Introduction: The role of adjuvant chemotherapy in breast cancer is well established as are the indications. Likewise the role of neoadjuvant chemotherapy in locally advanced breast cancer is well established. The use of neoadjuvant chemotherapy in operable breast cancer has only recently become of interest to researchers.

Patients and methods: This study included 34 cases of operable breast cancer that were given 4 cycles of neoadjuvant chemotherapy in the form of FEC100 then subjected to surgery. Surgery done was either breast conserving surgery (BCS) or modified radical mastectomy. All patients completed the treatment regimen and no patients were excluded from the study. All surgical specimens were studied pathologically for chemotherapy effect.

Results: An overall objective response was observed in 70.6% of the patients. Seven patients (20.6%) experienced a clinical complete response (cCR), seventeen patients (50.0%) had partial response , nine patients (26.5%) had no change of their disease, and only one patient had disease progression. Of the seven patients who had a cCR, only four patients (11.8%) had pathologic complete response (pCR), while pCR for the whole group was14.7 %( 5/34). Tumor size of more than 2 cm was observed in 28patients (82.4%) at time of presentation, while tumor size of 2 cm or less was seen in 6 patients (17.6%) only. After completion of the course of chemotherapy, twenty three patients (67.6%) were observed to have tumors of 2 cm or less that allowed for less extensive resections. Twenty three patients underwent breast conservative surgery (67.6%) while modified radical mastectomy was performed in 11 patients (32.4%).

Conclusion: : The use of neoadjuvant chemotherapy in operable breast cancer in this study was associated with tumor and axillary downstaging which increased the proportion of cases undergoing breast conservation, with acceptable side effects and reasonable cost. During the limited follow up time of this study no loco regional recurrences were observed and one distant treatment failure was recorded. Its impact, if any, on overall or disease-free survival is still ongoing.

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