European Journal of Cardiovascular Medicine

Background: Breast cancer is the most common cancer in women, affecting 2.1 million women per year and accounting for the majority of cancer-related deaths among women. The use of neoadjuvant chemotherapy in the treatment of breast cancer has been shown to be effective in down staging primary tumors, clear surgical  margins and improve patient’s overall outcome. The aim of this study is to look at various factors affecting the clinical and pathological response in patients with locally advanced breast cancer after of neoadjuvant chemotherapy. Study Design: A prospective cohort study Patients and methods: This was a prospective cohort study on patients who received neoadjuvant chemotherapy for locally advanced breast carcinoma. A total of 58 patients who presented with locally advanced breast cancer (LABC) were treated with neoadjuvant chemotherapy for 3 cycles and then were assessed for response,patients with adequate response to chemotherapy were continued further for 3 more cycles of NACT . Patients not responding to NACT after 3 cycles underwent Modified radical mastectomy. The clinical response was assessed with RECIST criteria before the start of NACT and then after 3 cycles or at end of therapy. The pathological response was checked with Chevallier’s criteria before the start of NACT and then after completion of 3 cycles or at the end of NACT. Results: A total of 58 female patients who received neoadjuvant chemotherapy for locally advanced breast carcinoma from February 2021 to July 2022 were studied. The median age of the patients at the time of diagnosis was 53.5 years (28 – 84 years). In terms of menopausal status, 10 patients (17.3%) were pre-menopausal and 48 patients (82.7%) were post-menopausal. Histological classification showed infiltrating ductal carcinoma in 54 patients (93.2%), infiltrating lobular carcinoma in 2 patients (3.4%) patients and squamous cell carcinoma in 2 patients (3.4%). Among 58 patients, 15 patients (25.9%) had clinically complete remission (cCR), 23 patients (39.7%) had partial remission, 14 patients (24.1%) had stable disease and 6 patients (10.3%) had progressive disease. Also among 58 patients, 17 patients(29.3%) had pathological complete response (pCR) followed by 2 patients who had near to complete pathological response. Our study showed downstaging of tumor in 37 patients (63.7%) with T3 and T4 stage. Conclusion: Preoperative chemotherapy downstages the primary tumors and axillary metastasis in patients with locally advanced breast carcinomathus, it help in achieving surgically clear margins and elimination of micrometastases which may further decrease the recurrence rates and morbidity/mortality in patients