Professional Documents
Culture Documents
Case Discussions in Breast Cancer
Case Discussions in Breast Cancer
BREAST CANCER
DR. KUMAR SAURABH
MD,DM
CONSULTANT MEDICAL ONCOLOGIST
SHAMBHAVI CENTRE FOR CANCER AND GYNECOLOGY&
HCG,RANCHI
CASE 1
35 YEAR OLD LADY PRESENTED WITH A 7
MONTH HISTORY OF PAINLESS LEFT BREAST
MASS
NO FAMILY HISTORY OF BREAST CANCER
WHAT NEXT?
PATIENT WENT TO TMC KOLKATA WHERE A
TRUCUT BIOPSY WAS DONE AND IT REVEALED
AN ER/PR NEGATIVE AND HER2 NEU 2+ TUMOR
NEXT?
FISH FOR HER2 NEU WAS DONE AND IT CAME
OUT TO BE POSITIVE
PATIENT WAS GIVEN A CHOICE FOR BCS VS MRM
AND OPTED FOR BCS
SENTINEL LYMPH NODE BIOPSY WAS DONE AND
IT CAME OUT TO BE NEGATIVE
PATIENT WAS STARTED ON NEOADJUVANT
CHEMOTHERAPY WHICH CONSISTED OF 4
CYCLES OF EC FOLLOWED BY 12 CYCLES
WEEKLY PACLITAXEL PLUS TRASTUZUMAB
THE PATIENT HAD A GOOD CLINICAL RESPONSE
TO THERAPY AND UNDERWENT BCS
Tumor Cell Stimulation
ATP ATP
TK TK
Cell Antiapoptosi
Proliferation s
Angiogenesis
Strategies to Inhibit Signaling
tyrosine Anti- mAbs Anti-ligand
kinase mAbs
“-mab”
inhibitors “-mab”
“-ibs”
ATP TK TK TK
- -
-
SURGICAL PATHOLGY REPORT WAS
SUGGESTIVE OF RESIDUAL TUMOR
POST OP RT WAS GIVEN AND PATIENT WAS
STARTED ON TDM1 WHICH WAS GIVEN FOR 1
YEAR AND PATIENT IS CURRENTLY ON
TREATMENT
TAKE HOME MESSAGE
ALWAYS DO A METASTATIC W/UP BEFORE SURGERY
IN A CASE OF BREAST CANCER
TRUCUT BIOPSY IS THE CURRENT STANDARD FOR
DIAGNOSIS
PREFERABLE TO KNOW THE RECEPTOR STATUS
BEFORE PROCEEDING
NACT IS PREFERRABLE IN MOST HER2 POSITIVE
AND TNBC CASES EVEN IN EARLY STAGES AND MAY
BECOME THE STANDARD OF CARE IN NEAR FUTURE
LOTS OF DEVELOPMENTS IN FORM OF NEW DRUGS
WHICH HAS LED TO INCREASED SURVIVAL WITH A
GOOD QOL EVEN FOR METASTATIC BREAST CANCER
CASES
Thank
You