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A Clinico-pathological study of Carcinoma Breast and it's management, in a tertiary care hospital in southern India

Dr Sadiqhusain Kachavi, Dr Manjunath Meti B, Dr Harish P.

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Introduction: Among the Indian women breast cancer is the most common type, with age adjusted rates goes upto 25.8/100,000 women and mortality is 12.7/100,000 women.
Material and Methods: A prospective study of 50 patients done at Victoria hospital and Bowring&Lady Curzon Hospital between October2013 to May 2015. Once diagnosed by FNAC. Modified radical mastectomy was done in all cases.
Results: The mean age of presentation was 4th–5thdecade. 28(56%)subjects attained menarche at 12-13years of age, 12(24%) at 10-11years, 10(20%) at 14-15years. 17(34%)patients were 20-24years by the birth of their first child, 13(16%) were 25-29years, 4(7.5%) were 30-34years, 15(30%) were 35years. All patients had breast-fed. Our study 39(78%) had 4 pregnancies. 46(92%)patients had no family history of breast carcinoma, 4(8%) had family history. Symptoms were lump in breast in 50(100%)patients, pain in 15(30%), nipple retraction in 6(12%), axillary lump in 5(10%), ulcer in 4(8%) and nipple discharge in 4(8%). Site of occurrence was upper quadrant in 31(62%)cases, central in 7(14%), upper inner in 6(12%), lower inner in 5(10%) and lower outer in 1(2%). 28(56%) had tumour size of 2-5cm and 22(44%) had size >5cm. 33(66%) had regional lymph node involvement and 17(34%). 20(40%) had stage II disease and 30(60%) had stage III. On histopathological examination 42(84%) had invasive ductal carcinoma, 2(4%) medullary carcinoma, 5(10%) colloid carcinoma and 3(6%) infiltrating ductal carcinoma. 64% cases were ER/PR+, 36% were ER/PR-. Post-operatively 3patients had serous discharge and 2patients seroma.
Conclusion: Breast cancer was predominantly a disease of middle aged, lump in breast is commonest presentation, Invasive ductal carcinoma is common type. We could not establish role of, age at menarche, age at first birth and breast-feeding as risk factors for breast cancer.

Key words: modified radical mastectomy, FNAC of breast lump, early-advanced breast cancer

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