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Objective: To evaluate the distribution of histological grades of breast cancer and its association with HER2/neu expression. Study Design: Cross-sectional study. Period: March 2024 to August 2024. Setting: Oncology, Jinnah Postgraduate Medical Center, Karachi, Pakistan. Methods: Patients diagnosed with breast carcinoma, with complete records for molecular subtype and hormone receptor status, and no history of recurrent, metastatic, or multiple cancers. Exclusion criteria were patients who refused participation, had benign lesions, or received neoadjuvant chemotherapy prior to presentation, were analyzed. Demographics, tumor site, histological grade, stage at diagnosis, and hormone profile of the patients were documented using a structured questionnaire. Results: In a total of 286 patients, 233 (81.5%) were over 40 years old, while 164 (57.3%) were overweight or obese. There were 257 (89.9%) patients who belonged rural areas of residence. The family history of breast cancer was noted among 42 (14.7%) women. A significant percentage of participants were HER2/neu positive, with expression varying across different tumor grades. Almost all patients with Grade I, Grade III, and Grade IV tumors were HER2/neu positive (100%, 99%, and 100%, respectively), while a slightly lower percentage was observed in Grade II tumors (95.9%). Conclusion: The nearly ubiquitous HER2/neu positivity observed across most tumor grades, with only a slight reduction in Grade II tumors, underscores the high prevalence of HER2/neu expression in this population. Routine HER2/neu testing in Pakistani breast cancer patients seems important, irrespective of tumor grade, for prognosis and treatment decisions. [ABSTRACT FROM AUTHOR]

Objective: To see the association between dietary habits in the development of oesophageal carcinoma. Study Design: Case control study. Place and Duration of Study: Department of Medical Oncology at Jinnah Postgraduate Medical Centre, Karachi Pakistan, from Feb 2019 to Dec 2019. Methodology: Patients from age 15-80 years of either gender were included in the study. All the patients presenting to hospital OPD with histopathologically confirmed of oesophagus carcinoma were included. Controls were the healthy attendants coming at the same hospital. The data was collected through pre-designed questionnaire. Results: Total of 173 cases and 173 controls were included in the study. The mean age of the cases and controls were reported as 48.07±14.13 years and 48.86±15.32 years. After adjusting odds in multivariate analysis family history of cancer (OR=3.76; 95% CI: 1.76-7.90, p<0.05), the consumption of chicken (OR=5.22; 95% CI: 3.01-9.056, p<0.05), red meat (OR=5.06; 95% CI: 2.70-9.46, p<0.05) & smoked food (OR=3.36; 95% CI: 1.76-6.44, p<0.05) more than three times per week remained positively associated with oesophagus carcinoma. Conclusion: The study showed association between consumption of chicken, red meat, hot drinks & smoked food with oesophageal carcinoma. [ABSTRACT FROM AUTHOR]

Objective: to find an association between the serum CA-125 level and the histopathological type of ovarian tumor. Study Design: Cross-sectional study. Place and Duration of Study: Medical Oncology, Jinnah postgraduate Medical Center, Karachi Pakistan from Jan 2018 to Dec 2019. Methodology: This study included 107 patients presenting with epithelial ovarian cancer. In each case, histological type, pathological stage, degree of differentiation and serum CA-125 was evaluated. The association between preoperative CA-125 and histopathological type of tumor were evaluated. Result: About 107 ovarian cancer patients were included. The mean age in our study was 50.80±10.16 years. Raised CA-125 level was found in most of the patients with serous histology 46(56.1%). Conclusion: Serum level CA-125 elevated in most patients with serous histology. A statistically non-significant association was found between raise CA-125 levels and histological types of ovarian cancer. [ABSTRACT FROM AUTHOR]

Objective: To see the type and frequency of lymphomas. Study Design: Prospective longitudinal study. Place and Duration of Study: Department of Medical Oncology at Jinnah Postgraduate Medical Centre, Karachi from Jan 2019 to Dec 2019. Methodology: Total of 150 patients with histopathological diagnoses of lymphoma of 17 to 71 years of age of either gender were included in the study using non-probability consecutive sampling technique. Prior to initiation of study ethics review committee has approved the study (NO.F.2-81-IRB/2019-GENL/10261/JPMC). The data regarding lymphoma type, histology, stage of disease, site, involvement of bone marrow, presence of B-symptoms were recorded. Results: Majority of the patients were male i.e., (n=104, 69.3%) with the mean age of 45.29±17.76 years. Non-Hodgkin's Lymphoma presented as the most common type of lymphoma i.e., (n=107, 71.3%) whereas Hodgkin's lymphoma (HL) contributed for (n=43, 28.7%) cases. Assessment of clinicopathological features of lymphomas revealed that (n=58, 38.7%) cases had bone marrow involvement. B-symptoms appeared in (n=102, 68%) cases, (n=61, 40.7%) cases were stage IV and the most common site were Neck lymph nodes (n=82, 58.3%), followed by abdomen (n=20, 13.3%). There was statistically significant difference between type of lymphoma with respect to age (p=0.001) and gender(p=0.015) Conclusion: Among lymphomas the most common type of lymphoma was Non-Hodgkin's Lymphoma, most common in patients >45 years of age showing relationship of its occurence with age and DLBCL is major subtype and among Hodgkin's lymphoma Classical type is the predominant type Epidemiologic characteristics and distribution of the disease varies with geographical region, racial & environmental factors. [ABSTRACT FROM AUTHOR]

