Incidence of phyllodes tumors of breast at a single centre in Allahabad, Uttar Pradesh, India

Background: Phyllodes tumor of breast is the rare fibro-epithelial tumor of breast constituting <1% of breast neoplasms. They are locally aggressive tumor and suddenly attain a big size. Fine needle aspiration cytology should have both stromal and epithelial component to make the diagnosis. Wide local excision of 1 to 2 cm margin of normal breast is the treatment of choice for tumour of <10 cm in size and simple mastectomy for tumor more than 10 cm. This study was conducted to evaluate the incidence and outcome after surgery for phyllodes tumor at our centre.Methods: Data of 15 patients at our centre was retrieved retrospectively from January 2011 to April 2016.Results: Out of these 15, 14 were female and 1 was male. 14 of them undergo wide local excision under general anesthesia while in one of the patients simple mastectomy was done. Based on tumor histology they are divided into 3 histotypes i. e. benign, borderline, and malignant. 12 patients were found to be benign, 3 borderline and none malignant. Out of 3 borderline disease patients 1 developed recurrence 8 months later to initial surgery. Wide local excision was done for total of 10 times and every time histopathology revealed borderline phyllodes but last report revealed sarcomatous changes. Patient also developed lung metastases and so was referred to oncology department and review histopathology revealed low grade spindle cell sarcoma. Full radiotherapy and complete course of MAID chemotherapy regimen was given but patient still developed local recurrence and metastasis to lungs. All patients in benign category were doing well and none of them developed recurrences in due course.Conclusions: Phyllodes tumor is an interesting entity for both surgeons as well as pathologists because of its rare occurrence and varied histological features. Rapidly growing nature of this tumor does not necessarily indicate malignant disease. No correlation was found between tumor size and recurrence

New Horizons in Regenerative Medicine in Organ Repair

Regenerative medicine is a scientific field that focuses on new approaches in the autologous repair and/or replacement of cells, tissues and/or organs. With time and technical advancements, urethral regeneration, corneal and retinal regeneration, genetically modified skin transplantation has become routine clinical and tissue reconstructive art only due to successful clinical use of stem cells and engineered tissue grafting at defined locations in respective organs in order to bring back the natural or improved physiological functions with enhanced capacity. The tissue engineering and reconstructive art are becoming integral part of the regenerative medicine. This chapter highlights the importance of regenerative medicine in successful tissue reconstruction for organ transplantation

The accuracy of USG and USG guided FNAC axilla in predicting nodal metastasis in a clinically lymph node negative cancer breast patient

Background: Breast malignancies are the second most common cause of cancer-related mortality among women. As the size of the primary breast cancer increases, some cancer cells are shed into cellular spaces and transported via the lymphatic network of the breast to the regional lymph nodes, especially the axillary lymph nodes. Objective of the study was to determine the accuracy of USG and US-FNAC in detecting lymph node metastasis in a clinically lymph node negative CA Breast patient.Methods: This prospective study was conducted on 40 consecutive patients with biopsy proven breast cancer with clinically negative axilla, who had attending the OPD or IPD in our department of surgery, Swaroop Rani Nehru Hospital, Allahabad, during the period of 2014 to 2015. All of these patients were planned to undergo surgery (breast conservation or modified radical mastectomy with axillary clearance).Results: Sensitivity of the study = 97.77%, specificity = 25%, positive predictive value =92.01%, negative predictive value =50%, diagnostic accuracy =90%.Conclusions: Using axillary ultrasound and selective US-FNAC is a rapid, non-morbid method of staging the axilla in newly diagnosed breast cancer patients and should become a routine part of patient care because it can spare many patients particularly those who are undergoing axillary dissection

Incidence of phyllodes tumors of breast at a single centre in Allahabad, Uttar Pradesh, India

