Connecting the Dots: A Narrative Exploration of Breast Cancer Risks in Sub-Saharan African
,
Abstract
Africa contribute significantly in the global burden of breast cancer. Crucial efforts have been made to understand the landscape of breast cancer in sub-Saharan Africa (SSA). This article specifically examine the the existing evidence to better understand the risk factors that shape the epidemiology of breast cancer within the SSA region. This article sets off by discussing the epidemiology of breast cancer in SSA, with emphasis on how disparities occur in the region. The article explored the incidence rate across various countries in SSA. The article explored the various risk factors associated with breast cancer in SSA including genetic factors, relevant biomarkers, hormonal factors, reproductive factors, and some disparities in treatments amongst others. Genetics mutations in BRCA1 and BRCA2 genes were discussed, buttressing how they contribute to the occurrence of breast cancer in the region. Certain biomarkers were also identified as risk factors of breast cancer and deserving of mention is the kaiso biomarker. Hormonal and reproductive factors such as age, breastfeeding time, family history, and body hormones such as estrogen and progesterone amongst others were identified as common risk factors of breast cancer in SSA. The poor treatment strategies and regimens in breast cancer care in SSA is also associated with breast cancer outcome, leading to an overall impact on the epidemiology of breast cancer in SSA. Evidence-based recommendations were also made to improve breast cancer care in SSA. Recommended techniques to addressing breast cancer care rely on genetic insights primarily aimed at informing a technologically-inclined future progress and research.
References
Sung H, Ferlay J, Siegel RL, Laversanne M, Soer¬jomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mor¬tality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2021 May;71(3):209- 49. https://doi.org/10.3322/caac.21660
Obafemi FA, Umahi-Ottah G. A review of global Cancer prevalence and therapy. J Cancer Res Treat Prev. 2023;1(3):128-47. Obafemi FA, Umahi-Ottah G. A review of global Cancer prevalence and therapy. J Cancer Res Treat Prev. 2023;1(3):128-47. https://doi. org/10.37191/Mapsci-JCRTP-1(3)-011
Morhason-Bello IO, Odedina F, Rebbeck TR, Har¬ford J, Dangou JM, Denny L, et al. Challenges and opportunities in cancer control in Africa: a perspec¬tive from the African Organisation for Research and Training in Cancer. The lancet oncology. 2013 Apr 1;14(4):e142-51. https://doi.org/10.1016/S1470- 2045(12)70482-5
Saini G, Ogden A, McCullough LE, Torres M, Rida P, Aneja R. Disadvantaged neighborhoods and racial disparity in breast cancer outcomes: the biological link. Cancer Causes & Control. 2019 Jul 1;30:677-86. https://doi.org/10.1007/s10552-019-01180-4
Hiatt RA, Brody JG. Environmental determinants of breast cancer. Annual review of public health. 2018 Apr 1;39:113-33.
Gibbon S, Joseph G, Mozersky J, Zur Nieden A, Palf¬ner S, editors. Breast cancer gene research and med¬ical practices: transnational perspectives in the time of BRCA. Routledge; 2014 Mar 5.
Antoniou AC, Easton DF. Models of genetic sus¬ceptibility to breast cancer. Oncogene. 2006 Sep;25(43):5898-905. https://doi.org/10.1038/ sj.onc.1209879
Turnbull C, Rahman N. Genetic predisposition to breast cancer: past, present, and future. Annu. Rev. Genomics Hum. Genet.. 2008 Sep 22;9:321-45.
Duggan C, Trapani D, Ilbawi AM, Fidarova E, Laver¬sanne M, Curigliano G, et al. National health system characteristics, breast cancer stage at diagnosis, and breast cancer mortality: a population-based analysis. The Lancet Oncology. 2021 Nov 1;22(11):1632-42. https://doi.org/10.1016/S1470-2045(21)00462-9.
Ahmad A. Breast cancer statistics: recent trends. Breast cancer metastasis and drug resistance: chal¬lenges and progress. 2019:1-7.
