SlideShare uma empresa Scribd logo
1 de 57
Breast  Conservation Therapy IRCH-AIIMS Experience Dr. Manish Varma, Dr. SVS Deo, Dr.NK Shukla,  Dr. Vinod Raina*, Dr.GK Rath** Dept. of Surgical , Medical* and Radiation oncology**, IRCH, AIIMS, New Delhi
Evolution  of  Surgery for BC Ultra Radical Early 19 th Century Conservation,  Reconstruction 20 th century Radical Late 19 th Century
Morbidity of Mastectomy  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Evolution of Modern BCT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Rationale of BCT ,[object Object],[object Object],[object Object],[object Object],[object Object]
Rationale of BCT ,[object Object],[object Object],[object Object],[object Object]
Surgery and Radiation as combined modality ,[object Object],[object Object]
Randomized Trials  - BCT  vs  MRM   Group  No  10 Yr Survival (%)  Loc. Rec(% ) BCT  -  MRM  BCT - MRM NSABP  2105  62  -  62  10  -  8 French  179  78  -  79  7  -  9 Milan  701  71  -  69  4  -  2 EORTC  903  75  -  75  13  -  9 Danish  905  79  -  82  3  -  4 NCI  237  77  -  75  17  -  9
Randomized Trials - BCT vs MRM ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NCI  Consensus Conference - EBC  In early breast cancer  breast conservation treatment is not only equivalent to mastectomy but also preferable  as it preserves the breast with all the attendant psychological and breast image advantages there by enhancing quality of life.
BCT - Multidisciplinary approach ,[object Object],[object Object],[object Object],[object Object],[object Object]
Goals of  Breast  Conservation ,[object Object],[object Object],[object Object],[object Object]
Breast  Conservation Therapy Patient Selection ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Contraindications to BCT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Contraindications to BCT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
BCT  Surgical  Margins  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Breast Conservation Surgery Indications for Re-excision ,[object Object],[object Object],[object Object],[object Object]
Breast Conservation Therapy Radiotherapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Breast Conservation Therapy Tumor Bed Boost
Breast Conservation Therapy Tumor Bed Boost
Breast Conservation Therapy: Radiotherapy  ,[object Object],[object Object],[object Object],[object Object],[object Object],Group  No.  Local Failure  (%) - RT  + RT NSABP '92  1141  39  12 Ontario '92  837  26  6 Milan  '93  567  9  0.3 Sweden '94  381  20  3
BCT- Recent Advances ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
BCT- Recent Advances ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
BCT- Recent Advances Surgery -  Oncoplastic Techniques – BCS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Oncoplastic Techniques for BCS :  Volume Displacement
Oncoplastic Techniques for BCS :  Volume Replacement -Mini Latissimus Dorsi flap (MLDF) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Mini Latissimus Dorsi flap (MLDF)
Mini Latissimus Dorsi flap (MLDF)
BCT- Recent Advances  MRI  in  BCT ,[object Object],[object Object],[object Object],[object Object]
BCT- Recent Advances  MRI  in  BCT
BCT- Recent Advances  MRI  in  BCT
BCT – Pushing Frontiers ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
BCT – Pushing Frontiers ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
BCT – Pushing Frontiers ,[object Object],[object Object],[object Object]
Mammo guided wire localization and lumpectomy
BCT – Pushing Frontiers ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
BCT in LABC post NACT ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],BCT in LABC post NACT
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],BCT in LABC post NACT
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],BCT in LABC post NACT
BCT  Rates ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Breast conservation therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Breast Conservation Therapy:  IRCH Treatment Protocol ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Breast Conservation Therapy:  IRCH Treatment Protocol ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Breast Conservation Therapy:  IRCH Treatment Protocol
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Breast Conservation Therapy:  IRCH Treatment Protocol
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Breast Conservation Therapy:  IRCH Treatment Protocol
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Breast Conservation Therapy:  IRCH Treatment Protocol
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Breast Conservation Therapy:  IRCH Treatment Protocol
IRCH –AIIMS Experience ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
IRCH –AIIMS Experience 50% 14.7% 20.5% 6.3% 6.8% Site
IRCH –AIIMS Experience ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
IRCH –AIIMS Experience ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
IRCH –AIIMS Experience 5 yr DFS – 76%
IRCH –AIIMS Experience 5 yr OS – 92%
Conclusions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Thank You ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Mais conteúdo relacionado

Mais procurados

Mais procurados (20)

oncoplasty breast
oncoplasty breast oncoplasty breast
oncoplasty breast
 
Landmark trials in breast Cancer surgery - NSABP 04,06,MILAN,EORTC 10853, ECO...
Landmark trials in breast Cancer surgery - NSABP 04,06,MILAN,EORTC 10853, ECO...Landmark trials in breast Cancer surgery - NSABP 04,06,MILAN,EORTC 10853, ECO...
Landmark trials in breast Cancer surgery - NSABP 04,06,MILAN,EORTC 10853, ECO...
 
