ca breast ,idc ,T4 in view of skin involvement.3 NACT then lumpectomy with Axillary dissec done.HPE shows margin clear with 6/20 lymph node positive for malig.pt has completed family .weather to observe her or sent patient for MRM.
i mean ofcourse send the patient for CT and EBRT after that
What is the age ? ER/PR status?, Was there residual tumor after NACT in the breast ?
age 38yrs,ERpositive n pr weakly posive.yes therre was residual tumor of around 2 cm
Its always better to give full history so that others can make valid comments.
Please let us know: age , menopausal status, Details of size of primary, aillary nodes at presention, presence of supraclav nodes, met work up, then whatchemo, dose schedule, response at each site.
Then path details: size of residual disease, grade, LVE, PNI, margins, ER/PR/cerb2, PNE in nodes
No need for mastectomy from whateer info u have given. However opion may change after full info.
Complete chemotherapy, locoregional RT and hormonal therapy(if indicated)
i just wanted to know that in this age when the disease is locoregionally advanced is it feasible to go for BCS or was the decision of BCS was wrong n MRM would have been the right option.
BCS is the standard treatment if feasible. Especially in young women it is all the more important and we already have evidence in favour of BCS. No need for Mastectomy for your case.
hi Pramod, The answer: There is NO clear cut off for age as such in site that you treat. It depends where the patient is, in west anything >70 people consider it old age, people are very aggressive, eg., we are treating a 82/F patient of ca cx IIb with CT+RT, another 81/ M prostate ca, busy with winter sports (which are very dangerous) received radical treatment. I think age is very subjective, back home things are different. Logistics also dictate the decision many times.
Mastectomy does have a huge impact on QOL of breast cancer patients, I would not recommend to any patient IF she is suitable for BCS. Menopausal status is very important as we all know (estrogen exposure is more in pre-menopausal women/young women). Please feel free to correct me if Iam wrong.