Fregene A, Newman LA. Breast cancer in sub‐Saha¬ran Africa: how does it relate to breast cancer in Afri¬ can‐American women?. Cancer: Interdisciplinary In¬ternational Journal of the American Cancer Society. 2005 Apr 15;103(8):1540-50. https://doi.org/10.1002/ cncr.20978
Joko‐Fru WY, Jedy‐Agba E, Korir A, Ogunbiyi O, Dz¬amalala CP, Chokunonga E, et al. The evolving epi¬demic of breast cancer in sub‐Saharan Africa: Results from the African Cancer Registry Network. Interna¬tional journal of cancer. 2020 Oct 15;147(8):2131-41. https://doi.org/10.1002/ijc.33014
Pilleron S, Soerjomataram I, Charvat H, Chokunonga E, Somdyala NI, Wabinga H, et al. Cancer incidence in older adults in selected regions of sub‐Saharan Africa, 2008–2012. International journal of cancer. 2019 Apr 15;144(8):1824-33.https://doi.org/10.1002/ ijc.31880
Hayat M, Chen WC, Brandenburg JT, De Villiers CB, Ramsay M, Mathew C. Genetic susceptibility to breast cancer in Sub-Saharan African populations. JCO glob oncol. 2021 Dec;(7):1462–71.
Babatunde A, Yonglan Z, Paul N, Antony G, Timothy M, Toshio FY, et al. Prevalence of Inherited Muta¬tions in Breast Cancer Predisposition Genes among Uganda and Cameroon Women. Cancer Epidemiol Biomarkers Prev. 2020;29(2):359–67.
American Cancer Society. Breast cancer risk fac¬tors you can’t change [Internet]. [Cited 2024, April 4]. Available from: https://www.cancer.org/cancer/ types/breast-cancer/risk-and-prevention/breast-can¬cer-risk-factors-you-cannot-change.html
National Cancer Institute. Genetics of Breast and Gy¬necologic Cancers (PDQ®)–Health Professional Ver¬sion [Internet]. Updated: April 4, 2024. [Cited 2024, April 4]. Available from: https://www.cancer.gov/ types/breast/hp/breast-ovarian-genetics-pdq
Chan-Ping You, Man-Hong Leung, Wai-Chung Tsang, Ui-Soon Khoo, Ho Tsoi. Androgen Receptor as an Emerging feasible Biomarker for Breast Can¬cer. Biomolecules. 2022; Jan 4;12(1):72. doi: 10.3390/ biom12010072.
Hercules SM, Alnajar M, Chen C, Mladjenovic SM, Shipeolu BA, Perkovic O, et al. Triple-negative breast cancer prevalence in Africa: a systematic review and meta-analysis. BMJ Open. 2022;12[5]:e055735.
Fleisher B, Clarke C, Ait-Oudhia S. Current advanc¬es in biomarkers for targeted therapy in triple-nega¬tive breast cancer. Breast Cancer (Dove Med Press). 2016;8:183-97.
Bassey-Archibong BI, Hercules SM, Rayner LGA, Skeete DHA, Smith Connell SP, Brain I, et al. Kaiso is highly expressed in TNBC tissues of women of Afri¬can ancestry compared to Caucasian women. Cancer Causes Control. 2017 Nov;28(11):1295–304.
Brown KF, Rumgay H, Dunlop C, et al. The fraction of cancer attributable to modifiable risk factors in England, Wales, Scotland, Northern Ireland, and the United Kingdom in 2015. Br J Cancer 2018; 118: 1130–41.
Yeo W, Lee HM, Chan A, Chan EYY, et al. Risk factors and natural history of breast cancer in younger. Chi-nese women. World J Clin Oncol. 2014, 5, 1097-106.
Colditz GA, Bohlke K. Priorities for the prima¬ry prevention of breast cancer. CA Cancer J Clin 2014;64:186–94.
Hawk N, O’Regan R. Treatment of triple-negative breast cancer. Community Oncology. 2010;7(7):328-332
Karapanou O, Papadimitriou A. Determinants of menarche. Reproductive biology and endocrinology. 2010; 8(115):1477. Kruger WM, Apffelstaedt JP. Young breast cancer pa¬tients in the developing world: incidence, choice of surgical treatment and genetic factors. South African Family Practice. 2007;49(9):18-24.
Mujagic Z, Srabovic N, Mujagic H. The role of prolac¬tin in human breast cancer. J of Croat Soc Med Bio¬chem. 2009;19(3):236-249.
Puri S, Mangat C, Bhatia V, Kalia M, Sehgel A, Kaur AP. Awareness of risk factors and aspects of breast cancer among North Indian women. Internet J Health. 2009; 8(2):1-12.
Lord SJ, Bernstein L, Johnson KA, Malone KE, Mc¬Donald JA, Marchbanks P A, et al. Breast cancer and hormone receptor status in older women by parity, age of first birth, and breastfeeding: A case-control study. Can Epidemiol Biomark Prev. 2018; 17:1723.
