CLINICAL OUTCOMES OF ANTHRACYCLINE-BASED NEOADJUVANT CHEMOTHERAPY FOLLOWED BY MODIFIED RADICAL MASTECTOMY IN PATIENTS WITH LOCALLY ADVANCED BREAST CARCINOMA: A PROSPECTIVE OBSERVATIONAL STUDY

Abstract

Background: Locally advanced breast carcinoma (LABC) remains a major challenge in developing countries because many patients present at an advanced stage due to delayed diagnosis, poor awareness, and limited screening facilities. Neoadjuvant chemotherapy (NACT) has become the standard initial treatment for LABC because it reduces tumour size, improves operability, and facilitates complete surgical excision. Anthracycline-based chemotherapy remains widely used because of its proven efficacy, affordability, and acceptable toxicity profile. Aim: To evaluate the clinical outcomes, chemotherapy-related toxicities, surgical outcomes, and short-term oncological results of anthracycline-based neoadjuvant chemotherapy followed by modified radical mastectomy in patients with locally advanced breast carcinoma. Methods: This prospective observational study included 100 female patients aged 45–70 years with Stage IIIA–IIIC breast carcinoma confirmed by clinical examination, sonomammography, and fine-needle aspiration cytology. All patients received three cycles of doxorubicin and cyclophosphamide administered every 21 days followed by modified radical mastectomy. Postoperative chemotherapy, radiotherapy and endocrine therapy were administered according to receptor status. Patients were followed for two years to evaluate tumour response, postoperative complications, recurrence, metastasis, and mortality. Results: Among the 100 enrolled patients, 97 completed treatment and follow-up. Partial clinical response was achieved in 80 patients (82.5%), whereas 17 patients (17.5%) showed no significant response. No complete clinical response or disease progression was observed. Nausea and alopecia occurred in all patients. Vomiting occurred in 40%, generalized weakness requiring admission in 20%, febrile illness in 30%, urinary tract infection in 20%, and chemotherapy extravasation in 5%. Histopathological examination demonstrated invasive ductal carcinoma in 72.2% of patients. Seroma was the most common postoperative complication. No local recurrence was observed during two years of follow-up, while three patients developed distant metastasis and five patients died due to disease progression. Conclusion: Anthracycline-based neoadjuvant chemotherapy followed by modified radical mastectomy provides satisfactory tumour downstaging, acceptable toxicity, and excellent locoregional disease control in patients with locally advanced breast carcinoma.