Clinical presentation and management of locally advanced breast carcinoma

Abstract

Background: Locally advanced breast cancer (LABC) encompasses a heterogeneous collection of breast neoplasia with widely different clinical and biological characteristics. Multidisciplinary therapy has become the treatment of choice for these patients. The present study was undertaken to study the clinical presentation and effects of various modes of management of LABC.Methods: Total 45 patients presented with stage III and inflammatory carcinoma of breast were included in the study and treated with neoadjuvant chemotherapy, followed by surgery and radiotherapy. Clinical and pathological responses to different chemotherapy regimens were assessed according to World Health Organization criteria. Results: Majority of patients were in stage IIIA (55.6%) followed by stage IIIB (37.7%). Lump was most common symptom in all the cases followed by distortion of nipple (35.5%). After neoadjuvant chemotherapy, 70% of cases had clinical partial response and 25% of cases had clinical complete response and all except one case were converted from inoperable to operable cases. Histopathology was found to be infiltrating ductal carcinoma in 91.1% of cases. Flap necrosis (27.2%) and seroma (15.9%) was major complications of surgery while alopecia (88.8%), anemia (62.2%) were major complications of chemotherapy. Follow up data suggested that 77.7% patients doing well. One patient had expired after developing distant metastasis and 20% patients were lost to follow up.Conclusions: Treatment of LABC is multimodal and neoadjuvant chemotherapy converts inoperable cases to operable cases and improves longevity of life of the patient. The results of inflammatory carcinoma remain to be dismal in spite of multimodality treatment.

Role of neoadjuvant chemotherapy in downstaging locally advanced breast carcinoma, selection of surgical procedure and its outcome

“…In a study conducted by Gedam et al, clinical presentation and management of locally advanced breast carcinoma majority of patients were in stage IIIA (55.6%) followed by stage IIIB (37.7%). 12 In a study Cance…”

Is CD 44 really a marker of breast cancer metastasis or is nefarious in its nature

“…6 Gedam et al in 2018 showed that most of the patients were in the age group of 41-50 years (40%) followed by 31-40 years (33.3%). 7 In our study majority of the patients (98.2%) were females compared to 1.8% males. Vijaya et al in 2020 in 2013 found more preponderance in females (99.8%).…”

“…5 In general, male breast cancer incidence trends were variable and a minority of countries showed increasing incidence while female incidence rates showed an increasing trend in a majority of countries. 7 Majority of the females in our study were postmenopausal (66.5%) as compared to premenopausal females (33.5%). Zuo et al 2018 studied that premenopausal patients accounted for 44.5% and postmenopausal patients accounted for 55.5%.…”

Intraoperative Specimen Ultrasonography: Is It a Reliable Tool for Margin Assessment Following Breast Conservation Surgery for Breast Carcinoma?

“…It is the commonest cancer in women and is a leading cause of cancer mortality [1]. Large number of breast cancers in developing countries are locally advanced at presentation (30-60%) [2]. These cancers and a majority of them require NACT to become amenable for surgery.…”

“…Locally advanced breast cancer (LABC) is the most common presentation in developing countries due to illiteracy, lack of awareness, poor health care, lack of active screening and late presentation. In India, up to 30-35% of breast cancer are locally advanced at the time of presentation [2]. Breast conservation surgery (BCS) is now an acceptable option for women with early-stage breast cancer and even in some cases of locally advanced breast cancer after response to neoadjuvant chemotherapy (NACT) [3][4][5].…”