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Background: To evaluate the effect of Tamoxifen on plasma lipid profile in breast cancer patients presenting at tertiary care hospitals. Methods: It was a longitudinal study conducted at the Department of Oncology of Jinnah Postgraduate Medical Center from December 2018 to November 2019. Eighty-eight females aged 26-66 years diagnosed with breast cancer were included in the study using a non-probability consecutive sampling technique. Detailed gynaecological and clinical investigations and detailed history were taken. The blood samples of all the patients were collected and the plasma lipid profile was measured before initiation of Tamoxifen treatment and three- and six-months post-treatment at the clinical laboratory. The plasma lipid profile includes the measurement of Total cholesterol (mg/dl), Triglyceride(mg/dl), High-density Lipoprotein (mg/dl) & Low-density Lipoprotein (mg/dl). SPSS version 23 was used to analyse data. Results: After treatment, there was a significant reduction in serum cholesterol & Low-density Lipoprotein level by 20.54 mg/dl & 16.46 mg/dl at 3 months (p<0.05), moreover there was a significant increase in Triglyceride by 22.14 at 3 months (p<0.05). No significant difference was observed in High density lipoprotein level at 3 months after using Tamoxifen. At 6 months there was a significant reduction in serum cholesterol and low-density lipoprotein by 32.29mg/dl and 24.11 mg/dl at 6 months (p<0.05), moreover there was a significant increase in Triglyceride level by 42.19 mg/dl at 6 months (p<0.05). No significant difference was observed in High-density lipoprotein level at 6 months after using Tamoxifen. Conclusion: Total cholesterol and Low-density Lipoprotein levels showed significant reduction over the period of six months from the baseline with the use of Tamoxifen. Hence Tamoxifen should be considered to have an added advantage on lipid metabolism and therefore, can reduce the risk of cardiovascular events. [ABSTRACT FROM AUTHOR]

Objective: To assess the correlation between tumor size and stage of tumor among BMI categories in females presenting with breast cancer at a tertiary care hospital of Karachi. Study Design: Cross-sectional study. Place and Duration of Study: Department of Medical Oncology, Jinnah Postgraduate Medical Center, Karachi Pakistan, from Nov 2018 to Dec 2019. Methodology: One eighty-seven women presenting with histologically proven breast carcinoma of age more than 20 years were included. Body Mass Index was estimated by dividing weight in kilogram with height in meter square (BMI=Weight/Height kg/m²). The data regarding histological type and grade, stage of tumor, tumor size, lymph node status, hormone receptor status and menopausal status were also collected. Results: On comparing body mass index categories with clinic-pathological factors; menopausal status, ER status, PR status, HER 2/Neu status and lymph node status showed statistically significant difference between groups (p<0.05). Underweight patients showed very strong correlation between stage and tumor size (r=0.894), whereas obese (r=0.678) and normal weight (r=0.676) females showed strong correlation between stage and tumor size. Conclusion: In conclusion, the present study reveals that body mass index is significantly associated with menopausal status, ER status, PR status, HER 2/Neu status and lymph node status. Though obesity is a modifiable factor which carries risk of developing fatal diseases, data relevant to obesity and breast cancer outcomes is still erratic. We further recommend more indepth study in this context. [ABSTRACT FROM AUTHOR]

Objectives: To find the association of breastfeeding and the risk of breast cancer in our population. Study Design: Case-control study. Place and Duration of Study: Oncology Ward-4 at Jinnah Postgraduate Medical Center, Karachi Pakistan, from Jun 2018 to Jun 2019. Methodology: All patients with diagnosed Breast Cancer visiting the outpatient department were enrolled in this study. Controls were randomly selected from the community. Demographic characteristics, reproductive history, breastfeeding pattern, and hormonal status of cancer were collected from all participants. Results: Among patients who had a positive history of breastfeeding were three times more likely to develop breast cancer than those with no history of breastfeeding [Odds Ratio 3.315 (95% Confidence Interval: 2.094-5.249)]. 69.7% of participants in our study breastfed for more than 2 years. There was also a weak inverse association between lactation amenorrhea and breast cancer risk. Women who experienced lactation amenorrhea had only half the risk of women who did not experience lactation amenorrhea [Odds Ratio 0.685 (95% of Confidence Interval: 0.397-1.182)]. Conclusion: There was a negative relationship between breast cancer and breastfeeding. Further research should explore the genetic and cultural differences and the risk of breast cancer. [ABSTRACT FROM AUTHOR]

Objective: To assess the frequency of lymphedema of the arm and forearm after complete axillary lymph node dissection in patients with breast cancer at one year of follow-up and see its association with body mass index among breast cancer patients presenting at a tertiary care hospital in Karachi. Study Design: Prospective longitudinal study. Place and Duration of Study: Department of Medical Oncology, Jinnah Postgraduate Medical Center, Karachi, Pakistan, from Apr 2019 to 2020. Methodology: One sixty-eight females of age 25-80 years who underwent complete axillary lymph node dissection for breast cancer were included in the study. A breast surgeon performed the axillary lymph node dissection with more than five years of experience. The patients were followed for one year post-operatively to determine the occurrence of lymphedema. All the demographic details and clinic-pathological findings were reported in the predesigned proforma. Results: About 168 females (97.6%) out of 172 have undergone complete axillary lymph node dissection. Lymphedema was the most common complication among them (38.1%). Common side effect observed after axillary lymph node dissection was pain (66.1%), followed by heaviness (59.5%), firmness/tightness (46.4%) and numbness. The patients with Body mass index = 25 kg/m2, right arm involved, exposure to radiotherapy and moderately differentiated tumour (grade-2) had a significantly higher occurrence of lymphedema (p<0.05). Conclusion: Lymphedema is higher among breast cancer survivors during the first postoperative year. The risk of lymphedema can be reduced by avoiding potential factors like obesity and carefully selecting patients for postoperative radiotherapy. [ABSTRACT FROM AUTHOR]