Title: Clinical and Morphological Profile in Breast Carcinoma Patients in a Tertiary Care Hospital, SMS Medical College, Jaipur, Rajasthan

Authors: Ranjita Bansal, Ajay Yadav, Vivek Gupta, Kavita Goyal

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i1.177

Abstract

Objectives: Breast cancer is the most common malignancy in females. Data on breast cancer profile of patients in Rajasthan is scant. Patients have different clinical and morphological presentation and each case require appropriate strategy for screening, diagnosis and treatment purpose.

This study is conducted to find out clinical stage at which the patients presented, to assess the clinicomorphological spectrum of breast cancer patients and to correlate histological grade (Richardson bloom score) with clinical stage of disease.

Method: This prospective study was carried out on 100 newly diagnosed cases of breast carcinoma. Every eligible surgical specimens of breast carcinoma received in department of pathology.

Results: Mean age of patients was found to be lower compared to western countries. Many of the patients were from rural background and patients often presented with longer duration of symptoms and advanced clinical stage. Left side was more frequently involved. The tumour was commonly of higher grade . The more advanced stages were associated with higher grade at time of diagnosis.

Conclusion: Breast cancer occurs in younger age females in India including Rajasthan. Considering the younger age of presentation and decreased affordability of patients, mammography might be a less effective screening test due to higher density of breast in young age, which decreases the sensitivity of mammography. Patients are mostly from rural background and present more frequently with advanced stage breast cancer. Most Patients presented with advanced stage of breast carcinoma. A statistically significant positive correlation was seen between Histological grade and clinical stage of breast cancer. Awareness campaigns, breast self-examination, improved access to diagnostic resources and health care are important measures that should be undertaken for early diagnosis particularly in rural areas.

Keywords: Breast Cancer-Clinical Profile-Stage-Grade-India.

References

  1. India: Prospects and challenges. Asian Pac J Cancer Prev 2004;5:226-8.
  2. Dumitrescu RG, Cotarla I. Understanding breast cancer risk-where do we stand in 2005? J Cell Mol Med 2005;9:208-21.
  3. Gupta P, Sharma RG, Verma M. Review of breast cancer cases in Jaipur region. J Indian Med Assoc 2002;100:282-3, 286-7.  
  4. Dixon JM, Anderson TJ, Lamb J, Nixon SJ, Forrest AP. Fine needle aspiration cytology, in relationships to clinical examination and mammography in the diagnosis of a solid breast mass. Br J Surg 1984;71:593-6.
  5. . Chopra R. The Indian scene. Journal of Clinical Oncology 2001;19:S106-11.
  6. Chow LW, Ting AC, Cheung KL, et al. Current status of breast cancer in Hong Kong. Chin Med J (Engl) 1997;110:474-8.
  7. Malik IA. Clinico-pathological features of breast cancer in Pakistan. J Pak Med Assoc 2002;52:100-4.
  8. Gupta P, Sharma RG, Verma M. Review of breast cancer cases in Jaipur region. J Indian Med Assoc 2002;100:282-3, 286-7.
  9. El-Tamer MB, Wait RB. Age of presentation of African-American and Caucasian breast cancer patients. J Am Coll Surg 1999;188:237-40.
  10. Hospital Episode Statistics Vol. 2 1991/92. Department of Health. London: HMSO, 1995.
  11. Joseph A, Mokbel K. Male breast cancer. Int J Fertil Womens Med 2004;49:198-9.
  12. Weiss JR, Moysich KB, Swede H. Epidemiology of male breast cancer. Cancer Epidemiol Biomarkers Prev 2005;14:20-6.
  13. Kelsey JL, Gammon MD, John EM. Reproductive factors and breast cancer. Epidemiol Review 1993;15:36.
  14. Rosner B, Colditz GA, Willett WC. Reproductive risk factors in a prospective study of breast cancer: the nurses‘ health study. Am J Epidemiol 1994;139:819
  15. RK Karwasra1, S Marwah1, DS Sandhu1, S Sandhu2. Profile of breast cancer patients at a tertiary care hospital in north India. Indian Journal of Cancer, Vol. 47, No. 1, January-March, 2010, pp. 16-22
  16. Chopra R. The Indian scene. Journal of Clinical Oncology 2001;19:S106-11.
  17. Malvia S., Bagadi S.A., Dubey U.S. and Saxena S., Epidemiology of breast cancer in Indian women, Asia-Pacific Journal of Clinical Oncology 2017; 13: 289–295.
  18. Abdul Muqtadir A.M., Shaikh J.M., Varudkar Anagha S, Dawle AV outcome of breast cancer at tertiary care hospital in rural maharashtra: An observational study April 2015; 2(4): 238-240.
  19. Rao M, Joshee R, Deval M, et al. Clinico-morphological profile in breast cancer patients in a tertiary care hospital in Western Rajasthan. J Evolution Med Dent Sci 2016;5(4):262-265.
  20. Gupta P, Sharma RG, Verma M. Review of breast cancer cases in Jaipur region. J Indian Med Assoc 2002;100:282-3, 286-7.
  21. Puglisi F, Follador A, Minisini AM, Cardellino GG, Russo S, Andreetta C, et al. Baseline staging tests after a new diagnosis of breast cancer: further evidence of their limited indications. Ann Oncol 2005;16:263-6.
  22. Oyama T, Koibuchi Y, McKee G. Core needle biopsy (CNB) as a diagnostic method for breast lesions: comparison with fi ne needle aspiration cytology (FNA). Breast Cancer 2004;11:339-42.
  23. Ghosh S, Sarkar S, Simhareddy S, et al. Clinico-morphological profile and receptor status in breast cancer patients in a South Indian Institution. Asian Pac J Cancer Prev 2014;15(18):7839-7842.
  24. Bloom HJG. Richardson WW. Histolo-gical grading and prognosis in breast cancer. Br J Cancer 1957: 11:359--377.
  25. Scat RW, Handley RS. Prognosis in carcinoma of the breast. Lancet 1938: 2582-583.

Corresponding Author

Ranjita Bansal