Terence B. Culas is currently working as Principal of Government Medical College, Palakkad, India since April 2014. He completed his MBBS from St. John’s medical college, Bangalore University and M.S (general surgery) from Govt. Medical College, Kerala University. He worked as Professor and Head of Department of surgery, Govt. Medical College, Thrissur since 2003 to 2005. Also he worked as full time consultant & Associate prof (contract), Government Medical College, Thrissur, June 2011 to march 2014.


In premenopausal women with breast cancer, adjuvant chemotherapy has alone reduced the annual odds of recurrence by 37% and mortality by 27%. Ovarian ablation by surgical means has on its own shown a similar picture with 30% reduction in risk of recurrence and 38% reduction in the incidence of mortality. The clinical benefit of such reduction is now understood to be based on the role of estrogen receptor (ER). The benefit of Chemotherapy seems act through the effect of chemical ovarian ablation (either totally or partially). Thus, surgical ovarian ablation may be considered as an adjuvant therapy in premenopausal women who refuse chemotherapy, who are ER positive and who have completed their families and who cannot be relied upon to come for regular clinical follow up. Surgical ovarian ablation can be done laparoscopically along with modified radical mastectomy and obtain the same results as chemotherapy minus its toxic side effects.

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