Outcomes of Breast Conservation Surgery.

Suresh Kumar, D (2009) Outcomes of Breast Conservation Surgery. Masters thesis, Cancer Institute (WIA), Chennai.


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INTRODUCTION : Breast conserving therapy is becoming widely used method for treating breast cancer, since major clinical trials have demonstrated that subsequent survival was equivalent to that of mastectomy. In breast conserving therapy, post operative breast radiation has been reported to reduce cancer recurrence in the breast. Despite the abundance of literature there has been no analysis of the outcomes of patient undergoing this procedure in patients from South India, we therefore present our experience with breast conservation surgery. AIM AND OBJECTIVES : 1. To evaluate the outcome, pattern of failure and survival of breast conservation surgery performed at Cancer Institute. 2. To compare the recurrence, overall and disease free survival from neoadjuvant chemo and concurrent chemoradiation group. 3. To study the relationship of various risk factors influencing the outcome of BCS. MATERIALS AND METHODS : Pooled data from patients undergoing breast conservation surgery for early breast cancer over a 11 year period from 1995 to 2005 was retrospectively evaluated and analyzed. A total number of breast cancer patients treated in our institute from 1995 to 2005 was 5589, of this 1564 case were early breast cancer. In this period 145 breast conservation surgery were performed from this early breast cancer group and selected stage III A patients. The numbers of conservation surgeries are low in our institute because of advanced stage at presentation and the preference for Mastectomy in our patients. All patients underwent thorough clinical examination, with initial staging work-up, which included FNAC / Tru-Cut biopsy of primary lesion, for patients who underwent excision biopsy outside, the slides were reviewed in the institute. Routine hemogram, renal function test, liver function test, chest x-ray, electrocardiogram, CECT-chest, bone scan and echocardiogram were done for all patients. Predictive factors like estrogen and progesterone receptors and Cerb2 were done for some patients. Neoadjuvant treatment, like chemotherapy and concurrent chemoradiation were used in some patients. Chemotherapy regimens used were CMF, FAC, FEC and TAXANE based, alone or concurrently with radiation. Radiation dose used was 40 GY to Breast and Axilla as per our Institute protocol. CONCLUSION : In conclusion in our study there was an increased pathological complete response and partial response in patients undergoing neoadjuvant chemo radiation, but it was not translated into overall survival when comparing with neoadjuvant chemotherapy and straight surgery. The results of breast conservation surgery from our institute are comparable with those in literature. Since our study is limited by the small samples, it needs to be validated in a larger study.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Breast Conservation Surgery ; Outcomes.
Subjects: MEDICAL > Surgical Oncology
Depositing User: Kambaraman B
Date Deposited: 26 Jul 2017 02:38
Last Modified: 26 Jul 2017 02:38
URI: http://repository-tnmgrmu.ac.in/id/eprint/2123

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