Fung TT, Hu FB, Hankinson SE, Willett WC, Holmes MD. Low-carbohydrate diets,Dietary Approach¬es to Stop Hypertension-style diets, and the risk of postmenopausal breast cancer. Ame J Epidemiol. 2011;174(6):652-660.
Celik S, Aksoy G. Identification of risk factors for breast cancer for women in Istanbul. Open Nurs J. 2007; 1:6-12.
Anderson BO, Ilbawi AM, El Saghir NS. Breast can¬cer in low and middle income countries (LMICs): a shifting tide in global health. Breast J. 2015;21:111–8.
Islami F, Liu Y, Jemal A, Zhou J, Weiderpass E, Colditz G, et al. Breastfeeding and breast cancer risk by receptor status–a systematic review and metaanal¬ysis. Ann Oncol 2015;26:2398–407.
Vaccarella S, Franceschi S, Bray F, Wild CP, Plummer M, Dal Maso L. Worldwide thyroid-cancer epidem¬ic? The increasing impact of overdiagnosis. N Engl J Med 2016;375:614–7.
Lauby-Secretan B, Scoccianti C, Loomis D, Ben¬brahim-Tallaa L, Bouvard V, Bianchini F, et al. Breast-Cancer Screening — Viewpoint of the IARC Working Group. N Engl J Med 2015;372:2353–8.
Ferlay J, Ervik M, Lam F, et al. Global cancer obser¬vatory: cancer today. 2018. https://gco.iarc.fr/today/ onlineanalysis. Accessed [Dec 1, 2019]. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer in¬cidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Can¬cer 2015;136:E359–86.
Coghill AE, Newcomb PA, Madeleine MM, et al. Contribution of HIV infection to mortality among cancer patients in Uganda. AIDS. 2013; 27: 2933–42.
Galukande M, Wabinga H, Mirembe F. Breast cancer survival experiences at a tertiary hospital in sub-Sa¬haran Africa: a cohort study. World J Surg Oncol 2015;13:220.
Coleman MP, Quaresma M, Berrino F, et al. Can¬cer survival in five continents: a worldwide pop¬ulation-based study Kantelhardt E, Zerche P, Mathewos A, et al. Breast cancer survival in Ethiopia: a cohort study of 1,070 women. Int J Cancer 2013;135:702–9.
Keegan TH, Press DJ, Tao L, et al. Impact of breast cancer subtypes on 3-year survival among adoles¬cent and young adult women. Breast Cancer Res 2013;15:R95.
Mathew A. Global survey of clinical oncology work¬force. J Glob Oncol .2018;4:1–12.
Joko-Fru, W. Y., Griesel, M., Mezger, N. C. S., Häm¬merl, L., Seraphin, T. P., Feuchtner, J., Wabinga, H., N’da, G., Mathewos, A., Kamaté, B., Nsonde Malan¬da, J., Gnangnon, F. H. R., Chesumbai, G. C., Korir, A., Lorenzoni, C., Zietsman, A., Borok, M. Z., Liu, B., Thomssen, C., McGale, P., … Kantelhardt, E. J. (2021). Breast Cancer Diagnostics, Therapy, and Out¬comes in Sub-Saharan Africa: A Population-Based Registry Study. Journal of the National Compre¬hensive Cancer Network : JNCCN, 20(13), 10.6004/ jnccn.2021.7011. https:// doi. org/10.6004/ jnccn . 2021.7011. Abdel-Wahab M, Bourque JM, Pynda Y, et al. Status of radiotherapy resources in Africa: an Internation¬al Atomic Energy Agency analysis. Lancet Oncol 2013;14:e168–175.
Egwuonwu OA, Anyanwu SN, Nwofor AM. Default from neoadjuvant chemotherapy in premenopausal female breast cancer patients: what is to blame? Ni¬ger J Clin Pract 2012;15:265–9.
