Preoperative ultrasound guided needle localisation for non-palpable breast lesions

Das, Kalyan; Sarkar, Diptendra Kumar; Karim, Rubaba; Manna, Amalesh Kumar

doi:10.1007/s12262-010-0035-2

Cited by 3 publications

(3 citation statements)

References 28 publications

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“…Painless lump was the most common presenting symptom. Majority patients in GTH presented with tumor stage 3B (27.66%) (similar to study by Das et al) [12] and in private 3A (30.33%). Late diagnosis carries poor prognosis and high fatalities, indicating the need of sensitization about self-breast examination and screening mammography.…”

Section: Discussionsupporting

confidence: 86%

A Study of Drug Utilization in Patients of Carcinoma Breast Receiving Systemic Chemotherapy in Tertiary Care Hospitals

Shah

Singh

Mundhava

2021

Asian J Pharm Clin Res

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Objective: The objective of the study is to study drug utilization in patients with breast carcinoma receiving systemic chemotherapy in government as well as private set-up. Methods: This was a record-based, retrospective-prospective study, analyzing the prescription pattern of drugs used for systemic chemotherapy in patients diagnosed with carcinoma breast at government teaching hospital (GTH) and private trust hospital (PTH) for 1 year in 600 patients. Patient’s demographic, clinical, and therapeutic data were collected from the files and personal interviews and analyzed in Microsoft Excel. Results: Diagnosis of breast carcinoma was highest in age bracket of 40–49 years (32.33% GTH and 32.67% PTH), and the most common presenting symptom was painless lump (76.33% GTH and 83% PTH). In GTH, most frequently prescribed regimen was 4AC → 4T → RT (17.33%). In PTH, most commonly prescribed regimen was 6FEC → RT (19.33%). Highest prescribed drugs were A (32.8%), C (29.12%), and F (20.24%) in GTH and A (32.26%), F (31.68%), and E (16.45%) in PTH. Average number of drugs prescribed per prescription was 12.55 and 11.37; percentage of chemotherapeutic agents prescribed by generic name was 100 and 95.02, and from the WHO essential drug list (2015) was 96.43 and 82.77 in GTH and PTH, respectively (A= Cyclophosphamide, C= Doxorubicin, T=Taxanes [Paclitaxel/Docetaxel], F=5-fluorouracil, E=Epirubicin, RT=Radiotherapy, → followed by, the number indicates chemotherapy cycle). Conclusion: The study results can help in generating local data regarding drug use pattern of the systemic chemotherapeutic agents in breast cancer patients and promote rational drug use.

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Section: Discussionsupporting

confidence: 86%

A Study of Drug Utilization in Patients of Carcinoma Breast Receiving Systemic Chemotherapy in Tertiary Care Hospitals

Shah

Singh

Mundhava

2021

Asian J Pharm Clin Res

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“…Sarkar, R. Karim, and A.K. Manna in March-April issue, 2010 [1] with great interest. Authors need to be congratulated for a well written manuscript.…”

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confidence: 99%

“…Margin clearance of the tumor in case of malignant lesion is not mentioned in the article. It is also not clear how could they stage node (n) disease in case of malignant lesions, as evident from the Table 2, [1] when end point of the surgery was lumpectomy only.…”

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confidence: 99%

Preoperative Diagnosis of Non-Palpable Breast Lesions

Kumar

Garg

2011

Indian J Surg

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1] with great interest. Authors need to be congratulated for a well written manuscript. After having read the article, we think there are few issues which need to be addressed. This study included 22 patients of non-palpable breast lesions with sonography/mammography BIRADS R3, R4, and R5 lesions. All of these 22 patients underwent sonography guided wire localization and lumpectomy without preoperative diagnosis. Only 3 out of 22 breast lesions (13.67%) were proved to be malignant on histopathological examination. Margin clearance of the tumor in case of malignant lesion is not mentioned in the article. It is also not clear how could they stage node (n) disease in case of malignant lesions, as evident from the Table 2, [1] when end point of the surgery was lumpectomy only.We believe that cases of BIRADS R3 could have been given the choice of either follow up/percutaneous image guided fine needle aspiration cytology (FNAC)/closed needle biopsy (CNB) rather than subjecting them to surgery. It is also not clear how many of these patients with BIRADS R3 actually ultimately proved to have malignancy on histopathology after excision. Category wise histopathological findings in various grades of BIRADS could have helped in understanding these results better. Though ultrasonography (USG) guided/ needle directed open biopsy is the gold standard for nonpalpable breast lesions, image guided CNB gives reasonable accuracy, enough to establish the diagnosis and then, undertake surgery under intraoperative sonography guidance with a curative intent. In a large study of 1,681 patients, Fajardo et al. [2] concluded that percutaneous, imaged-guided CNB is an accurate diagnostic alternative to surgical biopsy in women with non-palpable breast lesions with a sensitivity, specificity and accuracy of 91%, 100%, and 98%, respectively. In a study of 204 suspicious non-palpable breast lesions, Boliver et al. [3] showed 97% sensitivity, 100% specificity, 100% positive predictive value, and 95% negative predictive value of USG guided CNB for the diagnosis of malignancy and stressed the importance of minimum number of three cores per lesion. Comparison of FNAC and CNB with the literature available is largely difficult because of great differences in methodology and biases [4]. What may be more important to understand is their complementary role resulting in better preoperative diagnosis rate. Moreover, Abdel-Hadi et al. [5] concluded that it would be cost effective and time saving to use FNAC as a first-line investigation, followed by CNB in selected cases in order to maximize the preoperative diagnostic rate of cancer. In their study of 229 consecutive non-palpable breast masses, overall diagnostic accuracy was 98.9%, with a specificity and sensitivity of 99.3 and 96.7%, respectively. It is worthwhile to note that had image guided biopsy been done in those patients later found to have malignant lesion, USG guided excision of lump with curative intent would have been done in one sitting thus avoiding the trauma of second intervention. In a ...

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Digital Breast Tomosynthesis as a Tool in Confirming Negative Surgical Margins in Non-palpable Breast Lesions

Chand

Sharma

Dharmarajan

et al. 2019

Indian J Surg Oncol

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Preoperative ultrasound guided needle localisation for non-palpable breast lesions

Cited by 3 publications

References 28 publications

A Study of Drug Utilization in Patients of Carcinoma Breast Receiving Systemic Chemotherapy in Tertiary Care Hospitals

A Study of Drug Utilization in Patients of Carcinoma Breast Receiving Systemic Chemotherapy in Tertiary Care Hospitals

Preoperative Diagnosis of Non-Palpable Breast Lesions

Digital Breast Tomosynthesis as a Tool in Confirming Negative Surgical Margins in Non-palpable Breast Lesions

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