Document Title: Prepared by: Effective Date: 21/07/20

Committee Minutes Nandakishore Rajkumar, Sr. Mgr.

of Meeting format QIRM
Document No. 05 Approved by: David S. Feinberg, Last Review Date: Version:01
CEO 30/10/2019

Name of the Committee: Tumor Board Committee

Date 28/02/22 Time 3:30pm – 4:30pm Venue Board Room

Attendees Dr. Miro, Dr. Mariano, Dr. Neeza Haleem, Jyoti.

Non- Dr. Amru

attendees/Apologies

Chairperson/Meeting Dr. Miroslav Secretary/Coordinator: First Name/Last Name

called by:

Number Agenda/ Member / Action / Comment Responsible Target Date Remarks

Commenter Person /Completion Date

1 PRN- 00107994, 50 yrs old

Reason for Admission-
For elective MRM and Axillary Lymph node dissection
Right
Discharge Diagnosis-
1. Carcinoma in situ of breast, unspecified (D05.9) -
ICD 10:2016
2. S/P Right MRM and ALND on 16/02/2022
History (Brief)
Admitted for Right Mastectomy and Axillary clearance
under GA

TTH/F&F/EX/QR/CMM/001/2020 Page 1 of 4
 Document Title: Prepared by: Effective Date: 21/07/20
Committee Minutes Nandakishore Rajkumar, Sr. Mgr.
of Meeting format QIRM
Document No. 05 Approved by: David S. Feinberg, Last Review Date: Version:01
CEO 30/10/2019

Past Medical History

CA Breast (Sept 2021) Received 4 cycles of
Chemotherapy
Dyslipidemia
Diabetes Mellitus
No known drug allergies

Past Surgical History

Congenital Acyanotic Heart Disease - Pericardial patch
closure ASD (13/3/2007)
Lap Tubal Ligation
Hemorrhoidectomy

Hospital Course
She was admitted and underwent the procedure as
planned. Right arm precautions were taken during the
whole
course in the hospital. Drain collection and wound status
was observed. Right chest drain was removed on POD 4,
right axillar drain was removed on POD 5. Post op
uneventful

Services
1. MODIFIED RADICAL MASTECTOMY INCLUDING
BLOCK DISSECTION

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 Document Title: Prepared by: Effective Date: 21/07/20
Committee Minutes Nandakishore Rajkumar, Sr. Mgr.
of Meeting format QIRM
Document No. 05 Approved by: David S. Feinberg, Last Review Date: Version:01
CEO 30/10/2019

2. Summary of Operation Right MRM and ALND on

16/02/2022
3. Pre-Operative Diagnosis right breast carcinoma
with axillary mets
4. Post-Op Diagnosis Right breast invasive carcinoma
with axillary mets S/P NACT
5. Findings Right breast diffuse skin thickening
6. peu de orange
7. Right breast retro areolar lesion
8. Operative Procedures Under GA, painting and
draping, WHO checklist
9. Patient in supine Right arm abducted
10. Right breast elliptical incision given
11. Flaps raised and breast remove en mass and sent
for HPE
12. Inferior border margin further excised and sent
separately HPE
13. Right axilla incision extended and axillary
clearance dine level one and 2. specimens sent for
HPE
14. Care taken to preserve axillary vessels
thoracodorsal bundle , medial pect nerve and Lat
thoracic nerve
15. Hemostasis ensured through out procedure
16. Estimated blood loss about 350ml, One pint blood
transfusion given intraop

TTH/F&F/EX/QR/CMM/001/2020 Page 3 of 4
 Document Title: Prepared by: Effective Date: 21/07/20
Committee Minutes Nandakishore Rajkumar, Sr. Mgr.
of Meeting format QIRM
Document No. 05 Approved by: David S. Feinberg, Last Review Date: Version:01
CEO 30/10/2019

17. Romovac drain placed 10Fr in breast and 14Fr in

Axilla
18. Closure in layers, Skin ethilon.

Follow-up Instructions
1. Review in BCC on 28/02/2022
2. Avoid pressure over the surgical site
3. Dressing to change alternate days
4. Right arm precautions and physiotherapy to
continue

2 Plan- Chemotherapy to start at the earliest

Radiotherapy to start

Signatures and date:

Chairperson: _________________________________________

Secretary: ________________________________________

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