Background Pathological complete response (pCR) is a surrogate for the efficacy of neoadjuvant chemotherapy (NCT) in locally advanced breast cancer (LABC). We analyzed the predictive clinical factors for pathological responses and survival outcomes in a cohort of Egyptian patients. Methods We evaluated the medical records of patients with breast cancer who received NCT in our academic institute. Survival curves were estimated with the Kaplan-Meier method. Cox proportional models were used for multiple regression analysis. Results Our cohort included 368 patients with a median age of 48 years (range 21–70). The median follow-up time was 3 years. The clinical tumor stage (T3–4) represented 58%, with 80% having positive axillary nodes. The luminal subgroup prevailed by 68%. The objective response rate (ORR) reached 78%, and 16% of patients achieved pCR. The clinical node stage and optimal chemotherapy were associated with higher ORR (p = 0.035 and p = 0.001, respectively). Predictors of pCR were clinical T-stage (p = 0.026), high Ki-67 index > 20 (p = 0.05), and receiving optimal chemotherapy (p = 0.014). The estimated 3-year disease free-survival (DFS) was 53%. Receptor status, achieving ORR, and pCR were associated with better DFS with hazard ratios of 0.56, p = 0.008; 0.38, p = 0.04; and 0.28, p = 0.007, respectively. Conclusions Luminal tumors still draw benefit from neoadjuvant chemotherapy in terms of clinical response and breast conservative surgery. Treatment escalation to those who did not achieve pCR requires more investigation, given a higher recurrence rate in real-world experience.

Background: Majority of Egyptian breast cancer (BC) patients present at advanced stages. We examined the sociodemographic and clinical factors associated with late presentation of BC. Methods: This is a retrospective cohort study of patients who presented with BC between 2011 and 2020. Logistic regression was performed to examine the association between sociodemographic factors and advanced BC. Results: This cohort included 1,953 patients with median age of 52 years. 1,098 (56.2%) patients were diagnosed at early stages, while 855 (43.8%) patients were diagnosed at advanced stages. Univariate logistic regression analyses revealed that several sociodemographic and clinical factors were associated with advanced BC, including having negative family history of BC (OR= 0.1.27; 95% CI:1.05 to 1.54), having no job (OR= 1.28; 95% CI: 1.06 to 1.53), being married (OR=1.27; 95% CI:1.02 to 1.57), rural residence (OR=1.27; 95% CI:1.02 to 1.57), having more than three children (OR=1.42; 95% CI:1.15 to 1.75), higher KI-67% score (OR=1.01; 95% CI:1.00 to 1.01), having HER2-Enriched or TNBC subtypes (OR= 1.44; 95% CI:1.16 to 1.79), and having tumor grate II/III (OR=4.12; 95% CI:1.58 to 10.77 & OR= 1.44; 95% CI:1.16 to 1.79, respectively). In the multivariate logistic regression model, only KI-67% (aOR=1.01; 95% CI:1.00 to 1.02), having no job (aOR=1.44; 95% CI:1.10 to 1.90), and rural residence (aOR=1.88; 95% CI:1.03 to 3.42) were significantly associated with advanced BC. Conclusion: This study concluded that having no job and rural residence are highly associated with advanced BC. Raising the public awareness is the best strategy to encourage early detection of BC.