McKenzie F, Zietsman A, Galukande M, et al. Afri¬can Breast Cancer— Disparities in Outcomes (ABC-DO): protocol of a multicountry mobile health pro¬spective study of breast cancer survival in subSaha¬ran Africa. BMJ Open 2016;6:e011390. doi:10.1136/ bmjopen-2016-011390
Olopade OI, Grushko TA, Nanda R, Huo D. Advances in breast cancer: pathways to personalized medicine. Clinical Cancer Research. 2008 Dec 15;14(24):7988- 99. https://doi.org/10.1158/1078-0432.CCR-08-1211
Subhan MA, Parveen F, Shah H, Yalamarty SS, Ataide JA, Torchilin VP. Recent advances with pre¬cision medicine treatment for breast cancer in¬ cluding triple-negative sub-type. Cancers. 2023 Apr 8;15(8):2204. https://doi.org/10.3390/can¬cers15082204
Swathi NL, Chakrabarti M, Muzzamil M, Hamdar H, Jaber A, Chamoun A, et al. Precision Medicine: Insights From Case Studies and Cutting-Edge Tech¬nologies. InMedical Robotics and AI-Assisted Diag¬nostics for a High-Tech Healthcare Industry 2024 (pp. 257-280). IGI Global. DOI: 10.4018/979-8-3693- 2105-8.ch017
Pinker K, Chin J, Melsaether AN, Morris EA, Moy L. Precision medicine and radiogenomics in breast cancer: new approaches toward diagnosis and treat¬ment. Radiology. 2018 Jun;287(3):732-47. https://doi. org/10.1148/radiol.2018172171
Owens DK, Davidson KW, Krist AH, Barry MJ, Ca¬bana M, Caughey AB, Doubeni CA, et al. Risk as¬sessment, genetic counseling, and genetic testing for BRCA-related cancer: US Preventive Services Task Force recommendation statement. JAMA. 2019 Aug 20;322(7):652-65. doi:10.1001/jama.2019.10987 Piccinin C, Panchal S, Watkins N, Kim RH. An update on genetic risk assessment and prevention: the role of genetic testing panels in breast cancer. Exp Rev Anti¬cancer Ther. 2019 Sep 2;19(9):787-801. https://doi.or g/10.1080/14737140.2019.1659730
Carpenter WR, Reeder-Hayes K, Bainbridge J, Mey¬er AM, Amos KD, Weiner BJ, et al. The role of or-ganizational affiliations and research networks in the diffusion of breast cancer treatment innovation. Medical care. 2011 Feb 1;49(2):172-9. DOI: 10.1097/ MLR.0b013e3182028ff2
Curigliano G, Criscitiello C, Andrè F, Colleoni M, Di Leo A. Highlights from the 13th St Gallen Inter¬national Breast Cancer Conference 2013. Access to innovation for patients with breast cancer: how to speed it up?. ecancermedicalscience. 2013;7. Doi https://doi.org/10.3332%2Fecancer.2013.299
Obeagu EI, Obeagu GU. BRCA Mastery: Redefining Breast Cancer Care through Cuttingedge Diagnosis and Management. Elite J Med. 2024;2(2):55-66.
Sung H, Ferlay J, Siegel RL, Laversanne M, Soer¬jomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mor¬tality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2021 May;71(3):209- 49. https://doi.org/10.3322/caac.21660
Obafemi FA, Umahi-Ottah G. A review of global Cancer prevalence and therapy. J Cancer Res Treat Prev. 2023;1(3):128-47. Obafemi FA, Umahi-Ottah G. A review of global Cancer prevalence and therapy. J Cancer Res Treat Prev. 2023;1(3):128-47. https://doi. org/10.37191/Mapsci-JCRTP-1(3)-011
Morhason-Bello IO, Odedina F, Rebbeck TR, Har¬ford J, Dangou JM, Denny L, et al. Challenges and opportunities in cancer control in Africa: a perspec¬tive from the African Organisation for Research and Training in Cancer. The lancet oncology. 2013 Apr 1;14(4):e142-51. https://doi.org/10.1016/S1470- 2045(12)70482-5
Saini G, Ogden A, McCullough LE, Torres M, Rida P, Aneja R. Disadvantaged neighborhoods and racial disparity in breast cancer outcomes: the biological link. Cancer Causes & Control. 2019 Jul 1;30:677-86. https://doi.org/10.1007/s10552-019-01180-4
Hiatt RA, Brody JG. Environmental determinants of breast cancer. Annual review of public health. 2018 Apr 1;39:113-33.
Gibbon S, Joseph G, Mozersky J, Zur Nieden A, Palf¬ner S, editors. Breast cancer gene research and med¬ical practices: transnational perspectives in the time of BRCA. Routledge; 2014 Mar 5.
Antoniou AC, Easton DF. Models of genetic sus¬ceptibility to breast cancer. Oncogene. 2006 Sep;25(43):5898-905. https://doi.org/10.1038/ sj.onc.1209879
Turnbull C, Rahman N. Genetic predisposition to breast cancer: past, present, and future. Annu. Rev. Genomics Hum. Genet.. 2008 Sep 22;9:321-45.