Objective: To determine the association of different risk factors other than genetic factors in patients having colorectal carcinoma. Study Design: Case control study. Place and Duration of Study: Medical Oncology Department, Jinnah Postgraduate Medical Center, Karachi Pakistan, from Jan 2019 to Jan 2020. Methodology: A total of 200 patients of age more than 10 years of either gender were included in the study. Hundred were cases of newly diagnosed colorectal cancer and 100 were healthy controls. The data regarding socio-demographics and risk factors other than genetic risk factors was collected through pre-designed questionnaire. Results: The mean age of the cases was 42.76±15.02 and the controls were 39.42±14.03 years. After adjusting odds in multivariate analysis, physically inactive (OR=0.40; 95% CI: 0.16-0.98, p<0.05), low fruits and vegetable intake (OR=0.42; 95% CI: 0.22-0.82, p<0.05), processed meat intake (OR=2.00; 95% CI: 1.01-3.96, p<0.05) and fats intake (OR=5.12; 95% CI: 2.68-9.76, p<0.05) remained positively associated with colorectal carcinoma. Conclusion: Higher risk of developing colorectal carcinoma is associated with obesity, low fruits and vegetables intake, high red meat consumption, processed meat consumption, fats intake, physical inactivity and working during night. The initiative for screening would be helpful in determining the colorectal carcinoma at an early stage. Early diagnosis will increase the survival rate and help increasing long term prognosis of the colorectal carcinoma. [ABSTRACT FROM AUTHOR]

Background: Tamoxifen is a selective oestrogen receptor modulator; in the breast, it decreases the growth and proliferation of breast epithelial cells. We assessed the weight change after Tamoxifen use in breast cancer patients. Methods: This was a single-centred, prospective, observational cohort study. All patients diagnosed with breast cancer with ER and/or PR positivity were enrolled in the study. Out of these, 90 patients who have been prescribed Tamoxifen treatment either in adjuvant or palliative setting gave their consent to participate. Demographic data, treatment plan, menstrual status, weight, BMI, serum fasting lipid profile, change in diet, and change in physical activity were recorded at the time of diagnosis and then quarterly until 1 year of treatment. Results: A mean age of 42.12±8.5 years was reported, and the mean weight was 62.22±10.6 kg. The majority of the patients, i.e., 68 (75.55%) had advanced tumour stages (III and IV). The study reported that the mean weight of the patients changed significantly at different time intervals during the treatment course (p<0.0005). Moreover, there was an upward trend in weight from the time of starting Tamoxifen to 3-months (62.22±1.51 kg vs 62.88±1.45 kg, respectively). There was a statistically significant increase in weight at 6-month, 9-month, and 12-month of Tamoxifen treatment (63.72±1.46 kg, 64.35±1.42 kg, 65.12±1.44 kg, respectively). Also, most of the patients gained weight as time passed by. Conclusion: This study indicated that Tamoxifen has a significant correlation with the increase in weight in hormone receptor-positive breast cancer patients in our population. [ABSTRACT FROM AUTHOR]

This study was conducted to see the frequency of hormone receptors and Her-2/Neu positivity in different histology in breast cancer patients. Methods: It was a cross-sectional study conducted at the Department of Medical Oncology, Jinnah Postgraduate Medical Centre from June 2018- March 2019. Total 373 patients of age 22–81 years of which 360 female and 13 males, with histopathological proven diagnosis of breast cancer were included in the study using non-probability consecutive sampling technique. The immunohistochemistry (IHC) was performed on biopsy sample for the status of PR, ER and HER-2/Neu and the confirmation of Her-2/Neu was done by Fluorescent In situ Hybridization (FISH) technique if HER-2/Neu was equivocal by IHC testing. Information regarding demographics, family history, histology, grade, stage, metastatic site and other histopathological parameters were noted on predesigned proforma by the researcher. SPSS-23 was used to analyse data. Results: Total of 373 patients were included in the study. The mean patient age was 45.34±12.28 years. ER, PR, Her 2 Neu (IHC) & Her 2 Neu (FISH) were found positive in 206 (55.2%), 182 (48.8%), 121 (32.4%) & 23 (6.2%) patients, respectively. The histology with PR receptor & grade of tumour with ER & PR receptor showed statistical significance (p<0.05). Conclusion: ER, PR &HER-2/NEU expressions in breast cancer vary among different population and it is very important to find out the frequency among different histopathological types as it is of predictive and prognostic value. So, it is recommended to look for these markers and treat them accordingly. [ABSTRACT FROM AUTHOR]

