Aim:To determine the correlation between mammography and ultrasound features of breast cancer with molecular subtypes and to calculate the predictive value of these features.Materials and Method:This is a prospective study of consecutive patients with breast cancer presenting between January 2016 and July 2017, who underwent mammography and/or ultrasound of breast and excision of the breast mass. Patients with contralateral breast mass, metastases, h/o prior cancer treatment, and other malignancies were excluded. On mammography, the presence or absence of microcalcification was noted. On ultrasound examination size, margins, microcalcification, posterior acoustic features, vascularity, and axillary nodes were assessed. Margins were categorized into circumscribed and non-circumscribed. Posterior acoustic features were classified into four categories: shadowing, enhancement, mixed, and no changes. Vascularity was assessed based on Adler's index into grades 0, 1, 2, and 3. Grades 0 and 1 were considered low and 2 and 3 were high.Results:Tumors with non-circumscribed margins and posterior acoustic shadowing were likely to be luminal A or B subtype of breast cancer [odds ratio (OR) 5.78; 95% confidence interval (CI) 3.68–9.80; P < 0.0001]. Tumors with non-circumscribed margins, posterior acoustic shadowing, and high vascularity were more likely to be luminal B subtype (OR 2.88; 95% CI 2–4.14; P- <0.0001). Tumors with microcalcification and posterior mixed acoustic pattern were strongly associated to be HER2-positive (OR 5.48; 95% CI 3.06–9.80; P < 0.0001). Tumors with circumscribed margins and posterior acoustic enhancement were highly suggestive of triple-negative breast cancer (OR 7.06; 95% CI 4.64–10.73; P < 0.0001).Conclusion:Microcalcification detected on mammography and certain ultrasound features such as circumscribed or non-circumscribed margins, posterior acoustic features, and vascularity are strongly correlated in predicting the molecular subtypes of breast cancer, and thus may further expand the role of conventional breast imaging.

BACKGROUND Abdominal malignancies are a common problem in the western countries and is on a rise in India. This study was conducted to evaluate the reasons for delay in diagnosis and treatment of cancer. METHODS This is a prospective observational study conducted in the Department of Surgery Acharya Vinobha Bhave Rural Hospital, Sawangi (Meghe), Wardha, for a period of 2 years with a sample size of 46 patients. RESULTS Delay in presentation was noted in 74% of patients. Among them ‘taking local treatment’ was considered to be the main cause of delay in treatment. There was delay in diagnosis in 8 % of patients. There was delay in initiation of treatment in 18 % of patients. CONCLUSIONS Most of the patients presented in advanced stages to the hospital because of taking local treatment, due to lack of awareness, belief in herbal and ayurvedic treatment, poor financial resources, and fear of surgery. The proper treatment was delayed or denied leading to poor overall outcome. KEY WORDS Delay, Presentation, Diagnosis, Treatment

Background: The loco-regional recurrence rate remains the main concern in the treatment of esophageal cancer. However, there are controversial data regarding the benefit of dose escalation in the treatment of esophageal cancer. The study examines the implications of dose escalation with endoluminal brachytherapy after induction chemotherapy and definitive chemoradiation in cases of carcinoma esophagus. Material and Methods: Total 31 biopsy-proven patients with inoperable, locally advanced esophageal cancer of stage IIA-IIIB were enrolled from January 2006 till December 2018. All patients underwent two cycles of three weekly induction chemotherapy followed by definitive external beam radiotherapy of 45-50.4 Gray (Gy) at 1.8 Gy per fraction along with chemotherapy, followed by intraluminal brachytherapy boost of two fractions with 5 Gy each. Overall survival (OS) was censored at death or the last follow-up. Results: Of 31 patients, 26 (83.97%) received concurrent chemotherapy and 30 (96.77%) completed radiation therapy. At the end of 3 months, 10 (32.2%), 13 (41.9%), 5 (16.1%), and 3 (9.6%) had complete response, partial response, stable disease, and progression of the disease, respectively. Distal failure was seen in five (16.1%) cases. The median OS was 28 months. OS at 2 years and 5 years was 20 (64.5%) and 9 (28.3%), respectively. At the end of 3 months, 17 (54.8%) of patients had no dysphagia, four (12.9%) of patients had improvement of more than 2 points in dysphagia score, five (16.1%) of patients had no change in the score and five (16.1%) of the patients had worsening of the dysphagia score by 1 point. Median dysphagia-free survival was 10.7 months, eight (25.8%) developed dysphagia after the dysphagia-free interval and two (6.4%) had worsening of dysphagia after treatment. There were no reported grade III or grade IV acute toxicities. Conclusion: The protocol has shown an acceptable survival and dysphagia-free interval. The study suggests intraluminal brachytherapy with induction chemotherapy and definitive chemoradiation is a feasible option in locally advanced esophageal cancer.

Background: Cervical spondylosis (CS) is an age-related degenerative condition of the cervical spine. Peripheral vertigo is often observed to co-occur with CS. This study was done to evaluate the assocaition of cervical spondylosis and peripheral vertigo. Methods: 120 patients of either sex suffering from cervical spondylosis was selected for the study. Meticulous history and clinical examination was done to rule out peripheral vertigo. The mean age of 120 sampled patients was 45.70 years. The results were analysed statistically using Chi square test and inference was drawn. Results: Of the 120 patients, 27 males (22.5%) and 42 females (35%) had peripheral vertigo. The number of patients with peripheral vertigo was high in the middle aged group (40-59 years) when compared to the elderly. p value was found to be statistically significant (0.00012). Conclusions: A significant association between cervical spondylosis and peripheral vertigo has been confirmed.

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