A Five-Year Single-Center Retrospective Study of Neoadjuvant Therapy Response and Survival in Romanian Women with Breast Cancer

Background: Breast cancer remains a major public health problem, with increasing incidence and persistent survival disparities. In Romania, barriers to early diagnosis and access to multidisciplinary treatment may contribute to poorer outcomes. Methods: We conducted a retrospective single-center cohort study including 118 women diagnosed with and/or treated for breast cancer in our institution between 1 January and 31 December 2020. Patients were followed for 5 years. The primary outcome was overall survival (OS). Clinicopathological characteristics, treatment exposure, pathological response after neoadjuvant therapy, and factors associated with OS were analyzed. Results: The median age at diagnosis was 62 years. Most tumors were located in the upper quadrants, and the most frequent subtype was hormone receptor-positive/HER2-negative breast carcinoma. During follow-up, 26.27% of patients died from disease progression or associated complications. Estimated OS was 88.7% at 1 year and 72.8% at 5 years. Older age at diagnosis and treatment exposure patterns, including the absence of neoadjuvant therapy, were associated with OS. Conclusions: In this single-center retrospective cohort, overall survival was associated with age at diagnosis, tumor characteristics, and treatment patterns. The high proportion of early deaths and the frequent absence of documented surgical treatment in patients who died suggest important challenges related to late presentation, continuity of care, and access to guideline-concordant multidisciplinary treatment in the Romanian setting.