Rahulan, N (2020) Assessment of Response of Neoadjuvant Chemotheraphy in Locally Advanced Breast Carcinoma using Ki-67 as a Proliferative Marker. Masters thesis, Madurai Medical College, Madurai.
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Abstract
INTRODUCTION: While an enormous amount of information still remains intricately hidden with the human genome, research today is slowly but steadily decoding it. Every piece of data thus garnered alters to some extent our current understanding of malignancies and opens up new avenues for their management. Carcinoma [CA] of the breast is one of the most common malignancies encountered in the General Surgery Out Patient Department & operated on at Government Rajaji Hospital, Madurai. Patients, mainly from lower socioeconomic strata, often present with either palpable lump or in a more advanced stage. AIM OF THE STUDY: This study is aimed at assessing the response of neoadjuvant chemotheraphy in locally advanced breast carcinomas using Ki-67 as a proliferative marker. METHODOLOGY: This is a prospective randomised case control study done for the period of one year from May 2018 to May 2019. Patients from surgical OPD or casualty presenting with breast lump proven for malignancy in GRH Madurai are recruited. The patients were diagnosed on the basis of history, clinical examination and investigations like core needle biopsy, USG breasts with axilla. ER, PR, HER2 neu status were assessed along with Ki-67 index. 60 patients were recruited for this study. Patient were categorized into 2 groups based on Ki-67 index (low -< 20% ; High- > 20%). Patients were subjected to neoadjuvant chemotheraphy and reassessed following its completion. RESULTS: In low Ki-67 index group 53.30% were in Stage IIIc and 46.70% were in Stage IIIB. Following Neoadjuvant chemotheraphy 53.30% downstaged to Stage IIIA, 30% to Stage IIB. In High Ki -67 index group 66.70% were in Stage IIIC and 33.30% were in Stage IIIB. Following Neoadjuvant chemotheraphy 66.70 % downsatged to Stage IA and 20% to Stage IB and 13.30% to Stage IIA. CONCLUSION: From our study we concluded that KI -67 a proliferative marker can be used to assess the response of neoadjuvant chemotheraphy. Tumors with high index of Ki-67 respond significantly well to chemotheraphy and it can be used to assess the achievement of a pathological complete response. Neoadjuvant chemotherapy reduces tumor size, which enables patients who were initially inoperable to undergo mastectomy and makes breast-conserving surgery possible in patients who otherwise would have required mastectomy.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 221711122 |
| Uncontrolled Keywords: | Neoadjuvant Chemotheraphy, Locally Advanced Breast Carcinoma, Ki-67, Proliferative Marker. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 10 Feb 2021 02:40 |
| Last Modified: | 10 Feb 2021 02:40 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13981 |
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