Publication:

Hypercalcemia in advanced cases of carcinoma breast: hospital based study

Background Hypercalcemia due to cancer is an indicator of poor prognosis, and has been often found to be associated with the disseminated form of disease. Present study describes the serum and urinary calcium levels among the advanced cases of carcinoma breast with respect to stage of disease, presence of osseous metastases and also before and after treatment. It is a hospital based study done at Government Medical College, Jabalpur in Madhya Pradesh state of India.

Methods The present hospital-based and descriptive study was done at the Surgery Department of Government Medical College at Jabalpur in Madhya Pradesh, India. 50 patients with confirmed breast cancer diagnosis were enrolled in the study. Serum calcium was estimated by Clark and Collip’s method. Urinary calcium was estimated by Sulkowitch method. Serum and urinary calcium levels were compared with respect to stage of disease, presence of osseous metastases and also before and after treatment.

Results Out of 50 cases, raised level of serum calcium and positive urinary calcium was observed in all except 2 cases of stage II disease. Serum calcium levels were found to be higher in stage III and stage IV disease and the differences were found to be statistically significant. Serum calcium level was slightly more raised in cases with osseous metastasis (mean 14.4 mg%) in comparison with cases with non-osseous metastasis (mean 13.3 mg%) however, the difference was statistically not significant. Follow up data after treatment was available for 34 cases. After treatment, reduction in serum and urinary calcium levels was noted in all stages of disease and the decrease in serum calcium levels in stage III and stage IV disease was found to be statistically significant.

Conclusions Hypercalcemia was noticed in almost all cases of advanced carcinoma breast and the serum calcium levels were significantly higher in stage III and stage IV of the disease. There was a significant decrease in serum calcium levels after treatment of the disease which was predominantly surgical treatment alone or in combination with radiotherapy or chemotherapy.