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Breast cancer in Sub-Saharan Africa: opportunities for prevention

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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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Acknowledgments

This research was supported in part by funds from the intramural research program of the National Cancer Institute, National Institutes of Health. None of the authors has a financial relationship with the organization that sponsored the research.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Rm. 7E-102, MSC 9774, Bethesda, MD, 20892-9774, USA

    Louise A. Brinton, Jonine D. Figueroa & Shannon N. Wood

  2. Komfo Anoyke Teaching Hospital, Kumasi, Ghana

    Baffour Awuah & Daniel Ansong

  3. Korle Bu Teaching Hospital, Accra, Ghana

    Joel Yarney, Kofi Nyarko & Joe Nat Clegg-Lamptey

  4. Loma Linda University, Loma Linda, CA, USA

    Seth Wiafe

  5. Peace and Love Hospital, Kumasi, Ghana

    Beatrice Wiafe-Addai

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  1. Louise A. Brinton
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Correspondence to Louise A. Brinton.

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Brinton, L.A., Figueroa, J.D., Awuah, B. et al. Breast cancer in Sub-Saharan Africa: opportunities for prevention. Breast Cancer Res Treat 144, 467–478 (2014). https://doi.org/10.1007/s10549-014-2868-z

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