The Impact of Neoadjuvant Chemotherapy on Patients with Locally Advanced Breast Cancer in a Nigerian Semiurban Teaching Hospital: A Single‐center Descriptive Study

Abstract

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. 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. 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. 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.