RESPONSE OUTCOME OF NEO ADJUVANT CHEMO THERAPY AND FEASIBILITY OF BREAST CONSERVATION SURGERY AMONG LOCALLY ADVANCED BREAST CANCER PATIENTS: A PROSPECTIVE EVALUATION

Abstract

Background:Locally advanced breast cancer (LABC) poses a substantial clinical challenge, particularly in regions like India where it accounts for a signicant proportion of breast cancer cases. Neoadjuvant chemotherapy (NACT) has emerged as a promising strategy to downstage tumors and increase the feasibility of breast conservation surgery (BCS), thus improving patient outcomes. This prospective observational study aimed to comprehensively investigate the clinical characteristics of LABC patients and evaluate the impact of NACT on tumor downstaging and the feasibility of BCS. Methods:Atotal of 100 consecutive female LABC patients (Stage III) aged 25 to 70 years were enrolled in the study. Clinical and histopathological data were collected, including age, menstrual status, family history, symptom duration, tumor characteristics, and receptor status. NACT regimens were administered as per institutional protocols. Tumor and axillary lymph node size changes were measured, and clinical responses were evaluated using RECIST 1.1 criteria. Statistical analyses were conducted using SPSS software. Results: The study population exhibited a mean age of 49.43 years, with 61% of patients being premenopausal. The predominant histopathological subtype was invasive ductal carcinoma (91%), and common receptor statuses included ER+ PR+ HER2- (29%) and triple-negative (28%). Post-NACT, 82% of patients exhibited a partial response, while 10% achieved a complete response. Notably, BCS feasibility was observed in 60% of cases following NACT. Histological subtype and ER/PR status signicantly inuenced response rates (p < 0.05). Conclusion: Neoadjuvant chemotherapy demonstrated its efcacy in downstaging LABC tumors, resulting in a higher feasibility of breast conservation surgery. Receptor status emerged as an important predictor of chemotherapy response. The study underscores the potential of a multimodal approach involving NACT and BCS to optimize treatment outcomes for LABC patients, particularly in resource-constrained settings.