Comparison of Breast Cancer Management and Outcomes in a Single Cancer Surgical Unit in Teaching Hospital- Batticaloa, Sri Lanka: A Retrospective Analysis of Two Time Periods (2016-2018 vs. 2022-2024)

Objective: To compare the clinical characteristics, management approaches, and surgical outcomes of breast cancer patients treated at this institution during two distinct time periods (2016–2018 and 2022–2024).Methods: A retrospective review of breast cancer cases was conducted. A total of 93 female patients were included in each period, categorized into early invasive breast carcinoma (EIBC), locally advanced breast carcinoma (LABC), and metastatic breast carcinoma (MBC). Treatment modalities, including neoadjuvant chemotherapy, breast conservation, sentinel lymph node biopsy, and breast reconstruction, were compared between the two cohorts.Results: In the 2022–2024 period, there were fewer cases of early invasive breast carcinoma (44.1% vs. 53.8%) and a higher incidence of locally advanced breast carcinoma (45.2% vs. 33.3%). The use of neoadjuvant chemotherapy for LABC increased significantly (30.2% vs. 19.3%), and sentinel lymph node biopsy (SLNB) was more frequently performed (26.9% vs. 6.5%). Positive SLNB results led to axillary clearance in 7 cases during the later period, whereas no cases in the earlier cohort required further intervention. Breast conservation rates decreased (33.3% vs. 39.8%) in 2022–2024 which is due to a raised aged population with medical comorbidities, but 6 patients underwent breast reconstruction post-mastectomy compared to none in 2016–2018.Conclusions: The shift in breast cancer presentation and management between 2016–2018 and 2022–2024 at this institution reflects evolving treatment strategies. Increased use of SLNB and breast reconstruction are notable, as well as a higher uptake of neoadjuvant chemotherapy in LABC. Further study is required to assess the long-term impact of these changes on patient outcomes and quality of life.Breast cancer-related awareness, associated comorbidities and sociocultural norms of the patients might have affected the patient preferences of management options. In addition, the availability of the Mammogram, chemotherapy, intervention radiologist, and methylene blue for the Sentinel Lymph Node Biopsy (SLNB) might have affected the diagnostic stage and surgical options.