IntroductionBreast cancer is the most common female cancer in the world. Triple negative breast cancer (TNBC) is a recently identified biological variant with aggressive tumor behavior and poor prognosis. Data of hormonal status from the Indian population is scarce due to financial constraints in performing immunohistochemistry evaluation. The present study aims to prospectively analyze receptor status of all breast cancer patients and identify TNBC and compare their clinical profile and short term survival with other non-TNBC group.Materials and methodsAll cytologically and histopathologically confirmed cases of carcinoma breast were prospectively enrolled. In a longitudinal study at tertiary care hospital in central India based on the hormonal status, they were further divided into TNBC and other groups. Comparison of risk factors, clinical profile and short-term survival was carried out.ResultsA total 85 patients were enrolled and of them 37 (43.7%) were TNBC. On comparing risk factors ie, age, age at menarche, total reproductive age, age at first child birth, and menopausal status – no statistical significance was observed between the TNBC and non-TNBC groups. But on comparison of clinical profile TNBC tumors were significantly large with majority of patients presenting as locally advanced breast cancer (83%). No statistical difference was observed in axillary lymph node status between two groups. TNBC tumors were histologically more aggressive (grade 3) compared to other groups. No statistically significant difference was observed in short term overall survival but all three deaths were observed in the TNBC group only and two local recurrences after surgery were observed in the TNBC group.ConclusionTNBC forms a large proportion of carcinoma breast patients in a central Indian scenario and needs more research to identify appropriate treatment planning considering aggressive histology and advanced presentation.

Skin cancers account for less than 1 % of all malignancies in India. Squamous cell carcinomas occurring over the waistline due to tying of cotton cloth called dhoti in males and sarees in females are predominantly seen in traditional Indian population. On wearing of these clothes for years, there is a constant irritation which produces depigmentation, glazing of the skin, acanthosis, scar formation, and later on malignant transformation. Presenting a case of a 65-year-old male with 7 × 5 cm ulceroproliferative growth over the right waistline with a history of prolonged use of dhoti. Wide local excision of the growth with 2-cm margin and primary closure of wound by mobilizing the skin was carried out. Histopathology showed well-differentiated squamous cell carcinoma. The patient is clinically disease free after postoperative follow-up of 1 year.

Background: Breast cancer is the commonest female cancer representing a quarter of all cancers worldwide. An important development in breast cancer management was the realization of role of hormone receptors in disease. Thus, the present study was carried out to evaluate the receptor status and its correlation with clinical presentation, stage, grade and short term outcome.Methods: All female patients with lump in breast confirmed as breast cancer were included and their receptor status was evaluated using immunohistochemistry.Results: A total of 147 patients with a mean age of 50.16±12.08 years were enrolled. Almost half of the patients (48.3%) of the patients were found to have locally advanced breast cancer. Of the 147 patients, 91.49% tumours were either Nottingham grade 2 or 3. Triple negative breast cancer (TNBC) was the commonest subtype seen in 43.54% patients. On correlating the results with receptor status, it was found that TNBC patients were younger than HER2neu positive and ER PR positive patients. Also, TNBC patients had a longer duration of lump and the lump was of larger size at presentation. On correlating receptor status with tumour biology it was seen that more than half (54.69%) of the patients who were triple negative had a grade 3 tumour and poorer disease free survival and overall survival.Conclusions: In conclusion it is seen that TNBC forms a majority of the cases in the central Indian population with more aggressive presentations and outcomes. Absence of any targeted therapies against them leads to a worse DFS and overall survival.

Background. Gynecomastia, benign enlargement of the male breast is the most common breast pathology amongst males. The most widely used modality of treatment is liposuction under general anesthesia. To date however there is no published study that specifically addresses to use tumescent anesthesia & use of tranexamic acid in it for excision of gynecomastia. Objective. To evaluate the efficacy of tumescent anesthesia in surgical excision of gynecomastia. Methods. A 4-year study with 100 patients of gynecomastia aged 14 to 47 years were enrolled with follow up for 3 months. All patients were given tumescence anesthesia in each breast comprising subcutaneous infiltration of 500 ml RL, 20 ml 0.5% bupivacaine, 30 ml 2% lignocaine, 1 mg adrenaline & 1 gm tranexamic acid. Breast tissue was excised in each breast by a single infraareolar incision & patients were assessed for intra-op pain and post-op pain by using numeric rating scale (NRS). Results. Bilateral presentation was there in 69 patients and 31 unilateral with 4 recurrent cases. Size of gland excised were 12-14 cms in 53 cases, 15-18 cms in 38 & 19-20 cms in 9 patients. Average surgical time required for each breast was 30 minutes. Intraoperative pain NRS-0 for 66, NRS-1 for 31 & NRS-5 for 03 patients. Postoperative pain for first eight hours was NRS-0 for 69 and NRS-1 for 31 patients. Conclusion. Tumescent anaesthesia for surgical excision of gynecomastia using a periareolar incision is a minimally invasive bloodless and painless technique in which ductal and stromal tissue can be removed resulting in a high level of patient satisfaction. In todays covid era it avoids the use of general anesthesia and electrocautery.

Background Scalpel is the most common and oldest instrument used by surgeons for incision and to perform the surgery. A lot of improvement has occurred in the design of scalpel from the flint knife to the modern Bard-Parker handle with blades. The quest for improvement and finding a better instrument is neverending. In this study, we present an alternative scalpel to the no. 15 blade most commonly used by plastic surgeons. Material and Methods Consultants and residents in plastic surgery department used a no.15 blade and a 15-degree straight keratome on randomly selected patients and used subjective numerical rating scale to assess the ease of incision and dissection. The data were collected and statistically analyzed. Results In this study, 89 patients were included out of which 68 cases were operated by the consultants and 21 cases were operated by residents. The average score of ease of incision using a no. 15 blade by the consultants was 6.52 and by the residents was 6.125. The average score of ease of incision using a 15-degree straight keratome by the consultants was 8.74 and by the residents was 8.84. p-Value was statistically significant when no. 15 blades and 15-degree straight keratome were compared. Conclusion 15-degree straight keratome is an excellent scalpel that can be used in preference to no. 15 blade as it is difficult to use.