Fungating Breast Cancer: Experience in Low and Middle Income Country

Abstract

Fungating breast cancer (FBC) is a rare entity in developed nations. But this occurrence is not uncommon in our country. The aim of this study was to review clinico-pathologic profile and outcomes of FBC in a developing country. This retrospective study consisted of patients with FBC managed at our institute (Jan 2005–Dec 2015). Clinico-pathologic profile, management details, and outcomes were analyzed. The Kaplan-Meier method was used to determine overall survival (OS). Log-rank test was performed to compare survival in various subgroups. Seventy-nine patients were detected to have FBC constituting 3.3% of all breast cancers and 24.8% of those having T4b lesions. Mean age of the patients was 55 + 11 years. Ninety-six percent were women and 67% belonged to rural areas. A total of 75% women were postmenopausal. Mean duration of lump was 16 + 11 months. The mean tumor size was 8+ 2 cm. Eighty-seven percent had axillary lymph node involvement and 42% distant metastases. Fifty-eight percent (n = 46) patients had stage III and 42% (n = 33) stage had IV tumors. Hormone receptor (HR) positivity was noted in 44% (n = 35) and HER2/neu overexpression in 39% (n = 31) tumors, whereas 32% (n = 25) were triple negative. Overall, 95% (n = 75) of patients received chemotherapy, 91% (n = 72) patients underwent mastectomy, and 76% (n = 60) loco-regional radiotherapy. Median duration of follow-up was 40 (2–93) months. Median survival was 36 months, and 5-year OS was 40%. Except for stage (53% vs 22%, p = 0.005), no other factor influenced OS. Multimodality therapy in FBS results in good symptom palliation and comparable survival to stage III and IV patients without fungating tumors.

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Raouef Ahmed Bichoo, Sanjay Kumar Yadav, Anjali Mishra-literature search, figures, study design, data collection, data analysis, data interpretation, and writing.

Saroj Kanta Mishra, Gyan Chand, Gaurav Agarwal, Amit Agarwal, Punita Lal-revision and editing of manuscript.

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Correspondence to Anjali Mishra.

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Bichoo, R.A., Yadav, S.K., Mishra, A. et al. Fungating Breast Cancer: Experience in Low and Middle Income Country. Indian J Surg Oncol 11, 281–286 (2020). https://doi.org/10.1007/s13193-020-01040-7

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Keywords

  • Breast cancer
  • Ulcerated primary
  • LMIC