Arsenic causing gallbladder cancer disease in Bihar.

In recent times Gallbladder cancer (GBC) incidences increased many folds in India and are being reported from arsenic hotspots identified in Bihar. The study aims to establish association between arsenic exposure and gallbladder carcinogenesis. In the present study, n = 200 were control volunteers and n = 152 confirmed gallbladder cancer cases. The studied GBC patient's biological samples-gallbladder tissue, gallbladder stone, bile, blood and hair samples were collected for arsenic estimation. Moreover, n = 512 gallbladder cancer patients blood samples were also evaluated for the presence of arsenic to understand exposure level in the population. A significantly high arsenic concentration (p < 0.05) was detected in the blood samples with maximum concentration 389 µg/L in GBC cases in comparison to control. Similarly, in the gallbladder cancer patients, there was significantly high arsenic concentration observed in gallbladder tissue with highest concentration of 2166 µg/kg, in gallbladder stones 635 µg/kg, in bile samples 483 µg/L and in hair samples 6980 µg/kg respectively. Moreover, the n = 512 gallbladder cancer patient's blood samples study revealed very significant arsenic concentration in the population of Bihar with maximum arsenic concentration as 746 µg/L. The raised arsenic concentration in the gallbladder cancer patients' biological samples-gallbladder tissue, gallbladder stone, bile, blood, and hair samples was significantly very high in the arsenic exposed area. The study denotes that the gallbladder disease burden is very high in the arsenic exposed area of Bihar. The findings do provide a strong link between arsenic contamination and increased gallbladder carcinogenesis.

Evaluation of Clinicopathological Findings on 255 cases of Inoperable Locally Advanced Breast Carcinoma: A Tertiary Care Experience.

INTRODUCTION: Breast cancer is the second most common cancer in the Indian female population. LABC and metastatic breast cancer are the most common stages at presentation in most low-resource countries. Although the incidence of LABC has decreased significantly in countries with enhanced resources thanks to widespread education and screening programs, it remains a daily encounter for surgeons and oncologists in low-resource countries. Neoadjuvant therapy has been studied widely for the treatment of LABC and is followed by locoregional therapy. OBJECTIVES: As per our hospital data, breast cancer is also found to be the second leading malignancy in women and locally advanced breast cancer is the most common type of breast cancer. Hence, we undertook this study to evaluate the clinical profile, histopathologic types and grade of the disease in our patients. MATERIALS AND METHODS: This study was undertaken over a period of three years comprising of 255 patients who underwent modified radical mastectomy following neoadjuvant chemotherapy after preliminary diagnosis of carcinoma on histopathological examination of the trucut biopsy specimens. Clinicopathological evaluation was done in all of these cases following standard protocols. RESULTS: The study comprised of 252 female patients and 3 male patients in the age range of 26 to 70 years. Majority (255, 66.6%) of the cases were within the age range of 31­60 years. Three females had bilateral breast cancer. Invasive ductal carcinoma no special type was the most common histopathologic pattern, and was seen in 254 (98.4%) cases. Most tumors were Scarff Bloom Richardson grade II and American Joint Committee on Cancer pathologic stage 3. CONCLUSIONS: The present study has provided information about the clinicopathological aspects of locally advanced breast cancer in patients who are from rural areas. LABC remains a daily encounter and challenge for medical and surgical oncologists in developing low-resource countries. Neoadjuvant chemotherapy is recommended for inoperable LABC at all resource levels.