Peritoneal Carcinomatosis : Dr Amit Dangi
Peritoneal Carcinomatosis :  Dr Amit DangiPeritoneal Carcinomatosis :  Dr Amit Dangi
Peritoneal Carcinomatosis : Dr Amit Dangi
 
management of early breast cancer
management of early breast cancermanagement of early breast cancer
management of early breast cancer
 
Oncoplastic Breast Surgery; Principles of Techniques and Indications
Oncoplastic Breast Surgery; Principles of Techniques and IndicationsOncoplastic Breast Surgery; Principles of Techniques and Indications
Oncoplastic Breast Surgery; Principles of Techniques and Indications
 
LOCALLY ADVANCED BREAST CANCER
LOCALLY ADVANCED BREAST CANCERLOCALLY ADVANCED BREAST CANCER
LOCALLY ADVANCED BREAST CANCER
 
Accelerated partial breast irradiation
Accelerated partial breast irradiationAccelerated partial breast irradiation
Accelerated partial breast irradiation
 
Landmark trials in breast cancer.pptx
Landmark trials in breast cancer.pptxLandmark trials in breast cancer.pptx
Landmark trials in breast cancer.pptx
 
Basic Principles of Oncoplastic breast surgery
Basic Principles of Oncoplastic breast surgeryBasic Principles of Oncoplastic breast surgery
Basic Principles of Oncoplastic breast surgery
 
Accelerated partial breast irradiation
Accelerated partial breast irradiationAccelerated partial breast irradiation
Accelerated partial breast irradiation
 
Breast Conservation Treatment
Breast Conservation TreatmentBreast Conservation Treatment
Breast Conservation Treatment
 
Cross trial esophagus updated result
Cross trial esophagus updated resultCross trial esophagus updated result
Cross trial esophagus updated result
 
Management of Axilla in Breast Cancer
Management of Axilla in Breast CancerManagement of Axilla in Breast Cancer
Management of Axilla in Breast Cancer
 
Total Neoadjuvant therapy in locally advanced carcinoma Rectum
Total Neoadjuvant therapy in locally advanced carcinoma RectumTotal Neoadjuvant therapy in locally advanced carcinoma Rectum
Total Neoadjuvant therapy in locally advanced carcinoma Rectum
 
RAPIDO Trial
RAPIDO Trial RAPIDO Trial
RAPIDO Trial
 
Crs+hipec— jeddah,
Crs+hipec— jeddah,Crs+hipec— jeddah,
Crs+hipec— jeddah,
 
Management of Carcinoma Rectum.pptx
Management of Carcinoma Rectum.pptxManagement of Carcinoma Rectum.pptx
Management of Carcinoma Rectum.pptx
 
Gall bladder cancer management
Gall bladder cancer managementGall bladder cancer management
Gall bladder cancer management
 
Apbi
ApbiApbi
Apbi
 
Portec 3
Portec 3Portec 3
Portec 3
 

Destaque

Breast reconstruction manish jian
Breast reconstruction manish jianBreast reconstruction manish jian
Breast reconstruction manish jian
Manish Jain
 
Breast Cancer Webinar
Breast Cancer WebinarBreast Cancer Webinar
Breast Cancer Webinar
Mercy Health
 
Targeted Agents in Breast Cancer: Examining Advances in Management of Breast ...
Targeted Agents in Breast Cancer: Examining Advances in Management of Breast ...Targeted Agents in Breast Cancer: Examining Advances in Management of Breast ...
Targeted Agents in Breast Cancer: Examining Advances in Management of Breast ...
Breast Health Collaborative of Texas
 
Latissimus dorsi flap for reconstruction in head and neck deffects
Latissimus dorsi flap for reconstruction in head and neck deffectsLatissimus dorsi flap for reconstruction in head and neck deffects
Latissimus dorsi flap for reconstruction in head and neck deffects
Javed Akhtar
 
