Surgical Management of Locally Advanced Breast Cancer: A Retrospective Study of 60 Cases

Abstract: Locally advanced breast cancer (LABC) remains a significant public health challenge in low-resource settings, where late-stage diagnoses and limited access to multidisciplinary care contribute to poor outcomes. This retrospective study analyzes the surgical management of 60 T4++ breast cancer cases treated at a Moroccan tertiary center between 2015 and 2023. Patient demographics, tumor characteristics, surgical techniques, and survival outcomes were evaluated. The cohort exhibited a mean age of 49 years, with a median diagnostic delay of 14 months. Radical mastectomy was performed in 81.8% of cases, with reconstruction primarily utilizing locoregional flaps (65%) or skin grafts (22%). Despite aggressive surgical intervention, the 2-year disease-free survival rate was 42% for non-metastatic disease and 18% for metastatic cases. These findings underscore the critical need for improved early detection programs and accessible adjuvant therapies in resource-limited settings.