The Challenge of Radiological Evaluation of T4 Breast Cancer During Neoadjuvant Chemotherapy in a Resource-Limited Country,
Auteur(s): Ouedraogo Nina-Astrid, Bambara Augustin Tozoula, Atenguena Okobalemba Etienne , Kabore Bernard , Akanni Faycal, Sama Alice Cynthia , Diallo Ousseini, Cisse Rabiou,
Résumé

Locally advanced breast cancer, including Tumor-Node-Metastasis (TNM) stage T4, is the most frequently
diagnosed cancer in Burkina Faso. Breast imaging is essential in the initial assessment and evaluation of the response of breast cancers under neoadjuvant chemotherapy (NAC). A therapeutic challenge is posed by the poverty of the population, aiming to rationalise paraclinical explorations, particularly medical imaging. We conducted this study to discuss relevant imaging strategies for the evaluation of tumour response in advanced breast cancer during neoadjuvant chemotherapy in our context of resource-limited countries. It was a cross-sectional descriptive study based on the medical records of patients followed up in the oncology department of the Yalgado Ouédraogo University Hospital. All patients treated for T4 non-metastatic breast cancer and who received at least one course of neoadjuvant chemotherapy were included. The study variables were the socio-demographic
characteristics of the patients, the initial evaluation (clinical, radiological, anatomopathological); the mid-term and
end-of-treatment evaluation of the ANC (clinical, radiological). T4 patients accounted for 74.28% of non-metastatic cancers diagnosed during the study period. The average age was 46 years. There were 96.15% of non-specific invasive carcinomas. Inflammatory type cancers accounted for 66.67% of cases. Lymph node involvement was present in 89.74%. All patients were classified as stage IIIB according to the UICC (Union for International Cancer Control). Initial, mid-term and end-of-treatment clinical assessments of the tumour were performed in 65.38%, 85.5% and 82.98% of cases respectively. Ultrasound was performed only at the initial stage in 51.28% of cases. CT scans were performed in all these evaluations but did not mention tumour size. The tumour response rate was determined empirically. CT would allow, at the same time as the extension assessment, to perform a loco-regional assessment of the breast tumour in the absence of other dedicated breast imaging

Mots-clés

Breast Ultrasound CT Scan Tumour Response Rate burkina faso

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