-
Metastatic Hormone and Her-2 Positive Breast Cancer: A Community Approach
Ida Micaily,
Lakshmi Kolandra,
Shahrzad Abdollahi,
Anthony Scarpaci
Issue:
Volume 3, Issue 3, June 2018
Pages:
20-24
Received:
7 June 2018
Accepted:
26 June 2018
Published:
24 July 2018
Abstract: Metastatic hormone-receptor and HER-2 positive (triple-positive) breast cancer provides a treatment dilemma for oncologic clinicians. The current National Comprehensive Cancer Network (NCCN) Guidelines offer a variety of options in the first and second line for metastatic breast cancer. However, a more tailored treatment approach may be needed for the triple-positive metastatic breast cancer population. The aim of this study is to trend the therapeutic treatment selections for patients with metastatic, triple-positive breast cancer at a single, academic-affiliated community practice in the United States. The patient population included individuals with triple-positive, metastatic breast cancer who were treated over the span of six years at this institution. Ultimately, this patient population demonstrated variability across the various treating oncologists choice of therapy in the first, second and fourth line of treatment. The majority of patients (twelve out of fifteen) received combination therapy with trastuzumab in the first line of therapy. In the second line, seven out of eight patients received trastuzumab as part of their treatment regimen. In the third line, all three patients received trastuzumab emtansine as part of their therapy regimen. For patients who were able to survive until the fourth line and beyond, several other treatment options were utilized. Therefore, although metastatic, triple-positive breast cancer represents a subset of patients with vast treatment variability throughout the various lines of therapy, and there is a general lack of consensus on how to best treat this patient population. This study provides an opportunity for more expansive research in the field in order to help elucidate a treatment algorithm for all oncologic practitioners for patients with triple positive, metastatic breast cancer.
Abstract: Metastatic hormone-receptor and HER-2 positive (triple-positive) breast cancer provides a treatment dilemma for oncologic clinicians. The current National Comprehensive Cancer Network (NCCN) Guidelines offer a variety of options in the first and second line for metastatic breast cancer. However, a more tailored treatment approach may be needed for ...
Show More
-
Clinicopathological and Survival Pattern in Lung Cancer Patients of Different Age Group
Yumkhaibam Sobita Devi,
Srigopal Mohanty,
Laishram Jaichand Singh,
Daffilyne Lyngdoh Nongrum
Issue:
Volume 3, Issue 3, June 2018
Pages:
25-29
Received:
12 June 2018
Accepted:
1 July 2018
Published:
26 July 2018
Abstract: Lung cancer is considered as disease of older population with median age of 70 year at diagnosis. The aim of this study was to investigate the clinicopathological and survival pattern in younger and older age lung cancer patients. A retrospective study was carried out for all histopathologically or cytologically confirmed cases of primary lung cancer treated between 2011 and 2015at the Regional Cancer Centre, Imphal, Manipur, India. Cases were grouped into two age groups, i.e. the younger age group (<60 year) and the older age group (≥60 year).Out of the total 432cases of primary lung cancer, 124 were diagnosed at <60year of age with median age of 55 year and 308 patients were diagnosed at ≥60year of age with median age of 70year at diagnosis. Younger age group was found to have significantly lesser number of chronic smokers (p=0.000), lesser history of pulmonary tuberculosis (p=0.019), higher rate of adenocarcinoma (p=0.000), more positive family history (p=0.008), more advanced stage (III & IV) at presentation (p=0.000), greater proportion of patients undergone combined modality of treatment and lesser proportions of patients refused active cancer treatment (p=0.002) as compared to older age group. Response to treatment in terms of median survival (p=0.338) and three year overall survival (p=0.344) was found similar in both the age groups in spite of more advanced stage of the disease at presentation in younger age group, the reasons could be lesser proportion of older age patients got combined modality treatment due to greater comorbidities, poor performance status & greater proportion of older age patients refused active cancer treatment, because of lesser expectation in terms of long term benefit with treatment.
Abstract: Lung cancer is considered as disease of older population with median age of 70 year at diagnosis. The aim of this study was to investigate the clinicopathological and survival pattern in younger and older age lung cancer patients. A retrospective study was carried out for all histopathologically or cytologically confirmed cases of primary lung canc...
Show More
-
Omitting Preoperative Lymphoscintigraphy Does Not Decrease Sentinel Lymph Node Detection Rate in Vulvar Cancer
Kasey Marie Roberts,
Aine Emma Clements,
John Ottis Elliott,
Kellie Susan Rath,
Gary Craig Reid
Issue:
Volume 3, Issue 3, June 2018
Pages:
30-34
Received:
19 June 2018
Accepted:
16 July 2018
Published:
9 August 2018
Abstract: Sentinel lymph nodes in vulvar cancer can be detected in a variety of ways. A method described in GOG-173 involves injection of technetium-99m and isosulfan blue intraoperatively. Lymphoscintigraphy, for which the technetium-99m is injected preoperatively, became required two years into the study due to unpublished evidence that lymphoscintigraphy improved intraoperative sentinel lymph node localization. Despite this amendment, the need for preoperative lymphoscintigraphy has been questioned. The primary objective of this study was to determine the detection rate of sentinel lymph nodes in vulvar cancer when preoperative lymphoscintigraphy is omitted. The secondary objective was to compare the sentinel lymph node detection rate when lymphoscintigraphy is omitted to the rate reported in GOG-173, in which preoperative lymphoscintigraphy was performed. The tertiary objective was to determine lymphoscintigraphy cost at one institution. Patients with vulvar cancer who underwent sentinel lymph node dissection at a single institution from 2008 to 2016 were identified. All but one patient had intraoperative peritumoral injection of both technetium-99m and patent blue dye. Patients were excluded if preoperative lymphoscintigraphy was performed. Information on demographics, pathology, and outcomes were collected. Descriptive statistics were used for patient demographics, tumor characteristics, and the detection rate. A 1-sample proportion test was used to compare our detection rate to data available from GOG-173. Percentages were rounded to the nearest whole number. Current procedural terminology codes were used to estimate lymphoscintigraphy cost. Fifty patients were identified and 32 patients were deemed eligible for the study. The sentinel lymph node detection rate was 97% per patient, which was not statistically different from the rate of 92% reported in GOG-173 (p = 0.347). It was determined that lymphoscintigraphy cost $5,288.22 per imaging study. In this study, omitting preoperative lymphoscintigraphy did not decrease sentinel lymph node detection rates when compared to GOG-173. Furthermore, there is a substantial cost associated with lymphoscintigraphy, although this cost may vary between institutions.
