Many Breast Cancers in Sub-Saharan Africa Not Detected Until They’re Advanced-Stage

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Breast cancer is less common in West African countries than it is in the United States. Still, the disease is the most diagnosed cancer among women in sub-Saharan Africa.

Because doctors don’t know much about the characteristics of cancer in this region, researchers at the American Cancer Society studied the size and stage of breast cancer at diagnosis in Cote d’Ivoire (Ivory Coast) and the Republic of Congo.

The researchers found that most breast cancer in these two countries was already advanced-stage when diagnosed.

The study was published online on Sept. 11, 2015 by the journal The Breast. Read the abstract of “Tumor size and stage of breast cancer in Cote d’Ivoire and Republic of Congo -- Results from population-based cancer registries.

The researchers used information from national databases of health information in the two countries. They looked at the records of a randomly chosen sample of women who were diagnosed with breast cancer between 2008 and 2009 in both countries. This is the first time a study like this has been done in sub-Saharan Africa.

In Cote d’Ivoire:

  • 68% of the breast cancer tumors were 5 cm or larger in size
  • 74% of the cancers were stage III or stage IV at diagnosis

In the Republic of Congo:

  • 63% of the tumors were 5 cm or larger in size
  • 81% of the cancers were stage III or stage IV at diagnosis

To compare, in the United States, between 16% and 24% of breast cancers are stage III or stage IV at diagnosis.

Breast cancer that is more advanced at diagnosis is usually harder to treat and has worse outcomes than breast cancer that is early-stage at diagnosis.

Because these countries have limited resources, few women are screened for breast cancer with mammograms. The researchers said that making women aware of the importance of early detection would be a good way to find more breast cancers earlier, when they’re most treatable.

“…Raising public awareness may be one of the most important factors,” said Farhad Islami Gomeshtapeh, M.D., Ph.D., an epidemiologist with the American Cancer Society who lead the study. “That approach has reduced the stage of breast cancer at diagnosis in low- and middle-income countries, where it is among the highest priority strategies for early detection of breast cancer. That said, in order to improve the outcome of breast cancer, access to appropriate diagnosis and treatment should also be improved."

For more information about the symptoms of breast cancer, as well as the tests that are used to screen for it and diagnose it, visit the Symptoms and Diagnosis pages.

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