Jenny Morgan is a third-year UNC Hematology and Oncology fellow with research interests in global oncology, implementation science, and clinical outcomes. Her current research is focused on evaluating the breast cancer care continuum at UNC Project Malawi under the mentorship of Dr. Katie Reeder Hayes, UNC Associate Professor of Oncology and Dr. Tamiwe Tomoka, UNC Project Malawi Cancer Program Co-Director.
Abstract:
In Sub-Saharan Africa (SSA), breast cancer treatment in concordance with resource stratified guidelines is increasingly available however their real-world application is infrequently described. Our aim is to determine the type of curative-intent treatment received including neoadjuvant (NAC) and/or adjuvant chemotherapy (AC) and surgery (S) by breast cancer stage and HIV status, and the association between completion of treatment and overall survival (OS).
This study demonstrates the challenges of administering multi-modality breast cancer treatment with curative intent in a resource constrained setting. Patients treated with NAC had a significantly shorter OS than patients who received upfront surgery and AC, reflecting the prognostic value of achieving surgical resectability in this setting. Stage III and HIV+ patients were also less likely to complete curative-intent treatment. Further study is needed to identify barriers to treatment completion and inform targeted interventions to improve treatment outcomes in Malawi and SSA.
This study demonstrates the challenges of administering multi-modality breast cancer treatment with curative intent in a resource constrained setting. Patients treated with NAC had a significantly shorter OS than patients who received upfront surgery and AC, reflecting the prognostic value of achieving surgical resectability in this setting. Stage III and HIV+ patients were also less likely to complete curative-intent treatment. Further study is needed to identify barriers to treatment completion and inform targeted interventions to improve treatment outcomes in Malawi and SSA.