Local Regional Treatment: Examining Advances in Management of Breast Cancer, ...
Local Regional Treatment: Examining Advances in Management of Breast Cancer, ...Local Regional Treatment: Examining Advances in Management of Breast Cancer, ...
Local Regional Treatment: Examining Advances in Management of Breast Cancer, ...
Breast Health Collaborative of Texas
 
Breast Reconstruction - Jane Rothwell
Breast Reconstruction - Jane RothwellBreast Reconstruction - Jane Rothwell
Breast Reconstruction - Jane Rothwell
Irish Cancer Society
 

Destaque (20)

Breast Cancer: Dr. Patty Tenofsky
Breast Cancer: Dr. Patty TenofskyBreast Cancer: Dr. Patty Tenofsky
Breast Cancer: Dr. Patty Tenofsky
 
4 breast conservative_therapy_remi_salmon
4 breast conservative_therapy_remi_salmon4 breast conservative_therapy_remi_salmon
4 breast conservative_therapy_remi_salmon
 
New Advances in Treating Breast Cancer
New Advances in Treating Breast CancerNew Advances in Treating Breast Cancer
New Advances in Treating Breast Cancer
 
Breast Reconstruction
Breast ReconstructionBreast Reconstruction
Breast Reconstruction
 
Indications for breast reconstruction
Indications for breast reconstructionIndications for breast reconstruction
Indications for breast reconstruction
 
Advances in the management of breast cancer
Advances in the management of breast cancerAdvances in the management of breast cancer
Advances in the management of breast cancer
 
Breast reconstruction manish jian
Breast reconstruction manish jianBreast reconstruction manish jian
Breast reconstruction manish jian
 
Breast Surgery for Medical Finals
Breast Surgery for Medical FinalsBreast Surgery for Medical Finals
Breast Surgery for Medical Finals
 
Breast Reconstruction Options Following a Mastectomy
Breast Reconstruction Options Following a MastectomyBreast Reconstruction Options Following a Mastectomy
Breast Reconstruction Options Following a Mastectomy
 
Current concepts in_breast_reconstruction following Mastectomy
Current concepts in_breast_reconstruction following MastectomyCurrent concepts in_breast_reconstruction following Mastectomy
Current concepts in_breast_reconstruction following Mastectomy
 
Breast Cancer Webinar
Breast Cancer WebinarBreast Cancer Webinar
Breast Cancer Webinar
 
Targeted Agents in Breast Cancer: Examining Advances in Management of Breast ...
Targeted Agents in Breast Cancer: Examining Advances in Management of Breast ...Targeted Agents in Breast Cancer: Examining Advances in Management of Breast ...
Targeted Agents in Breast Cancer: Examining Advances in Management of Breast ...
 
Breast Reconstruction at Perimeter Plastic Surgery
Breast Reconstruction at Perimeter Plastic SurgeryBreast Reconstruction at Perimeter Plastic Surgery
Breast Reconstruction at Perimeter Plastic Surgery
 
Latissimus dorsi flap for reconstruction in head and neck deffects
Latissimus dorsi flap for reconstruction in head and neck deffectsLatissimus dorsi flap for reconstruction in head and neck deffects
Latissimus dorsi flap for reconstruction in head and neck deffects
 
Local Regional Treatment: Examining Advances in Management of Breast Cancer, ...
Local Regional Treatment: Examining Advances in Management of Breast Cancer, ...Local Regional Treatment: Examining Advances in Management of Breast Cancer, ...
Local Regional Treatment: Examining Advances in Management of Breast Cancer, ...
 
Breat cancer Therapy
Breat cancer TherapyBreat cancer Therapy
Breat cancer Therapy
 
Breast Reconstruction - Jane Rothwell
Breast Reconstruction - Jane RothwellBreast Reconstruction - Jane Rothwell
Breast Reconstruction - Jane Rothwell
 
BreastReconTiwari
BreastReconTiwariBreastReconTiwari
BreastReconTiwari
 
Sexually transmitted diseases 202
Sexually transmitted diseases 202Sexually transmitted diseases 202
Sexually transmitted diseases 202
 
Recent advances in carcinoma breast
Recent advances in carcinoma breastRecent advances in carcinoma breast
Recent advances in carcinoma breast
 

