Journal of Islamic International Medical College (Dec 2017)

Clinical and Histopathological Parameters of the Patients with Breast Cancer from North West Pakistani Population

  • Asif Ali , Mushtaq Ahmad , Nabila Javeed , Muhammad Ijaz , Mah Muneer Khan , Rauf Khattak , Mazhar Khan , Syeda Afsheen Hasnain Daud , Asma Fayyaz , Muhammad Naseem Khan , Abdul Salam , Zoufishan Rahat , Maham Israr

Journal volume & issue
Vol. 12, no. 4
pp. 208 – 212

Abstract

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Objective: To analyze the clinical and histopathologic parameters of patients with breast cancer from the North West population of Pakistan. Study Design: Cross sectional descriptive study. Place and Duration of Study: Data was extracted from the Institute of Radiology and Nuclear Medicine Hospital, Peshawar and Khyber Teaching Hospital, Peshawar from March 2014 to December 2016. Materials and Methods: Demographic, clinical and histopathological data was extracted from patient files using proformas. The following parameters were assessed: age, family history, marital status, side and type of surgery, resection margins, tumor markers, foci, tumor grade, TNM stage and lymph node, vascular and lymphatic invasion. Data was analyzed for descriptive statistics. Logistic regression was performed by stratifying patients according to the disease stage as early stage (ES) (stage I and II) and late stage (LS) (stage III and IV) to get odds ratios (ORs) and P -values. Results: Clinical and histopathological data of 362 patients with breast cancer was profiled. From the available data 82 (33%) patients were early stage breast cancer, while 167 (67%) were late stage breast cancer. The mean age of patients in the ES breast cancer (45.8 years) was not statistically different from LS breast cancer (45.8 years) (p=0.99). ER+ cases were 62%, PR+ cases were 47% and HER2 positive cases were 49%. Lymph node invasion (p<0.0001), vascular invasion (p=0.05) and lymphatic invasion (0.009) were statistically significantly associated with LS disease. Lymph node invasion was predictive of LS breast cancer (OR=17.1, p<0.0001). In addition, lymphatic invasion was predictive of LS breast cancer (OR=3.2, p=0.01). Conclusion: The clinical and histopathologic patterns in ES and LS breast cancer are different which may require different management approaches. Majority of the patients present with late stage disease. Tumor markers positivity pattern differs from western population. Lymph node invasion is a better predictor of late stage disease.

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