Neoadjuvant Chemotherapy Response Among Patients With Locally Advanced Breast Cancer At Tikur Anbessa Specialized Hospital (tash) Addis Ababa Ethiopia.

Background: Breast cancer is the leading cause of cancer death among females globally. Inrnsub-Saharan African countries, a high proportion of breast cancers are locally advanced breast rncancer (LABC) or metastatic at the time of diagnosis. LABC is primarily treated by neoadjuvantrnchemotherapy (NACT) before surgery. There is no data on response rate and resectability ofrnLABC after NACT in Ethiopia. rnObjective: The objective of this study is to assess the rate of clinicopathologic response andrnrate of resectability of LABC after NACT at Tikur Anbessa Specialized Hospital (TASH), rnEthiopia. rnMethods: This is a retrospective study which assesses response and resectability of LABC afterrnNACT at TASH from September 2017 G.C to August 2019 G.C. Patients who were evaluated atrnbreast multidisciplinary team (MDT) clinic by Breast surgeon and Oncologist and decided tornreceive upfront chemotherapy to downstage the tumor were included in this study. Patients wererngiven 4 cycles of NACT with AC (doxorubicin + cyclophosphamide) or 8 cycles of NACT withrnAC – T (4 cycles of AC + 4 cycles of paclitaxel). After chemotherapy patients were revaluated atrnMDT for modified radical mastectomy (MRM). Data were collected from patient charts andrnfilled on, cleared for completeness, analyzed using SPSS 25 software. rnResults: A total of 141 breast cancer patients were presented to the MDT. Of which 63 patientsrnwere decided to undergo upfront surgery and 78 patients to receive neoadjuvant therapy. Of thern78 patients who received neoadjuvant therapy only 51 patients were eligible for the study. Thernmean age of patients was 40.1 ± 9.96 SD years old (24-65). 11 patients (21.6 %) had completernclinical response (cCR), 31 patients (60.8 %) had clinical partial response (PR), 3 patients (5.9rn%) had stable disease (SD) and 6 patients (11.8 %) had progressive disease (PD) after NACT.rnForty-one patients (80.4 %) undergo mastectomy, 23 patients (56.1 %) had negative margins, 16rnpatients (39 %) had positive margins and in 2 patients (4.9 %) the surgical margin status was notrnmentioned. Only 4 patients (9.8 %) had complete pathologic response (pCR) after NACT.rnPatients who took AC – T (NACT) had a higher overall clinical response rate (p = 0.099) andrncCR (p = 0.037) but not statistically significant compared to patients who took AC NACT. Olderrnpatients (> 50 years old) with LABC had higher complete pathologic response but notrnstatistically significant after NACT during pathologic assessment compared to patients below thernage of 50 years (p = 0.062). rnConclusion: The study has shown administering neoadjuvant chemotherapy either with AC orrnAC – T has decreased the tumor size significantly to make it resectable with a clear margin. ACrn– T had a slightly higher overall response rate and complete clinical response rate.

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