<p class="abstract">Osteosarcoma is most frequently occurring bone malignancy which commonly occurs in the ends of the long bone. Usually osteosarcomas do not involve the bones of the chest wall. 22 year old patient presented with swelling in left anterior chest wall gradually enlarging over the period of 1 year accompanied by dull aching pain in the same. On examination there was 30×25 cm large hard irregular swelling which was fixed to chest wall. CECT Thorax was suggestive of 30×25×18 cm sized soft tissue lesion involving 3, 4, 5 rib involvement with sunburst periosteal reaction. Mass is having large extrathoracic with small intrathoracic extensions. Moderate pleural effusion was noted. Core biopsy of mass identified the tumor as osteosarcoma. Primary malignant bone tumors of the chest wall are very rare entity. Of these tumors chondrosarcomas are the most frequent. Chondrosarcoma are chemo-resistant as compared to osteosarcomas. Management of such tumors should follow the same oncological principles of resection with wide margins whenever possible. Neoadjuvant chemotherapy may be given in cases of responsive etiologies like Ewing sarcoma or osteosarcoma. These malignancies generally have poor prognosis.</p><p class="abstract"> </p>
<p><strong>Introduction:</strong> Epidermal growth factor receptor (EGFR) is member of human epidermal receptor is frequently expressed in diverse forms of cancer. Many studies have studied the relation of EGFR positivity in breast cancer and its prognostic value, but yet no conclusions have yet been drawn.We attempt to study the receptor positivity in our patient and its correlation with various clinic-pathological prognostic predictors and outcomes. <strong>Materials and Methods:</strong> Data of 355 patients of breast cancer registered in our department between November 2014 and November 2016 and followed up until December 2016 was collected and reviewed for epidemiological and clinical features. Results: <strong>Results</strong> of total 355 patients analyzed, TNBC group, were most common (n = 152) (43%) followed by luminal A (25%). Median age at disease presentation was 45.3 years (24–73 years). The EGFR-positivity rate was 30.3%. EGFR-negative patients presented as early breast cancer significantly more than EGFR-positive patients (47.36% vs. 27.10% P = 0.046). Significantly, higher proportion of EGFR-positive patients presented with Grade 3 cancers (44.10% vs. 19.16% P = 0.049). Nodal involvement was significantly more in EGFR-positive patients (66.6% vs. 37.5% P = 0.0364). Pathological complete response (CR) was significantly associated with EGFR positivity (16.1% vs. 12.5% P = 0.0349). There were more recurrences in a surgically treated group with EGFR positivity than negative group, but this difference did not reach significance (18.1% vs. 5.2% P = 0.061). <strong>Conclusion:</strong> We found that our breast cancer was quite young with the median age almost two decades earlier than that of the west with very high number of patients presenting as an advanced stage and triple negative phenotypes. We found that EFGFR receptor positivity in almost one-third of the patients. This could be subgroup of patients which could be targeed by anti-EGFR therapy. This EGFR positivity also acted as surrogate for an aggressive disease which was shown by significantly larger proportion of advanced stage, high grade and node-positive disease present in receptor-positive patients. This subset showed a higher rate of pathological CR in patients subjected to neoadjuvant chemotherapy. There was trend of worse outcomes in surgically treated EGFR-positive patients which may be due to short follow-up period in our study. As we continue this study, EGFR positivity may emerge as a true prognostic marker of breast cancer.</p>
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