Comparative Study of Neoadjuvant vs. Adjuvant Chemotherapy in Breast Cancer: A Tertiary Care Experience (50 Cases)

Background: Breast cancer management often includes chemotherapy, either before surgery (neoadjuvant) or after surgery (adjuvant). This study aims to compare the clinical outcomes, tumor response, and complications of neoadjuvant and adjuvant chemotherapy in a tertiary care setting.

Methods: A prospective observational study was conducted on 50 breast cancer patients treated at Oncology Department, Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh between January 2024 and December 2024. Patients were divided into two groups: neoadjuvant chemotherapy (NAC, n=25) and adjuvant chemotherapy (AC, n=25). Tumor response, surgical outcomes, and treatment-related complications were analyzed over a 12-month follow-up period.

Results: The mean age was 52.3 ± 10.1 years, with 60% of patients being postmenopausal. In the NAC group, 64% achieved partial or complete tumor response preoperatively, whereas the AC group showed a similar overall survival but had delayed tumor size reduction. Surgical margins were comparable between groups, but NAC facilitated breast-conserving surgery in 40% of cases compared to 20% in AC. Treatment-related complications were mild and comparable.

Conclusion: Neoadjuvant chemotherapy provides significant tumor downsizing, facilitating breast conservation without increasing adverse events, while overall survival and recurrence rates remain comparable to adjuvant chemotherapy.

Keywords: Breast Cancer, Neoadjuvant Chemotherapy, Adjuvant Chemotherapy, Tumor Response, Breast-Conserving Surgery, Chemotherapy Complications.