The outcome of breast conservative surgery vs modified radical mastectomy following neoadjuvant therapy among locally advanced breast cancer patients in national cancer institute, Gezira University, Sudan

Mohamed, Eman Ali and Saadeldein, Mohamed Soud and Alshaikh, Ahmad Alameen and Eltayeb, Elgaylani Abdalla and Elkhider, Alkhansa Hamid and Elsheikh, Sabah Eltom (2025) The outcome of breast conservative surgery vs modified radical mastectomy following neoadjuvant therapy among locally advanced breast cancer patients in national cancer institute, Gezira University, Sudan. World Journal of Biology Pharmacy and Health Sciences, 21 (1). pp. 475-481. ISSN 2582-5542

Background: Locally advanced breast cancer (LABC) is still a common presentation in Sudan. Lack of awareness of guidelines lead to high rates of unnecessary mastectomies among patients with locally advanced breast cancer. Objective: To compare the outcome of breast conservative surgery and modified radical mastectomy after neoadjuvant therapy for locally advanced breast cancer. Patients and Methods: Descriptive, cross-sectional, and hospital-based study. Included all the patients with locally advanced breast cancer seen in the National Cancer Institute-University of Gezira from the period of December 2018 to February 2020 and who received neoadjuvant therapy followed by surgery. Results: Forty-seven patients met the inclusion criteria of the study. The mean age of patients presented with LABC is 47.3 years (+/- 11.6 years) with the majority of patients, 31 patients (66%) less than 50 years and 24 patients (51.1%) are premenopausal. The commonest AJCC stage is stage IIIB in 37 patients (78.7%), 41 patients (87.2%) of tumors are invasive ductal carcinoma and 31 patients (66%) are estrogen receptor and/or progesterone receptor positive. Fortyone patients (87.2%) received anthracycline and taxane-based chemotherapy and 97.9% achieved partial clinical response. Breast conservative surgery was done for 13 patients (27.7%) and modified radical mastectomy for 27 patients (72.3%). There is no statistical difference in the outcome of BCS compared to MRM (P value 0.661). Negative predictive factors of the outcome include skin ulceration, negative ER/PR status, and omission of adjuvant radiotherapy (p-value < 0.05 for each variable). Conclusion: At 15 months follow-up, there is no difference in the final outcome of BCS and MRM following neoadjuvant therapy in the LABC.