Semelhante a BCT - AIIMS Experience

Vakalis new techniques in breast radiotherapy
Vakalis new techniques in breast radiotherapyVakalis new techniques in breast radiotherapy
Vakalis new techniques in breast radiotherapy
fondas vakalis
 
New techniques in breast radiotherapy
New techniques in breast radiotherapyNew techniques in breast radiotherapy
New techniques in breast radiotherapy
fondas vakalis
 
MON 2011 - Slide 12 - C. Sessa - Cervical and endometrial cancers
MON 2011 - Slide 12 - C. Sessa - Cervical and endometrial cancersMON 2011 - Slide 12 - C. Sessa - Cervical and endometrial cancers
MON 2011 - Slide 12 - C. Sessa - Cervical and endometrial cancers
European School of Oncology
 
MCO 2011 - Slide 15 - C. Sessa - Cervical and endometrial cancers (part II)
MCO 2011 - Slide 15 - C. Sessa - Cervical and endometrial cancers (part II)MCO 2011 - Slide 15 - C. Sessa - Cervical and endometrial cancers (part II)
MCO 2011 - Slide 15 - C. Sessa - Cervical and endometrial cancers (part II)
European School of Oncology
 
San Antonio Breast Cancer Symposium 2007 Highlights – Radiotherapy
San Antonio Breast Cancer Symposium 2007 Highlights – RadiotherapySan Antonio Breast Cancer Symposium 2007 Highlights – Radiotherapy
San Antonio Breast Cancer Symposium 2007 Highlights – Radiotherapy
fondas vakalis
 

Semelhante a BCT - AIIMS Experience (20)

Who Benefits From Apbi March2009
Who Benefits From Apbi March2009Who Benefits From Apbi March2009
Who Benefits From Apbi March2009
 
Vakalis new techniques in breast radiotherapy
Vakalis new techniques in breast radiotherapyVakalis new techniques in breast radiotherapy
Vakalis new techniques in breast radiotherapy
 
New techniques in breast radiotherapy
New techniques in breast radiotherapyNew techniques in breast radiotherapy
New techniques in breast radiotherapy
 
Treatment of breast cancer
Treatment of breast cancerTreatment of breast cancer
Treatment of breast cancer
 
Ductal Carcinoma In Situ (DCIS)
Ductal Carcinoma In Situ  (DCIS)Ductal Carcinoma In Situ  (DCIS)
Ductal Carcinoma In Situ (DCIS)
 
EASO2011 BRS 9 Clough
EASO2011 BRS 9 CloughEASO2011 BRS 9 Clough
EASO2011 BRS 9 Clough
 
Should triple negative breast cancer (tnbc) subtype
Should triple negative breast cancer (tnbc) subtypeShould triple negative breast cancer (tnbc) subtype
Should triple negative breast cancer (tnbc) subtype
 
Should triple negative breast cancer (tnbc) subtype
Should triple negative breast cancer (tnbc) subtypeShould triple negative breast cancer (tnbc) subtype
Should triple negative breast cancer (tnbc) subtype
 
MON 2011 - Slide 12 - C. Sessa - Cervical and endometrial cancers
MON 2011 - Slide 12 - C. Sessa - Cervical and endometrial cancersMON 2011 - Slide 12 - C. Sessa - Cervical and endometrial cancers
MON 2011 - Slide 12 - C. Sessa - Cervical and endometrial cancers
 
MCO 2011 - Slide 15 - C. Sessa - Cervical and endometrial cancers (part II)
MCO 2011 - Slide 15 - C. Sessa - Cervical and endometrial cancers (part II)MCO 2011 - Slide 15 - C. Sessa - Cervical and endometrial cancers (part II)
MCO 2011 - Slide 15 - C. Sessa - Cervical and endometrial cancers (part II)
 
MCC 2011 - Slide 21
MCC 2011 - Slide 21MCC 2011 - Slide 21
MCC 2011 - Slide 21
 
Mastectomy.docx
Mastectomy.docxMastectomy.docx
Mastectomy.docx
 
breast cancer
breast cancerbreast cancer
breast cancer
 
Brachytherapy in breast cancer
Brachytherapy in breast cancerBrachytherapy in breast cancer
Brachytherapy in breast cancer
 
San Antonio Breast Cancer Symposium 2007 Highlights – Radiotherapy
San Antonio Breast Cancer Symposium 2007 Highlights – RadiotherapySan Antonio Breast Cancer Symposium 2007 Highlights – Radiotherapy
San Antonio Breast Cancer Symposium 2007 Highlights – Radiotherapy
 
