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Review
. 2014 Apr;144(3):467-78.
doi: 10.1007/s10549-014-2868-z. Epub 2014 Mar 7.

Breast cancer in Sub-Saharan Africa: opportunities for prevention

Louise A Brinton  1 , Jonine D Figueroa, Baffour Awuah, Joel Yarney, Seth Wiafe, Shannon N Wood, Daniel Ansong, Kofi Nyarko, Beatrice Wiafe-Addai, Joe Nat Clegg-Lamptey
Affiliations
Review

Breast cancer in Sub-Saharan Africa: opportunities for prevention

Louise A Brinton et al. Breast Cancer Res Treat. 2014 Apr.

Abstract

Although breast cancer is a growing health problem in sub-Saharan Africa, reasons for its increased occurrence remain unclear. We reviewed the published literature to determine the magnitude of the increase in breast cancer, associated risk factors (including for breast cancer subtypes), and ways to reduce incidence and mortality. Some of the increased breast cancer occurrence likely reflects that women are living longer and adopting lifestyles that favor higher incidence rates. However, a greater proportion of breast cancers occur among premenopausal women as compared to elsewhere, which may reflect unique risk factors. Breast cancers diagnosed among African women reportedly include a disproportionate number of poor prognosis tumors, including hormone receptor negative, triple negative, and core basal phenotype tumors. However, it is unclear how lack of standardized methods for tissue collection, fixation, and classification contribute to these rates. Given appropriate classifications, it will be of interest to compare rates with other populations and to identify risk factors that relate to specific tumor subtypes. This includes not only risk factors that have been recognized in other populations but also some that may play unique roles among African women, such as genetic factors, microbiomata, xenoestrogens, hair relaxers, and skin lighteners. With limited opportunities for effective treatment, a focus is needed on identifying etiologic factors that may be amenable to intervention. It will also be essential to understand reasons why women delay seeking care after the onset of symptoms and for there to be educational campaigns about the importance of early detection.

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Conflict of interest statement

Conflict of interest: The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Estimated age-standardized breast cancer incidence rate per 100,000
Figure 2
Figure 2
Comparison of breast cancer incidence in Zimbabwe and Uganda from 1990–2007.
Figure 3
Figure 3
Age-standardized breast cancer incidence by female adult literacy rate for sub-Saharan African countries
Figure 4
Figure 4
External beam radiotherapy machines in Africa 2010
See this image and copyright information in PMC

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