European Journal of Molecular & Clinical Medicine

Breast cancer is a leading cause of cancer mortality among women second only to lung carcinoma. There has been substantial progress over the years and decline in mortality is due to early diagnosis and intervention. Growing knowledge regarding breast carcinoma biology has had a greater impact on its management. SARS CoV-2 COVID-19 outbreak had a significant effect on the existing health care services. This pandemic posed multiple challenges in care and management of non-COVID diseases including breast cancer management. Methods: The present study is retrospective data analysis of patients suffering from carcinoma breast reporting to the Government Medical College and Hospital, Jammu from March 2020 to August 2022 and type of management offered to them. This was compared with data from January 2018 to December 2019. 372 patients in the age group of 20-80 years of either sex reported in 2020-2022 and 710 patients in the age group of 20-80 years of either sex reported during 2018-2019. Result: During 2020-2022, most of the patients (n= 346) presented with advanced breast cancer and underwent neo-adjuvant therapy. 26 patients underwent modified radical mastectomy followed by adjuvant chemotherapy. 157 patients were lost to follow up. As against the previous years where the number of patients who underwent modified radical mastectomy were n= 67(2018), n= 73(2019) and number of patients who underwent neoadjuvant therapy were n= 253 (2018) and n= 317 (2019). Conclusion: Due to COVID – 19 pandemic, there was drastic decrease in carcinoma breast patients reporting to tertiary health care centre. Whosoever reported were in advanced stage of the disease leading to poor prognosis. Furthermore, large number of patients were lost to follow up. Healthcare policy needs to be redefined for non-COVID surgical diseases management including cancer patients

The development of breast cancer in many women appears to be related to female reproductive hormones, particularly endogenous estrogens. Early age at menarche, nulliparity or late age at first full-term pregnancy, and late age at menopause increase the risk of developing breast cancer. In postmenopausal women, obesity and postmenopausal hormone replacement therapy (HRT), both of which are positively correlated with plasma estrogen levels and plasma estradiol levels, are associated with increased breast cancer risk. Most hormonal risk factors have a relative risk (RR) of ≤2 for breast cancer development. The elective Modified Radical Mastectomy procedure was done in standard fashion. Patients in group A (Study group) received intraoperatively instillation of 0.5% bupivacaine into operative bed at the end of surgery. Patients in group B (Placebo group) received intraoperative instillation of normal saline into the operative bed at the end of surgery position. Approval from the ethical committee of the institution was obtained. All the patients were explained about the basis of the study and informed consent were obtained. Patients who received bupivacaine had longer postoperative analgesia when compared with normal saline group.

Breast cancer is the most common cancer in women worldwide and the second most common cause of cancer related deaths in women. Incidence of breast cancer is increasing with age as there is improvement in survival rate. It has attracted considerable interest in the study of carcinoma breast in elderly. Study was conducted on all the clinically diagnosed cases of breast cancer in the elderly women aged above 60years. Data was collected from the patient after obtaining a written informed consent. Detailed history, clinical examination and relevant laboratory investigations were done and clinical diagnosis confirmed perioperatively and postoperatively based on histopathological examination in the elderly patients. 4(8%) patients presented with clinical T1 stage, 22 (44%) patients presented with T2 Stage, 15 (30%) patients with T3, 5(10%) patients with T4a and 4 (8%) patients with T4b tumor status. 25 (50%) patients had clinically N0 Status at presentation. 20 (40%) patients were N1 at presentation, 5(10%) patients presented with N2 nodal status and 1 (2%) patients with N3 status. Infiltrating ductal carcinoma was the most common histological variant constituting 22 (44%) of the population. Clinico pathological features and treatment vary in elderly compared to young patients, Infiltrating ductal carcinoma is the most common histological variant of breast cancer seen.

Surgery still has a pivotal role in the management of breast cancer, even though recent
advances in oncology are trending towards more conservative techniques followed by
chemotherapy.The consensus development conference on the treatment of breast cancer in
1979 stated that modified radical mastectomy was the standard of treatment for stage 1 and 2
disease. 60 patients of either sex between age group 30 to 60 years undergoing elective
Modified Radical Mastectomywere divided into two groups of 30 patients each randomly
who fulfilled the inclusion and exclusion criteria. In this study, When we look closer, we
could see that, despite of being statistically significant, the VAS and VRS scores at initial
intervals (1hr, 4hrs) were low in group A when compared to group B. At 8 hours and, there
was a marked increase in VAS and VRS score in group B and thereafter it was akin in two
groups.