BALKAN MCO 2011 - E. Vrdoljak - Radiotherapy
BALKAN MCO 2011 - E. Vrdoljak - RadiotherapyBALKAN MCO 2011 - E. Vrdoljak - Radiotherapy
BALKAN MCO 2011 - E. Vrdoljak - Radiotherapy
 
EARLY BREAST CANCER MANAGEMENT.pptx
EARLY BREAST CANCER MANAGEMENT.pptxEARLY BREAST CANCER MANAGEMENT.pptx
EARLY BREAST CANCER MANAGEMENT.pptx
 
Mundt Gyn Session
Mundt Gyn SessionMundt Gyn Session
Mundt Gyn Session
 
EBRT in breast cancer: Evolution to cutting edge
EBRT in breast cancer: Evolution to cutting edgeEBRT in breast cancer: Evolution to cutting edge
EBRT in breast cancer: Evolution to cutting edge
 
ADJUTANT RADIOTHERAPY IN BREAST CANCER
ADJUTANT RADIOTHERAPY IN BREAST CANCER ADJUTANT RADIOTHERAPY IN BREAST CANCER
ADJUTANT RADIOTHERAPY IN BREAST CANCER
 

Último

MASTERING FOREX: STRATEGIES FOR SUCCESS.pdf
MASTERING FOREX: STRATEGIES FOR SUCCESS.pdfMASTERING FOREX: STRATEGIES FOR SUCCESS.pdf
MASTERING FOREX: STRATEGIES FOR SUCCESS.pdf
Cocity Enterprises
 
Call Girls in Tilak Nagar (delhi) call me [🔝9953056974🔝] escort service 24X7
Call Girls in Tilak Nagar (delhi) call me [🔝9953056974🔝] escort service 24X7Call Girls in Tilak Nagar (delhi) call me [🔝9953056974🔝] escort service 24X7
Call Girls in Tilak Nagar (delhi) call me [🔝9953056974🔝] escort service 24X7
9953056974 Low Rate Call Girls In Saket, Delhi NCR
 

Último (20)

Benefits & Risk Of Stock Loans
Benefits & Risk Of Stock LoansBenefits & Risk Of Stock Loans
Benefits & Risk Of Stock Loans
 
W.D. Gann Theory Complete Information.pdf
W.D. Gann Theory Complete Information.pdfW.D. Gann Theory Complete Information.pdf
W.D. Gann Theory Complete Information.pdf
 
Famous No1 Amil Baba Love marriage Astrologer Specialist Expert In Pakistan a...
Famous No1 Amil Baba Love marriage Astrologer Specialist Expert In Pakistan a...Famous No1 Amil Baba Love marriage Astrologer Specialist Expert In Pakistan a...
Famous No1 Amil Baba Love marriage Astrologer Specialist Expert In Pakistan a...
 
Certified Kala Jadu, Black magic specialist in Rawalpindi and Bangali Amil ba...
Certified Kala Jadu, Black magic specialist in Rawalpindi and Bangali Amil ba...Certified Kala Jadu, Black magic specialist in Rawalpindi and Bangali Amil ba...
Certified Kala Jadu, Black magic specialist in Rawalpindi and Bangali Amil ba...
 
✂️ 👅 Independent Bhubaneswar Escorts Odisha Call Girls With Room Bhubaneswar ...
✂️ 👅 Independent Bhubaneswar Escorts Odisha Call Girls With Room Bhubaneswar ...✂️ 👅 Independent Bhubaneswar Escorts Odisha Call Girls With Room Bhubaneswar ...
✂️ 👅 Independent Bhubaneswar Escorts Odisha Call Girls With Room Bhubaneswar ...
 
Escorts Indore Call Girls-9155612368-Vijay Nagar Decent Fantastic Call Girls ...
Escorts Indore Call Girls-9155612368-Vijay Nagar Decent Fantastic Call Girls ...Escorts Indore Call Girls-9155612368-Vijay Nagar Decent Fantastic Call Girls ...
Escorts Indore Call Girls-9155612368-Vijay Nagar Decent Fantastic Call Girls ...
 
