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Fungating Breast Cancer: Experience in Low and Middle Income Country

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Indian Journal of Surgical Oncology Aims and scope Submit manuscript

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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Author notes

  1. Raouef Ahmed Bichoo and Sanjay Kumar Yadav contributed equally to this work.

Authors and Affiliations

  1. Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India

    Raouef Ahmed Bichoo, Sanjay Kumar Yadav, Anjali Mishra, Gyan Chand, Gaurav Agarwal, Amit Agarwal & Saroj K. Mishra

  2. Department of Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India

    Punita Lal

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  1. Raouef Ahmed Bichoo
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Contributions

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.

Corresponding author

Correspondence to Anjali Mishra.

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This is to declare that all authors have contributed to the study. No part of the manuscript has been sent for consideration elsewhere or published in any international or national journal. The authors clearly certify that there is no aspect of plagiarism. All the conflicts of interest have been clearly defined and the source of grant disclosed. Due ethical permission/consent has been obtained for carrying out the study. In case of any dispute, the authors will be held fully responsible for the statement disclosed in the cover letter. The authors are also aware of the copyright rules and also declare that they will not reproduce any published text without due permission from the journal.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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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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