Determinants Of Complete Pathological Response Following Neo-Adjuvant Chemotherapy Among Breast Cancer Patients In A Tertiary Hospital In Ghana

Abstract Background The wide-ranging features of breast cancer presents a challenge in accurate prognostication of the disease. There is a recent shift towards investigating pathological complete response(pCR) of surgical specimen following neo-adjuvant chemotherapy. However, there is dearth of information on such works in Ghana. This study sought to evaluate the determinants of complete pathological response in breast cancer patients who underwent surgery following neo-adjuvant chemotherapy at Komfo Anokye Teaching Hospital Method The study was a retrospective hospital-based study that included breast cancer patients who had neo-adjuvant chemotherapy and breast surgery between January 2021 to June 2023. Data collected included age, laterality, BMI, Histologic type and Grade, ER/PR/ HER-2 receptor status and final post-surgery pathological stage. Intrinsic subtype classification was performed according to the 2011 St Galen consensus. Results In the present study, the age distribution of malignant breast diseases showed a bimodal pattern. Invasive ductal carcinoma with no special type (IDC-NST) was the predominant histological type (85.5%). Triple-negative breast cancer formed the majority (46%) based on the immunohistochemical intrinsic subtype. A third of the study participants were at stage IIIB of the disease. A quarter of those who underwent neo-adjuvant chemotherapy before surgery achieved a complete pathological response. A multivariate analysis showed that patients who received 3 weekly doses of docetaxel had higher odds [OR: 2.94, p = 0.038] of achieving a complete pathological response. However, there was no significant difference between 3 weekly paclitaxel and weekly paclitaxel. Similarly, patients who received Herceptin as part of their neo-adjuvant treatment were more likely to have a complete pathological response [OR: 4.68, p = 0.023] in this study. Conclusion The clinicopathological features of breast cancer patients, along with neo-adjuvant therapeutic agents, can help predict complete pathological response and predict overall survival