Abstract: Sentinel lymph nodes in vulvar cancer can be detected in a variety of ways. A method described in GOG-173 involves injection of technetium-99m and isosulfan blue intraoperatively. Lymphoscintigraphy, for which the technetium-99m is injected preoperatively, became required two years into the study due to unpublished evidence that lymphoscintigraphy ...
Show More
-
Comparative Study of Precancerous Lesions of the Uterine Cervix Among Users and Non-Users of Combined Oral Contraceptive Pills in Jos, Nigeria
Yakubu Emmanuel Nyam,
Ajen Stephen Anzaku,
Innocent Emmanuel,
Isikhuemen Ehikoya Maradona,
Ekwedigwe Chinedu Kenneth,
Daru Patrick Haruna,
Ocheke Ngozi Amaka,
Ujah Achanya Otobo Innocent
Issue:
Volume 3, Issue 3, June 2018
Pages:
35-40
Received:
3 January 2018
Accepted:
31 August 2018
Published:
27 September 2018
Abstract: Combined oral contraceptive pills (COCP) use, is link to the development of precancerous cervical lesions. There are variations in reports across studied populations. Our study was a comparative, cross-sectional study. SPSS version 20 (IBM, Armonk, NY, USA) was used for data analysis and P-Value < 0.05 was considered statistically significant. The Prevalence of precancerous cervical lesions in the Exposed and Control groups were 16.4% (9/55) and 14.5% (8/55) respectively (P = of 0.79). In the exposed group, four out of the nine women that had abnormal cervical cytology results had high grade squamous intra-epithelial lesions (HGSIL) while only one out of 8 women that had abnormal cytology results in the control group had HGSIL. We found no significant difference in the prevalence of pre-cancerous cervical lesions between users and non-users of COCP. However, women who used COCP had higher cases of HGSIL when compared with the control group. Therefore, we suggest relatively short schedule of cervical cytology screening for this group of women relative to the general population.
Abstract: Combined oral contraceptive pills (COCP) use, is link to the development of precancerous cervical lesions. There are variations in reports across studied populations. Our study was a comparative, cross-sectional study. SPSS version 20 (IBM, Armonk, NY, USA) was used for data analysis and P-Value ...
Show More
-
Techniques and Practice of Post Mastectomy Radiotherapy in Nigeria: A Multi-Centre Study
Salako Omolola,
Aliyu Usman Malami,
Jimoh Mutiu Alani,
Oboh Oseiwe Evaristus,
Nwankwo Kenneth,
Ogunnorin Babatunde Olutoye,
Habeeb Muhammed,
Olukiran Olugbenro Emmanueal,
Ahmed Rilwan,
Joseph Adedayo,
Roberts Alero Ann,
Oyesegun Razaak,
Ketiku Kingsley Kayode,
Adenipekun Adeniyi Adesina,
Campbell Oladapo Babatunde,
Adewuyi Sunday,
Chukwuocha Ikechukwu,
Otene Samuel Anaja,
Duncan Josbert Thomas Kofi,
Durosinmi-Etti Francis Abayomi
Issue:
Volume 3, Issue 3, June 2018
Pages:
41-48
Received:
10 August 2018
Accepted:
28 August 2018
Published:
8 October 2018
Abstract: Breast cancer affect millions of women worldwide with an increasing incidence in developing countries. In Nigeria, late presentation is the norm, with most patients presenting at stages III and IV. Patients may be at risk of local recurrence after mastectomy due to areas of microscopic residual disease such as the chest wall and regional nodal basins. Post-mastectomy radiotherapy (PMRT) has been found to reduce this risk. The aim of the study was to evaluate the techniques and practice of post mastectomy radiotherapy among breast cancer patients treated in Nigeria. This descriptive retrospective study was carried out for all histologically confirmed breast cancer cases that had post mastectomy radiotherapy between 2004 and 2015, in all (8) centres in Nigeria. Information from patient’s records were extracted using data proforma. Data of 2,143 patients were analysed. All patients received radiation to the chest wall. Thirty nine point one percent had two regional nodes irradiated, while 38% had only axilla treated, and 6.3% had three regional lymph nodes irradiated. All patients had treatment planning, majority (93.7%) with conventional technique. The primary beam used was photon with electron boost to the scar (62.8%). Fractionation method was mostly 50Gy in 25 fractions over 5 weeks (61.8%). Three fields were used in treating more than half of the patients (63.0%) while 30.9% were treated with 4 fields’ techniques. The study revealed a short fall in access to radiotherapy within the study period. Two dimensional treatment planning method was the dominant with considerable variations across centres in terms of practice and techniques.
Abstract: Breast cancer affect millions of women worldwide with an increasing incidence in developing countries. In Nigeria, late presentation is the norm, with most patients presenting at stages III and IV. Patients may be at risk of local recurrence after mastectomy due to areas of microscopic residual disease such as the chest wall and regional nodal basi...
Show More
