2006 ◽  
Vol 72 (9) ◽  
pp. 798-801
Author(s):  
Matthew Voth ◽  
Raye Budway ◽  
Angela Keleher ◽  
Philip F. Caushaj
Keyword(s):  
Breast Cancer ◽  
Treatment Plan ◽  
Breast Conservation ◽  
Radical Mastectomy ◽  
Axillary Lymph ◽  
Ultrasound Guided ◽  
Breast Pathology ◽  
Poorly Differentiated ◽  
Her 2 ◽  
Negative Tumor

Women undergoing breast conservation therapy (BCT) for stage 1 breast cancer have adjuvant external beam radiotherapy (EBR). In addition, the use of brachytherapy radiation is being used. We present two local tumor recurrences for review. Our first patient underwent BCT, sentinel lymph node biopsy (SLNBx) and MammoSite® brachytherapy for a T1N0M0 infiltrating ductal carcinoma (IDC) of the right breast. Pathology: 0.6 cm poorly differentiated ER, PR, and Her-2/ Neu negative IDC. At 18 months, she had palpable axillary lymph nodes. Fine needle aspiration and ultrasound-guided core biopsy of a nodule showed IDC. She underwent modified radical mastectomy (MRM) and EBR. Our second patient underwent BCT, SLNBx, and MammoSite® brachytherapy for a T1N0M0 IDC of the left breast. Pathology: 0.8 cm poorly differentiated, ER+, PR-, and Her-2/Neu negative tumor. At 18 months, a retroareolar mass was detected. Ultrasound guided core needle biopsy showed recurrent IDC. She chose a re-excision and EBR and not MRM. Pathology: 1.3 cm poorly differentiated, ER+, PR-, and Her-2/Neu negative tumor. Our 2 recurrences were >2 cm away from the lumpectomy site and therefor outside the 1 cm treatment plan of the MammoSite® catheter. Both recurrences were biologically identical to the initial tumors and are felt to be local failures rather than new primaries.

scholarly journals Sequential Versus Concurrent Trastuzumab in Adjuvant Chemotherapy for Breast Cancer

2011 ◽  
Vol 29 (34) ◽  
pp. 4491-4497 ◽  
Author(s):  
Edith A. Perez ◽  
Vera J. Suman ◽  
Nancy E. Davidson ◽  
Julie R. Gralow ◽  
Peter A. Kaufman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Growth Factor Receptor ◽  
Disease Free Survival ◽  
Standard Of Care ◽  
Phase Iii ◽  
P Value ◽  
Sequential Administration ◽  
Taxane Chemotherapy

Purpose NCCTG (North Central Cancer Treatment Group) N9831 is the only randomized phase III trial evaluating trastuzumab added sequentially or used concurrently with chemotherapy in resected stages I to III invasive human epidermal growth factor receptor 2–positive breast cancer. Patients and Methods Patients received doxorubicin and cyclophosphamide every 3 weeks for four cycles, followed by paclitaxel weekly for 12 weeks (arm A), paclitaxel plus sequential trastuzumab weekly for 52 weeks (arm B), or paclitaxel plus concurrent trastuzumab for 12 weeks followed by trastuzumab for 40 weeks (arm C). The primary end point was disease-free survival (DFS). Results Comparison of arm A (n = 1,087) and arm B (n = 1,097), with 6-year median follow-up and 390 events, revealed 5-year DFS rates of 71.8% and 80.1%, respectively. DFS was significantly increased with trastuzumab added sequentially to paclitaxel (log-rank P < .001; arm B/arm A hazard ratio [HR], 0.69; 95% CI, 0.57 to 0.85). Comparison of arm B (n = 954) and arm C (n = 949), with 6-year median follow-up and 313 events, revealed 5-year DFS rates of 80.1% and 84.4%, respectively. There was an increase in DFS with concurrent trastuzumab and paclitaxel relative to sequential administration (arm C/arm B HR, 0.77; 99.9% CI, 0.53 to 1.11), but the P value (.02) did not cross the prespecified O'Brien-Fleming boundary (.00116) for the interim analysis. Conclusion DFS was significantly improved with 52 weeks of trastuzumab added to adjuvant chemotherapy. On the basis of a positive risk-benefit ratio, we recommend that trastuzumab be incorporated into a concurrent regimen with taxane chemotherapy as an important standard-of-care treatment alternative to a sequential regimen.

