30 yrs female presented with unilateral breast cancer associated with axilary lymph node enlargement. Modified radical mastectomy was done, fuhur traeatment plan will be
. Chemotherapy in Carcinoma Breast (Indications) * In advanced carcinoma breast as a palliative procedure. * In postoperative period after simple mastectomy in stage III carcinoma breast with fixed axillary nodes. * In inflammatory carcinoma of breast. * In stage IV carcinoma breast with secondaries in bone, lungs, liver. * In premenopausal age group with poorly differentiated tumours. Toxic effects are: Alopecia, bone marrow suppression, cystitis, megaloblastic anaemia, GIT disturbances, nephritis. * Neoadjuvant (primary) chemotherapy is useful in large operable primary tumour to make it amenable for conservative breast surgeries. Post operative radiotherapy and chemotherapy is a must in this situation. * High dose chemotherapy with stem cell rescue is not found to be beneficial by trials in patients with heavy large nodal spread. ref:SRB&;s manual of surgery,ed 3,pg no 487
Observation and followup
Adriamycin based chemotherapy followed by tamoxifen depending on estrogen\/progesterone receptor status
Adriamycin based chemotherapy only
Tamoxifen only
Endocrinology and breast