Background: Breast cancer is a leading cause of death worldwide and ranks as the 5th cause of death from all cancers, and the most common cause of cancer death in women in both developing and developed countries. Objective: The study was conducted to assess the trend, treatment outcomes and associated factors of breast cancer patients at TGSH and FHRH from January 1, 2018 to December 30, 2021. Methods: Institution based retrospective study conducted on patients who was treated for breast cancer from January 1, 2018 to December 30, 2021 at TGSH and FHRH, Bahir Dar. Secondary data collected by reviewing patient’s charts by trained personnel. The collected data entered into Epi data and exported to SPSS for further analyses. A univariate logistic regression done to identify the associated factors. Variables with P-value ≤ 0.25 in binary logistic regression analysis were a candidate for multi-variable analysis. P-value <0.05 used to declare statistical significance. The AOR with at 95% CI used to measure the strength of association. Results: among 132 patients operated for breast cancer 119(90.2%) were females. The median age at the time of diagnosis was 38 (25-76) years. About 75.3% of patients presented with only breast lump. The mean duration of presenting symptoms was 7.87 months. One patient had bilateral breast cancer. The late presentation of the patients and the locally advanced stage at the time of presentation was observed in most of the patients. The predominant histology was ductal carcinoma witnessed in 70 patients (53.0%), followed by breast carcinoma of NST seen in 53 (40.2%) and one patient had mucinous carcinoma. NACT was administered only in 18 (13.6%) patients. During the follow up, 45 of 132(34.1%) and 5 of 132 patients (3.8%) developed local wound complications and recurrences respectively. Only one patient referred for radiotherapy. Presenting symptoms and waiting time for surgery after diagnosis significantly associated with short-term complications with (AOR=0.28; 95% CI (0.09,0.93)) and (AOR=0.16; 95% CI (0.03,0.89)) respectively. In multivariable models, doing surgery within 10 days of diagnosis decreases the incidence of short-term complications. Conclusion: Our study has shown that relatively young females are commonly affected; majority presented in locally advanced stage of the disease. Keywords: breast, cancer, treatment, outcome, recurrence, TGSH, FHRH