Validation of EORTC quality-of-life questionnaire in Indian women with operable breast cancer

Background: The European Organization for Research and Treatment of Cancer (EORTC) module QLQ-C30 and the breast cancer-specific module BR-23 have been validated world-wide to assess the quality of life ( QOL) in women with breast cancer. No such study has been published on Indian women using EORTC questionnaires. Methods: QOL was assessed in relation to surgery, adjuvant chemotheraphy, radiation therapy and hormone therapy in 299 Indian women with operable breast cancer (OBC) at the Breast Unit of Tata Memorial Hospital( TMH), Mumbai, from October 1998 to September 2001. The QLQ-C30 module was used to assess physical health, emotional, cognitive and social functioning, and the BR-23 module to assess breast cancer treatment-related symptoms. Assessment was done at 3 visits: visit 1 ( after surgery); visit 2 ( during adjuvant therapy) and visit 3 ( on completion of adjuvant therapy). Results: Of the 299 women at first visit, 274 (91.6%) completed the visit 2 questionnaire and 239 ( 80%) completed the visit 3 questionnaire. Only those women who filled the questionnaires at all 3 visits were included as 'valid visits' for analysis ( 193 of 299; 64.5%). The reliability and validity of the English and translated versions of the questionnaires were tested by Cronbach alpha (0.61-0.96) and item-scale correlation (0.63-0.93). Women with breast conversion treatment had a superior body image as compared to those with mastectomy (p<0.01). Physical, emotional and cognitive functions were not related to the type of surgery. Global QOL, physical, sexual and role functioning were found to deteriorate with chemo-therapy ( p≤0.01). Radiotherapy had only local adverse wffects (p<0.001), while hormone theraphy had no adverse impact on QOL. Conclusion: QLQ-C30 and BR-23 questionnaires can be used reliably to assess QOL in Indian patients. The translated versions were found to be valid for further use in clinical trials on Indian women with breast cancer

Hydrogenated Nanocrystalline Silicon Thin Films Prepared by Hot-Wire Method with Varied Process Pressure

Hydrogenated nanocrystalline silicon films were prepared by hot-wire method at low substrate temperature (200∘C) without hydrogen dilution of silane (SiH4). A variety of techniques, including Raman spectroscopy, low angle X-ray diffraction (XRD), Fourier transform infrared (FTIR) spectroscopy, atomic force microscopy (AFM), and UV-visible (UV-Vis) spectroscopy, were used to characterize these films for structural and optical properties. Films are grown at reasonably high deposition rates (>15 Å/s), which are very much appreciated for the fabrication of cost effective devices. Different crystalline fractions (from 2.5% to 63%) and crystallite size (3.6–6.0 nm) can be achieved by controlling the process pressure. It is observed that with increase in process pressure, the hydrogen bonding in the films shifts from Si–H to Si–H2 and (Si–H2)n complexes. The band gaps of the films are found in the range 1.83–2.11 eV, whereas the hydrogen content remains <9 at.% over the entire range of process pressure studied. The ease of depositing films with tunable band gap is useful for fabrication of tandem solar cells. A correlation between structural and optical properties has been found and discussed in detail

Sentinel node biopsy in operable breast cancer

The advent of mammography and increased awareness about breast cancer has resulted in the detection of smaller tumours. The majority of these small tumours would not have had metastasized to the axillary lymph nodes. Sentinel node biopsy (SNB) in operable breast cancer has gained popularity since it promises to avoid treatment of the axilla when the nodes are negative for metastasis. However, it has not been able to achieve its objective. The world literature quotes a false negative rate ranging from 4.7% to 12.5% on immunohistochemistry while our own results of a pilot study at the Tata Memorial Hospital (TMH) have shown a false negative rate as high as 16.6% (22.2% on frozen section). The consequence of leaving behind untreated positive non-sentinel nodes in the axilla is a potential risk for axillary recurrence. Axillary sampling is a simple and inexpensive procedure in which level I nodes are removed by a blind dissection. We have tried to critically analyze the efficacy of both the procedures, i.e. targeted sentinel node biopsy versus blind axillary sampling to see whether the latter could be a preferred alternative in terms of accuracy and cost-effectiveness in countries with limited resources

