Background: There is a paucity of data on the response of breast cancer to neoadjuvant c in low-resources developing African countries such as Nigeria. We therefore decided to study the impact of neoadjuvant chemotherapy on breast cancer patients in Nigeria in the light of constrained resources.
Methods: This was a single-center retrospective descriptive study. Sixty-two patients with locally advanced breast cancer treated with neoadjuvant chemotherapy in the last 24 years in Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, Nigeria, constituted the study population. The outcome measures were clinical tumor response, disease-free survival, overall survival, and chemotherapy toxicity profile.
Results: Patients ranged in age from 30 to 85 years (mean = 49.1 +/- SD 12.7 years) and included one male. After three cycles of chemotherapy, complete clinical response was observed in 4 patients (6.5%), partial clinical response in 28 patients (45.2%), no clinically measurable response in 24 patients (38.7%), and progressive disease in 6 patients (9.7%). Forty-one patients completed six cycles, of which 9 patients (22.0%) had complete clinical response and 12 patients (29.3%) had partial clinical response. Four of 30 patients (13.3%) with tumor size of 6-10 cm had complete clinical response, while no patient with a tumor bigger than 10 cm had complete clinical response. Of the 62 patients, 42 were followed up for more than 1 year. The 1-, 2-, and 5-year survival rates of this cohort were 66.7, 42.9, and 11.9%, respectively The median follow-up period was 9 months and the disease-free survival and overall survival rates at median follow-up period were 45 and 37%, respectively.
Conclusion: There was a poor overall clinical response rate to neoadjuvant chemotherapy in the Black population studied. Late presentation with large tumor mass may be accountable for this.