Dubai Call Girls Deira O525547819 Dubai Call Girls Bur Dubai Multiple
Dubai Call Girls Deira O525547819 Dubai Call Girls Bur Dubai MultipleDubai Call Girls Deira O525547819 Dubai Call Girls Bur Dubai Multiple
Dubai Call Girls Deira O525547819 Dubai Call Girls Bur Dubai Multiple
 
Virar Best Sex Call Girls Number-📞📞9833754194-Poorbi Nalasopara Housewife Cal...
Virar Best Sex Call Girls Number-📞📞9833754194-Poorbi Nalasopara Housewife Cal...Virar Best Sex Call Girls Number-📞📞9833754194-Poorbi Nalasopara Housewife Cal...
Virar Best Sex Call Girls Number-📞📞9833754194-Poorbi Nalasopara Housewife Cal...
 
Call Girls Howrah ( 8250092165 ) Cheap rates call girls | Get low budget
Call Girls Howrah ( 8250092165 ) Cheap rates call girls | Get low budgetCall Girls Howrah ( 8250092165 ) Cheap rates call girls | Get low budget
Call Girls Howrah ( 8250092165 ) Cheap rates call girls | Get low budget
 
Fixed exchange rate and flexible exchange rate.pptx
Fixed exchange rate and flexible exchange rate.pptxFixed exchange rate and flexible exchange rate.pptx
Fixed exchange rate and flexible exchange rate.pptx
 
In Sharjah ௵(+971)558539980 *_௵abortion pills now available.
In Sharjah ௵(+971)558539980 *_௵abortion pills now available.In Sharjah ௵(+971)558539980 *_௵abortion pills now available.
In Sharjah ௵(+971)558539980 *_௵abortion pills now available.
 
cost-volume-profit analysis.ppt(managerial accounting).pptx
cost-volume-profit analysis.ppt(managerial accounting).pptxcost-volume-profit analysis.ppt(managerial accounting).pptx
cost-volume-profit analysis.ppt(managerial accounting).pptx
 
Female Escorts Service in Hyderabad Starting with 5000/- for Savita Escorts S...
Female Escorts Service in Hyderabad Starting with 5000/- for Savita Escorts S...Female Escorts Service in Hyderabad Starting with 5000/- for Savita Escorts S...
Female Escorts Service in Hyderabad Starting with 5000/- for Savita Escorts S...
 
Collecting banker, Capacity of collecting Banker, conditions under section 13...
Collecting banker, Capacity of collecting Banker, conditions under section 13...Collecting banker, Capacity of collecting Banker, conditions under section 13...
Collecting banker, Capacity of collecting Banker, conditions under section 13...
 
Q1 2024 Conference Call Presentation vF.pdf
Q1 2024 Conference Call Presentation vF.pdfQ1 2024 Conference Call Presentation vF.pdf
Q1 2024 Conference Call Presentation vF.pdf
 
logistics industry development power point ppt.pdf
logistics industry development power point ppt.pdflogistics industry development power point ppt.pdf
logistics industry development power point ppt.pdf
 
Premium Call Girls Bangalore Call Girls Service Just Call 🍑👄6378878445 🍑👄 Top...
Premium Call Girls Bangalore Call Girls Service Just Call 🍑👄6378878445 🍑👄 Top...Premium Call Girls Bangalore Call Girls Service Just Call 🍑👄6378878445 🍑👄 Top...
Premium Call Girls Bangalore Call Girls Service Just Call 🍑👄6378878445 🍑👄 Top...
 
MASTERING FOREX: STRATEGIES FOR SUCCESS.pdf
MASTERING FOREX: STRATEGIES FOR SUCCESS.pdfMASTERING FOREX: STRATEGIES FOR SUCCESS.pdf
MASTERING FOREX: STRATEGIES FOR SUCCESS.pdf
 
Call Girls in Tilak Nagar (delhi) call me [🔝9953056974🔝] escort service 24X7
Call Girls in Tilak Nagar (delhi) call me [🔝9953056974🔝] escort service 24X7Call Girls in Tilak Nagar (delhi) call me [🔝9953056974🔝] escort service 24X7
Call Girls in Tilak Nagar (delhi) call me [🔝9953056974🔝] escort service 24X7
 
Call Girls in Benson Town / 8250092165 Genuine Call girls with real Photos an...
Call Girls in Benson Town / 8250092165 Genuine Call girls with real Photos an...Call Girls in Benson Town / 8250092165 Genuine Call girls with real Photos an...
Call Girls in Benson Town / 8250092165 Genuine Call girls with real Photos an...
 

BCT - AIIMS Experience