Background: Because of resource constrains in sub-Saharan African countries, breast conserving surgery has no role in patients with locally advanced breast cancer following neoadjuvant chemotherapy, and mastectomy remains the standard surgical treatment for these patients.

Objectives: To assess the safety of oncoplastic breast conserving surgery in patients with locally advanced breast cancer who showed good clinical response to neoadjuvant chemotherapy in a breast center with enhanced level of resources in Sudan. A second objective is to assess the cosmetic outcome.

Patients and Methods: 250 patients with locally advanced breast cancer were treated with neoadjuvant chemotherapy at Khartoum Breast Care Center during the period 2013-2019. Out of this, 52 patients were surgically treated with oncoplastic breast conserving surgery. Kaplan-Meier curve was used to calculate the survival rates. The cosmetic outcome was subjectively assessed by the Harris scale.

Results: The median follow-up period was 53 months. The 3 and 5- years distant metastasis free survival rates were 92.9% and 82.2% respectively. One patient developed regional recurrence and 6 patients developed distant metastasis. 80% of patients admitted to have good to excellent cosmetic outcome.

Conclusion: This Sudanese experience showed that oncoplastic breast conserving surgery is oncologically safe and aesthetically satisfactory in patients with locally advanced breast cancer who demonstrated good clinical response to neoadjuvant chemotherapy in a setting with enhanced levels of resources for breast cancer care.