Background: Phyllodes tumor of breast is the rare fibro-epithelial tumor of breast constituting &lt;1% of breast neoplasms. They are locally aggressive tumor and suddenly attain a big size. Fine needle aspiration cytology should have both stromal and epithelial component to make the diagnosis. Wide local excision of 1 to 2 cm margin of normal breast is the treatment of choice for tumour of &lt;10 cm in size and simple mastectomy for tumor more than 10 cm. This study was conducted to evaluate the incidence and outcome after surgery for phyllodes tumor at our centre.Methods: Data of 15 patients at our centre was retrieved retrospectively from January 2011 to April 2016.Results: Out of these 15, 14 were female and 1 was male. 14 of them undergo wide local excision under general anesthesia while in one of the patients simple mastectomy was done. Based on tumor histology they are divided into 3 histotypes i. e. benign, borderline, and malignant. 12 patients were found to be benign, 3 borderline and none malignant. Out of 3 borderline disease patients 1 developed recurrence 8 months later to initial surgery. Wide local excision was done for total of 10 times and every time histopathology revealed borderline phyllodes but last report revealed sarcomatous changes. Patient also developed lung metastases and so was referred to oncology department and review histopathology revealed low grade spindle cell sarcoma. Full radiotherapy and complete course of MAID chemotherapy regimen was given but patient still developed local recurrence and metastasis to lungs. All patients in benign category were doing well and none of them developed recurrences in due course.Conclusions: Phyllodes tumor is an interesting entity for both surgeons as well as pathologists because of its rare occurrence and varied histological features. Rapidly growing nature of this tumor does not necessarily indicate malignant disease. No correlation was found between tumor size and recurrence

Outcome of ultrasound guided foam sclerotherapy (UGFS) treatment for varicose veins: A four years retrospective study at a tertiary care hospital in north India

Objective:The purpose of this study was to determine the outcome and rate of recurrence for varicose veins treated with ultrasound-guided foam sclerotherapy (UGFS). Methods:Data was collected from hospital records. Patients treated with UGFS for superficial venous insufficiency were included in the study. Total 361 legs in 241 patients, out of which 121 patients with unilateral limbs and 120 patients with bilateral limbs were found to be treated by this method. Results:Out of these 361 legs great saphenous vein (GSV) varicosity was found in 88 legs, short saphenous vein (SSV) in 76, GSV &amp; SSV both in 63, others 134. 264 legs with primary varicosity while 97 were with recurrent. In 294 legs clinical CEAP was 2-3 while in 67 legs it was 4-6. Saphenofemoral junction (SFJ) incompetence was found 60 legs, saphenopopliteal junction (SPJ) incompetence in 68, only perforator’s incompetence was in 56, SFJ with perforator’s incompetence 61, SPJ with perforator’s 29 and no incompetence was noted in 87 legs.Outcome at 6 months was 96.23% while treatment failure and recurrences were noted in 2.77 % of legs. Complications which were noted at 1 week were superficial skin necrosis in 3.04%, pain at injection sites in 15.23%, superficial thrombophlebitis in 16.62%, bruising in 12.18%, skin staining in 11.08%, superficial vein thrombosis (SVT) in 9.97% while no DVT was noted in any of the treated legs. Conclusion:On conclusion it was found that UGFS is a popular office based treatment modality, safe, effective, easy and improvement in venous signs and symptoms. Even on recurrence patients easily accepts retreatment with this method. Furthermore it is associated with lesser pain, anesthesia requirements; time off work and driving gives it additional advantage

The accuracy of USG and USG guided FNAC axilla in predicting nodal metastasis in a clinically lymph node negative cancer breast patient

Background: Breast malignancies are the second most common cause of cancer-related mortality among women. As the size of the primary breast cancer increases, some cancer cells are shed into cellular spaces and transported via the lymphatic network of the breast to the regional lymph nodes, especially the axillary lymph nodes. Objective of the study was to determine the accuracy of USG and US-FNAC in detecting lymph node metastasis in a clinically lymph node negative CA Breast patient.Methods: This prospective study was conducted on 40 consecutive patients with biopsy proven breast cancer with clinically negative axilla, who had attending the OPD or IPD in our department of surgery, Swaroop Rani Nehru Hospital, Allahabad, during the period of 2014 to 2015. All of these patients were planned to undergo surgery (breast conservation or modified radical mastectomy with axillary clearance).Results: Sensitivity of the study = 97.77%, specificity = 25%, positive predictive value =92.01%, negative predictive value =50%, diagnostic accuracy =90%.Conclusions: Using axillary ultrasound and selective US-FNAC is a rapid, non-morbid method of staging the axilla in newly diagnosed breast cancer patients and should become a routine part of patient care because it can spare many patients particularly those who are undergoing axillary dissection