Objective: To determine patient preferences in the surgical options of early breast cancers and surgeon’s role in the decisionmaking. Study Design: cross-sectional study. Place and Duration of Study: Breast Surgery Department, Combined Military Hospital Rawalpindi Pakistan, from Nov 2020 to May 2021. Methodology: Patients having early carcinoma breast were studied, i.e., clinical stage 1 or 2, and their surgical preference was recorded. The cases were discussed in multidisciplinary meetings, and a discussion session with patient conducted and then final decision taken from the patient was recorded again, and the results compared. Results: A total of 28 patients were included in this study and their surgical preferences recorded. Of these patients 22 (78.5%) agreed to breast conservation initially, whereas one of the patients wanted mastectomy. Five (17.8%) patients were undecided between the two. After multidisciplinary team recommendation and discussion with surgeon, only one patient opted for mastectomy (3.6%). Conclusion: Patients with early breast cancer when offered a surgical decision between breast conservation and mastectomy mostly opt for breast conservation; those who select mastectomy do so because of the fear of recurrence.
Objective: To determine the frequency of discordance of receptor status in our breast cancer patients, find out its causes, and suggest remedial measures. Study Design: Retrospective longitudinal study. Place and Duration of Study: Breast clinic and Radiation Oncology Department of Combined Military Hospital Rawalpindi Pakistan from Jan 2018 to Nov 2021. Methodology: Estrogen Receptor, Progesterone Receptor and Her2 Neu status differences between diagnostic tru-cut biopsy and surgical specimen were compared. Results: Receptor status between initial core biopsy and final histopathology of 63 patients were compared. Discordance rates of 05 (7.90%), 13 (20.60%) and 12 (19%) were noted for Estrogen receptor, progesterone receptor and Her2, respectively. The highest discordance noted was for the progesterone receptor, followed by the HER2 receptor and the Estrogen receptor. Conclusion: The highest discordance noted was for the progesterone receptor, followed by the HER2 receptor and the Estrogen receptor. Further studies are required to know more about the causes of receptor status discordance, its impact on treatment decisions and its impact on disease progression and survival.
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