Abstract
Objective: To determine the Role of medical therapy and surgical intervention in carcinoma of breast.
 Study Design: Prospective observational study.
 Place and Duration: Two years study from January 2018 to December 2020 was conducted at Liaquat university of Medical and Health Sciences Jamshoro.
 Methods: The study comprises 50 patients. Data was collected from all who were admitted at OPD. The patients were evaluated fully after history & Clinical examinations and Specific investigations of Fine Needle Aspiration Cytology (FNAC), Tru cut biopsy for Histology ERPR Receptor and Herceptin receptor, ultra sound of breast, and Abdomen, Mammography, C T scan, M R I, Tumor marker CA15.3. CA 125 for ovary and breast, X ray chest and Bone scan. Sentinel lymph node biopsy for lymphatic involvement, Liver Function Test, serum calcium, Complete Blood Picture (CBP), blood sugar, blood urea. HBSAG, HCV, HIV and COVID-19 Evaluated patients were evaluated fully after history, clinical examinations & specific investigations.
 Results: In this study 50 patients of Carcinoma of breast. The maximum numbers of patients were in age group 20 to 80 years. 15 patients were in age group 20 to 39 year, 24 patients were in age group 40 to 59 years, 11 patients were in age group 60 to 80 year. Out of 50 patients 29 patients were presented with breast lump, 8 patients were presented with bloody discharge, 7 patients were presented with nipple destruction and 6 Patients were presented with pricking sensation Out of 50 patients 21 patients were presented with stage I, 13 Patients presented with stage II, 9 patients were presented with stage III and 7 patients were presented with stage IV. Out of 50 patients 22 Patients were diagnosed duct cell carcinoma, 11 patients were diagnosed Phyllodes tumor, 9 patients were diagnosed lobular cell carcinoma, 5 patient were diagnosed tubular cell carcinoma and 3 patients were diagnosed Paget’s type of carcinoma .Out of 50 patients 25 patients were ERPR positive treated by Nolvadex (tamoxifeen) 16 Patients were ERPR negative treated by chemotherapy drugs and Aromatase inhibitors, 9 Patients were Her2neu receptor positive treated by Herceptin (Trastuzumab) Out of 50 patients 34 patients were treated by Modified radical mastectomy, 16 patients were initially were treated neo adjuvant therapy. Then Modified Radical Mastectomy, Out of 50 patients 25 patients were treated with Nolvadex (tamoxifeen) after Modified Radical Mastectomy better outcome seen in those patients.
 Conclusion: Carcinoma of breast is a common problem all over the word, patient can present with lump over the breast, bloody discharge, destruction of nipple or areola if not diagnosed and treat early stage, patient can die within a year without Medical and surgical treatment.
Highlights
Breast Carcinoma is a common cancer all over the world
The maximum numbers of patients were in age group 20 to 80 years. 15 patients were in age group 20 to 39 year, 24 patients were in age group 40 to 59 years, 11 patients were in age group 60 to 80 year
Out of 50 patients 29 patients were presented with breast lump, 8 patients were presented with bloody discharge, 7 patients were presented with nipple destruction and 6 Patients were presented with pricking sensation Out of 50 patients 21 patients were presented with stage I, 13 Patients presented with stage II, 9 patients were presented with stage III and 7 patients were presented with stage IV
Summary
Breast cancer is a more common in female population 20% of all cancer death in females in USA; it affects about one out of every ten women in Western Countries It is the most second cause of death after lung cancer, breast carcinoma can occur any age before 20 years but most common seen in nulliparous, postmenopausal women who having strong family history and taking contraceptive pills [1]. Breast carcinoma can occur any age but most commonly seen in those patients who have strong family history, taking long standing contraceptive pill, and avoid breast feeding, suspicious of carcinoma of breast can be evaluated/diagnosed with help of History, Clinical examinations, imaging (ultrasound, mammogram) Biopsy FNAC, Trucut biopsy [4]. Prognosis of the patient of carcinoma of breast best seen on the basis of Notingum prognostic index Best option of management, are New adjuvant, Chemotherapy, Tamoxifeen, Herceptin & Aromatase inhibitors [7], Options of surgical treatment Depend on, site of tumor, size of tumor, size of the breast either breast conservative surgery i.e. Lumpectomy, wide local excision or breast scarifying surgery simple mastectomy with axillary sampling or clearance, with Sentinel lymph node biopsy, Modified radical mastectomy or Radical mastectomy, adjuvant chemotherapy Radiotherapy, Gene therapy, Endocrine therapy, Immunotherapy [8]
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