Background:In developing countries like India, advanced metastatic disease is not an uncommon initial presentation of carcinoma breast.Understanding the heterogeneity and regional variation of breast cancer in Indian population, we intend to study the pattern of metastatic breast carcinoma in our rural population.We also emphasized and advocated the idea of its early diagnosis and palliation, so as to reduce its associated morbidity and mortality.
Aim:We studied the common metastatic sites of carcinoma breast and its association with recurrences. We also assessed the axillary lymph node involvement and its relation to lung metastasis (locoregional spread).
Methods:A retrospective study was done from 1992-2014. Records of 1265 rural patients of carcinoma breast admitted over a period of 23 years were used for data analysis. Only patients with complete records were included in the analysis.
Results:Unfortunately 13.2% patients had metastatic disease with mean age group of 41-50 years (35.9%). 61.07% of them were in their postmenopausal period. 40.11% patients with metastasis had their lump in upper outer quadrant and in 24.55% had multiquadrant involvement. Size of breast lump was more than 5 cm in 58.08%. More than 5 lymph nodes were positive in 32.33% cases. 15.58% patients had loco regional recurrence. Metastasis was seen in liver (31.6%), lung (20.95%), bone(11%) and other organs. ER, PR was negative in 66% cases with patients having a median survival of 24.70 months. Patients with triple negativity of receptors had a survival of 25.54 months. Lymph node positive patients had a survival of 3.13 years. Post metastatic survival was less than 6 months in 45.45% cases.
Conclusions:The high velocity with which this metastatic breast carcinoma is affecting our rural population, it is our responsibility to encourage the government to implement breast cancer screening programme with stress on public health education in rural areas.