A Clinical Study of Early Breast Carcinoma and Its Management

Abstract

BACKGROUND Breast Carcinoma is the most common malignancy among Indian women 1 and the leading cause for carcinoma related death in women. According to GLOBOCAN 2012, India along with United States and China collectively accounts for almost one-third of the global breast cancer burden. In India for the year 2012 -144,937 women were newly detected with breast cancer and 70,218 women died of breast cancer. India is facing challenging situation due to 11.54% increase in incidence and 13.82% increase in mortality due to breast cancer during 2008 -2012. 2,3 Aims and Objectives-To identify various risk factors associated with breast carcinoma, age, parity, menarche, menopause etc., various clinical presentations and also various modes of management. MATERIALS AND METHODS RESULTSThe youngest woman in our study was 28 years old and oldest 65 years. In the present series, 12.9% of the patients attained menarche at the age of 11 yrs. or below, 77.6% of the patients were in the age group (12, 13 or 14 yrs.), only 9.2% of the patients attained menarche at 15 yrs. or above. 98% of the patients had breast-fed their children for more than 6 months in our study. 9% of the patients had a family history of breast cancer in either first-or second-degree relatives. All the cases presented to us with history of lump in the breast. The next common symptom was pain followed by axillary mass. 42% of the cases presented with tumour size of 2 -5 cm with axillary node positive, and only 11% of the cases with tumour size < 2 cm was positive for axillary node. In the present study, sensitivity for FNAC procedures was 66% and for Tru-Cut biopsy was 90%. In the present series, only 18% of the patients underwent Breast Conserving Surgery, majority of them underwent MRM, Auchincloss type. ER status was found to be positive in 51% of patients and PR status was positive in 50% of cases. Post-operatively, 78% of our cases were discharged without any significant complications. CONCLUSIONThe mean age of presentation for breast carcinoma in the present study was a decade earlier compared to western patients. Most of the breast cancers are sporadic rather than familial. 100% of the patients presented with lump in the breast. Upper outer quadrant is the common site for breast cancer due to greater amount of breast tissue in the upper outer quadrant. The finding of present series strengthens the notion that the likelihood of axillary involvement is directly related to the size of the primary tumour. Most cases of early breast cancer belonged to Stage IIB. 50% of the patients had ER/PR positive, reflecting an overall low positivity rate when compared to western studies. Majority of the patients underwent Modified Radical Mastectomy as surgical treatment. The comparatively low take-up rate of BCS may relate to factors such as social and economic circumstances. KEYWORDSEarly Breast Carcinoma. HOW TO CITE THIS ARTICLE: Vora K, Deka RK, Roshan R. A clinical study of early breast carcinoma and its management. J. Evolution Med. Dent. Sci. 2018;7(11...