ABSTRACT
Breast cancer (BC) is a heterogeneous disease. Numerous chemotherapeutic agents are available for early stage or advanced/metastatic breast cancer to provide maximum benefit with minimum side effects. However, the clinical outcome of patients with the same clinical and pathological characteristics and treated with similar treatments may show major differences and a vast majority of patients still develop treatment resistance and eventually succumb to disease. It remains an unmet need to identify specific molecular defects, new biomarkers to enable clinicians to adopt individualized treatment for every patient in terms of endocrine, chemotherapy or targeted therapy which will improve clinical outcomes in BC. Our study aimed to identify frequent hotspot mutation profile in BC by targeted deep sequencing in cancer-related genes using Illumina Truseq amplicon/Swift Accel-Amplicon panel and MiSeq technology in an IRB-approved prospective study in a CLIA compliant laboratory. All the cases had pathology review for stage, histological type, hormonal status and Ki-67. Data was processed using Strand NGS™. Mutations identified in the tumor were assessed for 'actionability' i.e. response to therapy and impact on prognosis.
ABSTRACT
INTRODUCTION: Neglected knee dislocations are a rare entity. They present with gross degenerative changes and ligament laxity. There is no defined protocol for the treatment of arthritic knees in neglected knee dislocations. CASE REPORT: A 54-year-old male presented with pain and limp over his left knee after sustaining a knee dislocation 25 years back which was unsuccessfully reduced by open methods twice. Since the patient was a farmer and involved in heavy labor activities, we decided to avoid arthrodesis of his knee and help him ambulate immediately without any functional limitations. We performed a hinged total knee arthroplasty (TKA) which corrected the deformity, ligament laxity, and pain and helped him gain complete range of movements. The patient was followed-up till 30 months after the surgery with excellent clinical and radiological results. CONCLUSION: A hinged TKA is a reliable technique to correct a neglected knee dislocation in a single sitting provided thorough pre-operative assessment and post-operative physiotherapy are done.