Efficacy and safety of neoadjuvant docetaxel, carboplatin, trastuzumab, and pertuzumab (TCH-P) in HER2-positive breast cancer: An Indian experience.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12619-e12619
Author(s):  
Ajay Gogia ◽  
Shalabh Arora ◽  
SVS Deo ◽  
Sandeep Mathur ◽  
Dayanand Sharma
Keyword(s):  
Breast Cancer ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Breast Conservation ◽  
Radical Mastectomy ◽  
Stage Ii ◽  
Breast Conservation Surgery ◽  
Secondary Outcome ◽  
Her2 Positive ◽  
Positive Breast Cancer

e12619 Background: Dual targeted therapy with chemotherapy is one of the therapeutic approaches as neoadjuvant treatment in HER2/neu positive breast cancer (BC). However the safety and efficacy data of dual-targeted, chemotherapy regimen (docetaxel, carboplatin, trastuzumab, & pertuzumab [TCH-P] is limited from the Indian subcontinent. Methods: This retrospective study aims to evaluate the efficacy and toxicity of neoadjuvant TCH-P regimen in early, locally advanced, and oligometastatic (OM) HER2-positive BC, at All India Institute of Medical Sciences, New Delhi, India, in between the period 2015-2020. Total 6 cycles of 3-weekly neoadjuvant chemotherapy (NACT) protocol containing docetaxel (75 mg/m2), carboplatin (AUC = 6), trastuzumab (8 mg/kg loading followed by 6 mg/kg) and pertuzumab ( 840 mg loading followed by 420 mg) were planned. Subcutaneous peg-filgrastim was prophylactically administered on day 2 of each cycle. The primary outcome was the pathological complete response (pCR), which was defined as an absence of invasive and noninvasive cancer in breast or lymph node and secondary outcome were clinical overall response rate (ORR), rate of breast conservation surgery( BCS) for patients for whom modified radical mastectomy( MRM)was planned and toxicity. Results: Forty-five patients with a median age of 48 years (31-65) were included in this study. The TNM (AJCC-7th edition) stage distribution was stage II, 14 (31.1%); stage III, 29 (64.5%); and stage IV (OM), 2 (4.4%). Clinical node positivity disease was found in 26 (57.8%) cases. Nineteen (42.2%) patients had hormone-positive and 26(57.8%) cases were premenopausal. The clinically ORR and CR were seen in 100% and 60% respectively. Overall pCR rate was observed in 25 (55.6%) patients (70% in stage II). BCS was performed in 23(51.1%) cases. In 12(26.6%) cases, planned MRM was changed to BCS following NACT. Grade 3 and 4 toxicities were diarrhea 7 cases, thrombocytopenia in 6, neutropenia in 4, febrile neutropenia in 1, and anemia in 2 cases. Ten patients required dose modification and interruption. No patient had congestive heart failure or induction death. Conclusions: This is the first study of the non-anthracycline-based neoadjuvant protocol in HER2 positive BC from India. The TCH-P is an effective, safe, and well-tolerated, protocol with a path CR rate of 55.6% and 26.6% BCS conversion rate from planned MRM.

MMTV Prevalence in Breast Cancer Samples in Romania - Do Major Geographical Differences Exist in The World Population?

2021 ◽  
Author(s):  
Zsolt Fekete ◽  
Bristena Octavia Terțan ◽  
Lajos Ráduly ◽  
Dan Tudor Eniu ◽  
Rares Buiga ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Dna Sequences ◽  
Mus Musculus ◽  
Breast Tissue ◽  
Neoadjuvant Treatment ◽  
Metastatic Breast ◽  
Radical Mastectomy ◽  
Cancer Tissue ◽  
World Population ◽  
Breast Cancer Patients

Abstract Background Breast cancer, although the most frequently diagnosed malignant tumor in humans, has a less clear etiology compared to other frequent cancer types. Mouse-mammary tumor virus (MMTV) is involved in breast cancer in mice and dogs and might play a role in the etiology of some breast cancers in humans, since it has been identified in 20-40% of breast cancer samples in Western Europe, USA, Australia and some other parts of the world’s population. The purpose of our study was to identify MMTV DNA sequences in breast tissue samples from breast cancer patients who underwent curative surgery in our regional center in Romania, EU. MethodsWe selected 75 patients with non-metastatic breast cancer treated surgically with curative intent, which did not undergo any neoadjuvant treatment. Out of these patients, 50 underwent radical lumpectomy and 25 modified radical mastectomy. We searched using PCR the MMTV-like DNA env sequence in the breast cancer tissue and normal breast tissue obtained from the same patients. ResultsNone of the examined samples was positive for MMTV-like target sequences on PCR.ConclusionsWe could not prove that MMTV plays a role in the etiology of breast cancer in our patient group. This finding is similar to publications of other geographically related research groups and might be due to the fact that only the Mus musculus domesticus mouse species was proven to carry infectious MMTV, but not the Mus musculus musculus species, which is specific to South-Eastern Europe (including Romania) and some parts of Asia.

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