Background: Acute myeloid leukaemia (AML) is malignant neoplasms of myeloid cells categorized by clonal expansion of hematopoietic blasts of myeloid lineage in peripheral blood and bone marrow. The aim of current study is to identify the common cytogenetic abnormalities in AML patients presenting at a tertiary care hospital of Pakistan. Methods: It was a cross-sectional study conducted at the department of Medical oncology of the Jinnah Postgraduate Medical Center, Karachi from Jun 2017- Jan 2019. The non-probability consecutive sampling technique was used to select patients. Total 92 cases of AML of age 15–55 years of either gender were included in the study. The detection of cytogenetic abnormality was done on the bone marrow biopsy. The cytogenetic abnormalities were classified into the three cytogenetic risk groups as favourable, intermediate and unfavourable. For analysis of data SPSS 23 version was used. Results: The cytogenetic abnormalities were detected in 34 (37%) of the AML patients while 58 (63%) patients had normal cytogenetic. Thirty-two females (34.8%) had a normal cytogenetic (46; XX), and 15 females (16.3%) had various cytogenetic abnormalities. Twenty-six males (28.3%) had normal cytogenetic (46; XY) and 19 males (20.7%) had various cytogenetic abnormalities. Most of the patients were in intermediate risk group (67.4%), followed by favourable (17.4%) and unfavourable risk group (15.2%). The most frequent chromosomal abnormalities observed were complex cytogenetic which was detected in 5 AML patients. Conclusion: In the present study cytogenetic abnormalities were found in 37% of AML patients. Sixty-seven of the AML patients were in intermediate risk group and five patients had complex cytogenetic. Hence the cytogenetic analysis provides significant information regarding prognosis of AML patients and the cytogenetic abnormalities are less than international literature. [ABSTRACT FROM AUTHOR]

Background: This study was conducted to determine the frequency of amenorrhea after chemotherapy among breast cancer patients". Methods: Total 201 premenopausal females (having menstruation during the past 6 months at the time of diagnosis) of age 15-45 years and had confirmed diagnosis of breast cancer requiring chemotherapy were included in the study using non-probability consecutive sampling technique. Amenorrhea within 6 months after the completion of chemotherapy was labelled as chemotherapy induced amenorrhea. Data was entered and analysed using SPSS-23. Results: The mean age of the patients was reported as 37.06±5.68 years. Majority of the females were married (86.6%) & multigravida (81.1%). Most of the patients (23.9%) received neoadjuvant chemotherapy followed by surgery and radiotherapy. A total of 129 patients received Adriamycin plus cyclophosphamide followed by paclitaxel as chemotherapy regimen. Out of 201 females, 184 (91.5%) experienced amenorrhea after start or completion of chemotherapy. Conclusion: The frequency of CIA was very high among breast cancer patients in our study, long term follow-up is needed to see input of CIA on future fertility. [ABSTRACT FROM AUTHOR]

Objective: To determine the complete clinical response in rectal carcinoma after neoadjuvant chemo radiation. Study Design: Cross-sectional study. Place and Duration of Study: This study was conducted in Clinical Oncology department, Jinnah Postgraduate Medical Centre Karachi, from Jan 2016 to Jan 2017. Material and Methods: Seventy Two Patients meeting the inclusion criteria were enrolled in study after complete staging workup. Neoadjuvant concurrent chemoradiotherapy was planned, consisting of oral capecitabine 825mg/m² BID five days a week along with 50.4 Gy Radiotherapy with linac machine. Radiation was delivered over a period of 5 weeks at a rate of 1.8 Gy/day. Patients received Radiotherapy in Atomic Energy Medical Centre (AEMC) and in Sindh Institute Urology & Transplant (SIUT), Radiation department. Chemotherapy was given in clinical oncology department of JPMC. Sixty one patients completed planned treatment and were available for post concomitant chemo radiotherapy response assessment with Pelvic CT/MRI after 6-8 weeks of completion of concomitant chemo radiotherapy. Response assessment was done according to Response Evaluation Criteria in solid tumor (RECIST) criteria version 1.1 and then Patients were referred for surgical evaluation. Result: A total of 61 cases of locally advanced adenocarcinoma rectal cancer patients were included in the study. Mean age of the patients was 41 years with ± 17.06 years SD. Complete clinical response was identified in 4 (6.6%) while 31 (50.8%) were identified as partial response, progressive disease was 13 (21.3%) and 13 (21.3%) were with stable disease. All confounding variables were found statistically significant with p-value found less than 0.05. Conclusion: Neo-adjuvant chemoradiotherapy for locally advanced rectal cancer is associated with high rates of tumor response in terms of downs tagging (complete & partial) and is relatively safe with acceptable morbidity, which favors its use in future. [ABSTRACT FROM AUTHOR]