Breast cancer is a global health problem, with more than 1 million cases of breast cancer diagnosed worldwide each year, and is the most common cancer among Indian women. Locally advanced breast cancer (LABC) accounts for 10-20% in the Western world while in India it accounts for 40-50% of all cases. Locally advanced breast cancer is a very common clinical scenario especially in developing countries possibly due to various factors like lack of education and poor socioeconomic status. Women with the locally advanced disease require multimodality therapy and coordinated treatment planning. This study aimed to prospectively study the clinical profile of the LABC patients presenting to our institute and also to evaluate the role of neoadjuvant chemotherapy in downstaging the tumor. Materials and MethodsSeventy patients diagnosed with locally advanced breast cancer were enrolled in this prospective study. After thorough preoperative workup, patients were either taken up for upfront surgery or neoadjuvant chemotherapy followed by surgery. Post chemotherapy clinical response of the tumor and postoperative histopathological evaluation of the specimen was performed. ResultsThe mean age of the patients in our study was 45 years. Out of 70 patients, 18 underwent upfront surgery, and 52 received neoadjuvant chemotherapy followed by surgery. A total of 44 cases had a clinical response to chemotherapy with 9% having a complete response. The incidence of margin positivity in the postoperative specimen was significantly lower in patients who received neoadjuvant chemotherapy. ConclusionLocally advanced breast cancer accounted for the predominant number of breast cancer patients mostly females in their middle age. Neoadjuvant chemotherapy was effective in downstaging the tumor in the majority of cases, although complete clinical response was lower in our study. The rate of margin positivity in mastectomy specimens can also be reduced if chemotherapy is considered prior to mastectomy.

Incisional surgical site infection is an important cause of postoperative morbidity which results in extended hospital stay and may result in future incisional hernia. We intended to evaluate the thickness of subcutaneous fat with a cut-off value of 2.5cm as a risk factor in causing surgical site infection using a simple, cost-effective, and direct intraoperative method for measuring subcutaneous fat thickness. MethodsA total of 147 patients who underwent abdominal surgeries from September 2017 to April 2019 were included in this prospective study. A proforma was used to collect information of all patients regarding various variables. Abdominal subcutaneous fat thickness was measured in the supine position intraoperatively with a measuring scale from below dermis to rectus sheath at 1cm caudal to umbilicus level. ResultsThe study's overall incidence of incisional surgical site infection (SSI) in laparotomy surgeries was 10.8%. Subcutaneous fat thickness was independently associated with incisional SSI. Subcutaneous fat thickness association with SSI was more statistically significant than that of BMI. The other associated risk factors were found to be obesity, diabetes, and emergency surgery. ConclusionOur results suggest that the risk of incisional SSI increases with the increased subcutaneous fat thickness of more than 2.5cm. Placement of subcutaneous drain in patients undergoing laparotomy with increased subcutaneous fat thickness plays a significant role in reducing the incidence of surgical site infection. Risk of SSI increases in obesity, diabetes, increased age group, dirty surgery, and emergency surgeries. Subcutaneous fat thickness is an independent risk factor for surgical site infection and subcutaneous drain decreases the risk of SSI in thick subcutaneous fat.

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Introduction The incidence of breast cancer in India is on the rise, and it is now the most common cancer affecting women in India. The main objective of our study was to estimate the prevalence of triple-negative breast cancer (TNBC) in our study population and compare the various clinicopathological characteristics of TNBC with those of non-TNBC in these patients. Methods A retrospective, cross-sectional study was conducted among 249 cases of female breast cancer who reported to a tertiary care hospital in Southern India from September 2017 to September 2021. Results The mean age at presentation was 52 years (range: 26-82 years). The prevalence of triple-negative breast cancer was 19.7%. Most of the subjects belonged to the age group of 40-60 years. The majority were with grade 2 and 3 diseases. Of the cases, 50.6% were estrogen receptor (ER) positive and 48.2% were progesterone receptor (PR) positive, and 40.1% were HER2/neu positive. Conclusion The prevalence of triple-negative breast cancer in our study population is 19.7%, which is in concordance with the literature. Large tumor size, high-grade tumors, and a higher rate of axillary lymph node metastasis are characteristic features of TNBC. TNBC are tumors with aggressive tumor biology and are associated with poor prognosis.

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