Breast Cancer in Sub-Saharan Africa

Abstract

Breast cancer is poised to become one of the biggest public health concerns in Sub-Saharan Africa by the mid-twenty-first century. Three factors conspire to propel breast cancer to the forefront of disease burden in the region. Firstly, as Sub-Saharan African demographics rapidly come to resemble those of Western societies, rates of the disease are set to surge in the coming decades. Secondly, there is evidence that breast cancer in Sub-Saharan African women is a distinct – and overall more aggressive – disease than that seen in the West, with higher rates of adverse histological and molecular features and poor outcome. Finally, on top of the above, is the irony that the very societies being presented with these challenges are those least able to confront them effectively: with little health infrastructure and poor levels of public health awareness. Here, we provide an overview of the epidemiology, molecular biology and challenges of breast cancer diagnosis and management in Sub-Saharan Africa. This should not, however, be cause for resignation. Examples abound of practical initiatives in Sub-Saharan Africa which have driven monumental improvements in outcomes for breast cancer patients. Furthermore, increasing interest in the biology of this unique disease has already begun to deliver palpable benefits to its sufferers, and has the potential to overcome the challenges which it poses.