Feasibility of Laparoscopic Abdomino - Perineal Resection for Large - Sized Anorectal Cancers : A Single - Institution Experience of 59 Cases

Background: Laparoscopic surgery for anorectal carcinoma is steadily gaining acceptance. While feasibility has already been reported, there are no reports addressing the impact of the actual size of large tumors on laparoscopic resectability . Aim: To assess the feasibility and short-term results (including oncological surrogate end points) of performing laparoscopic abdomino-perineal resection (APR) for large rectal cancers. Materials And Methods: Data of 59 patients undergoing laparoscopic APR (LAPR) for anorectal malignancies were reviewed retrospectively. Outcomes were evaluated considering the surgical procedure, surface area of the tumor and short-term outcomes. Results: Of the 59 cases, LAPR could be completed in 53 (89.8%) patients. Thirty-one (58.4%) patients had Astler-Coller C2 stage disease. The mean surface area of the tumors was 24±17.5 (4-83) cm2. The number of median lymph nodes harvested per case was 12 (1-48). Circumferential resection margin (CRM) was positive in 11 (20.7%) patients. No mortality was reported. Conclusion: This appears to be the first report analyzing the impact of the size of the rectal tumor in LAPR. The data clearly indicates that LAPR is not hampered by the size of the tumor. There appears to be a need for preoperative radiotherapy and chemotherapy before undertaking surgery on larger tumors in view of the higher circumferential resection margin positivity

Conservative surgery in breast cancer

Breast conservation surgery (BCS) has become a standard treatment for early breast cancers with results equivalent to modified radical mastectomy (MRM) as evident from various randomized trials. Based on available evidence, the Breast Unit at Tata Memorial Hospital (TMH) has also evolved a standard protocol for the management of breast cancer. The proportion of cases undergoing BCS in operable breast cancer has shown a significant upward trend from 12.6 % in the year 1997 to 59.3% in the year 2001. In operable breast cancer, the overall incidence of gross positive cut margin has been 4 % after BCS. With encouraging results in early breast cancer, BCS is also being offered to women with larger, locally advanced breast cancer (LABC) after downsizing with neo-adjuvant chemotherapy. In 1997, 0.4% of LABC had breast conservation as compared to 34% in the year 2001. The gross positive margin rate in LABC after BCS was 2.4% in our patients (p=0.43). The local recurrence rate after BCS in our patients was 2% in both operable breast cancer (15 out of 726 women) and locally advanced cancers (2 out of 101 women). Even as conservative surgical treatment in early breast cancer is fast becoming the gold standard, conservative radiotherapy to tumour bed alone is also under study. Presently, radical radiotherapy to whole breast plus tumour bed boost is the standard protocol for all women after BCS. A feasibility study of conservative radiotherapy with a high dose brachytherapy for tumour bed alone in early breast cancer is presently on at TMH with a close collaboration between the departments of Breast Services Surgical Oncology and Radiation Oncology with early morbidity as the end-point

Evaluation of Thyroid Lesions by Cytology Testing Along with Thyroid Function Tests in East Nimar Region, India

Background: Thyroid swelling is one of the concerned health issues in middle age female patients. Though majority of the thyroid lesion were benign in nature but its cost-effective preliminary diagnosis is a big challenge.&nbsp; Fine Needle Aspiration Cytology (FNAC) is a simple, cost-effective, highly sensitive and specific test for preliminary diagnosis of thyroid swelling. FNAC accompanying with the thyroid function tests (TFT) may be helpful in the proper assessment and management of thyroid swellings. We aimed to evaluate the thyroid swellings by FNAC and correlate FNAC findings with the TFT. Material &amp; Methods: This study was performed in the Sampurna Sodani Diagnostic Clinic, Khandwa (M.P) for the period of one year from July 2019 to July 2020. Total 50 patients with thyroid swelling enrolled in the current study. Assessment of cytomorphological features of thyroid swelling by using FNAC and also the thyroid function test (TFT) by using chemiluminescence immunoassay (CLIA) method. Results: Most of the cases belong to age range 41 - 50 years with female predominance.1:4.6 was male to female ratio. Cytological diagnosis comprised benign thyroid lesion was 88% amongst them colloid goiter (30%) was predominant