Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
Breast Cancer is the most common cancer in women in India and accounts for 1‐3% of deaths in resource poor countries. Surgical management of breast cancer has evolved over the years, from radical procedures to breast conservative surgeries, but MRM still remains the surgery of choice for many surgeons‐for its overall curative outcomes and low recurrence rates. Hence, it is necessary to assess its effectiveness and long term outcomes, in this modern era of molecular diagnosis and adjuvant therapies. To assess the clinical presentation, histopathology, management, treatment outcomes and short term and long‐term complications of patients with Breast carcinoma undergoing MRM in our institution and to compare with the published literature. The medical records of all patients with breast carcinoma, who underwent MRM by a single surgeon at Chigateri District Hospital over a period of 15 years (2009‐2024) were reviewed. Their clinical characteristics, histopathology, management, treatment outcomes, short‐term and long‐term complications were studied. Out of the 100 patients who underwent MRM at our center, 28% of patients developed seroma as an early complication, which could not be attributed to any patient characteristics, but was higher in patients with large tumor sizes. Wound dehiscence was noted to be more in diabetics, whereas flap necrosis was more in patients with large tumors. The study showed that 15% of the patients developed recurrence and the factors that could be responsible were‐tumor size and grade., lymph node status., ER and PR status., molecular subtype., presence of positive tumor margins and lymphovascular invasion and incomplete treatment. All of the above variables were found to be statistically significant, with a p value of <0.001. 68.75% of the patients presented with metastatic disease during recurrence. Usual management of recurrence was surgical clearance followed by systemic therapy in the form of chemotherapy, hormone and radiotherapy. However, in the presence of advanced age and extensive metastatic disease, palliative chemotherapy was preferred. 4% of the patients developed hypertrophied scar, which could not be attributed to any patient or tumor characteristics, whereas only 1% developed limb edema. 23% of the patients reported complications which affected their quality of life, but after 5 year follow‐up these complications had negligible effect on patient’s lives. Although MRM is a commonly performed procedure for patients with breast carcinoma, optimization of the surgical techniques and post‐operative management is required, to minimize short‐term and long‐term complications and to reduce patient morbidity. Patient education and counselling regarding the disease, its treatment and follow‐up, as well as, physical and vocational rehabilitation, is of utmost importance in the course of the management of Breast carcinoma.
How to cite this article:
B.V.C. Jagadeesha, D.N. Puneeth, D.T. Naveen and G.S. Praharsha. Clinical Outcomes after Modified Radical Mastectomy: A Prospective Cohort Study at a Tertiary Care Centre.
DOI: https://doi.org/10.36478/10.36478/makrjms.2024.12.751.756
URL: https://www.makhillpublications.co/view-article/1815-9346/10.36478/makrjms.2024.12.751.756