NEED FOR ROUTINE X-RAY CHEST AND ULTRASONOGRAPHY OF LIVER IN WORKUP, DIAGNOSIS AND STAGING OF EARLY CARCINOMA OF BREAST IN PATIENTS PRESENTING FIRST TIME: A PROSPECTIVE SINGLE INSTITUTIONAL STUDY
English

Vineeth Rao, Mohamed Shameem P M
2016 Journal of Evolution of Medical and Dental Sciences  
BACKGROUND Carcinoma breast is a common malignant tumour in urban Indian women and second common among the rural. Early diagnosis and prompt treatment reduces the incidence of metastases and complication. The work-up and staging of invasive breast cancer includes: history and physical exam, a complete blood cell count, liver function tests, bilateral diagnostic mammography, breast Ultrasonography if necessary; tumour ER and PR determinations, HER-2 tumour status determination and pathology
more » ... and pathology review. Mammography and thorough clinical workup in every suspected patient result in initiating early management. Aim of the Study-To find out the percentage of early breast cancer (Stages I and II) cases without any systemic symptoms and signs of metastasis, which are upgraded to metastatic breast cancer with the detection of findings in routinely done Chest radiography and Liver Ultrasonography. MATERIALS AND METHODS A retrospective analytical study of 1112 patients with invasive carcinoma attending the Govt. Medical College, Kozhikode between 2008 and 2011; 909 out of 1112 patients were included as per criteria, out of which 505 patients were having early carcinoma breast. Out of 1842 radiological investigations 909 Chest x-rays, 909 Liver ultrasonograms, 10 CT abdomen, 8 CT chest and 6 Bone scans were analysed. True-positive result was determined as being one that unequivocally confirmed metastatic disease. A false-positive result was taken as being any staging investigation that was initially reported as being either abnormal or indeterminate, but upon subsequent investigation was proven to be negative. RESULTS Majority of the patients were aged above 45 years accounting for 58% of post-menopausal age; 6 were male patients; 2 patients had bilateral disease. Less than 6 months duration of symptoms was found in majority of them; 96% patients had Invasive Ductal Carcinoma and 15 (1.65%) out of 909 cases had Stage I disease, while 54.45% cases had Stage II and 43.9% had Stage III breast cancer; 35 out of 909 patients had metastasis detected either in the lung or liver with the help of CXR and LUS; 4 out of 35 cases had early stage breast cancer, while the rest belonged to the group of locally advanced breast cancer. CONCLUSIONS In conclusion our study strengthens the recommendation to limit baseline staging tests, especially LUS and CXR, to patients at higher risk of distant metastases (Stage III). HOW TO CITE THIS ARTICLE: Rao V, Shameem MPM. Need for routine x-ray chest and ultrasonography of liver in workup, diagnosis and staging of early carcinoma of breast in patients presenting first time: a prospective single institutional study. BACKGROUND Carcinoma breast is the commonest malignant tumour in urban and the second commonest after carcinoma uterine cervix among the rural women of India. It is also the most extensively researched cancer, and a wide array and hugely varying management strategies are in use in the different parts of the world. Breast cancer incidence in India has steadily
doi:10.14260/jemds/2016/1309 fatcat:qq5wxei6vjfyzjwnq4pzqn4sue