Duggan C, Trapani D, Ilbawi AM, Fidarova E, Laver¬sanne M, Curigliano G, et al. National health system characteristics, breast cancer stage at diagnosis, and breast cancer mortality: a population-based analysis. The Lancet Oncology. 2021 Nov 1;22(11):1632-42. https://doi.org/10.1016/S1470-2045(21)00462-9.
Ahmad A. Breast cancer statistics: recent trends. Breast cancer metastasis and drug resistance: chal¬lenges and progress. 2019:1-7.
Fregene A, Newman LA. Breast cancer in sub‐Saha¬ran Africa: how does it relate to breast cancer in Afri¬ can‐American women?. Cancer: Interdisciplinary In¬ternational Journal of the American Cancer Society. 2005 Apr 15;103(8):1540-50. https://doi.org/10.1002/ cncr.20978
Joko‐Fru WY, Jedy‐Agba E, Korir A, Ogunbiyi O, Dz¬amalala CP, Chokunonga E, et al. The evolving epi¬demic of breast cancer in sub‐Saharan Africa: Results from the African Cancer Registry Network. Interna¬tional journal of cancer. 2020 Oct 15;147(8):2131-41. https://doi.org/10.1002/ijc.33014
Pilleron S, Soerjomataram I, Charvat H, Chokunonga E, Somdyala NI, Wabinga H, et al. Cancer incidence in older adults in selected regions of sub‐Saharan Africa, 2008–2012. International journal of cancer. 2019 Apr 15;144(8):1824-33.https://doi.org/10.1002/ ijc.31880
Hayat M, Chen WC, Brandenburg JT, De Villiers CB, Ramsay M, Mathew C. Genetic susceptibility to breast cancer in Sub-Saharan African populations. JCO glob oncol. 2021 Dec;(7):1462–71.
Babatunde A, Yonglan Z, Paul N, Antony G, Timothy M, Toshio FY, et al. Prevalence of Inherited Muta¬tions in Breast Cancer Predisposition Genes among Uganda and Cameroon Women. Cancer Epidemiol Biomarkers Prev. 2020;29(2):359–67.
American Cancer Society. Breast cancer risk fac¬tors you can’t change [Internet]. [Cited 2024, April 4]. Available from: https://www.cancer.org/cancer/ types/breast-cancer/risk-and-prevention/breast-can¬cer-risk-factors-you-cannot-change.html
National Cancer Institute. Genetics of Breast and Gy¬necologic Cancers (PDQ®)–Health Professional Ver¬sion [Internet]. Updated: April 4, 2024. [Cited 2024, April 4]. Available from: https://www.cancer.gov/ types/breast/hp/breast-ovarian-genetics-pdq
Chan-Ping You, Man-Hong Leung, Wai-Chung Tsang, Ui-Soon Khoo, Ho Tsoi. Androgen Receptor as an Emerging feasible Biomarker for Breast Can¬cer. Biomolecules. 2022; Jan 4;12(1):72. doi: 10.3390/ biom12010072.
Hercules SM, Alnajar M, Chen C, Mladjenovic SM, Shipeolu BA, Perkovic O, et al. Triple-negative breast cancer prevalence in Africa: a systematic review and meta-analysis. BMJ Open. 2022;12[5]:e055735.
Fleisher B, Clarke C, Ait-Oudhia S. Current advanc¬es in biomarkers for targeted therapy in triple-nega¬tive breast cancer. Breast Cancer (Dove Med Press). 2016;8:183-97.
Bassey-Archibong BI, Hercules SM, Rayner LGA, Skeete DHA, Smith Connell SP, Brain I, et al. Kaiso is highly expressed in TNBC tissues of women of Afri¬can ancestry compared to Caucasian women. Cancer Causes Control. 2017 Nov;28(11):1295–304.
Brown KF, Rumgay H, Dunlop C, et al. The fraction of cancer attributable to modifiable risk factors in England, Wales, Scotland, Northern Ireland, and the United Kingdom in 2015. Br J Cancer 2018; 118: 1130–41.
Yeo W, Lee HM, Chan A, Chan EYY, et al. Risk factors and natural history of breast cancer in younger. Chi-nese women. World J Clin Oncol. 2014, 5, 1097-106.
Colditz GA, Bohlke K. Priorities for the prima¬ry prevention of breast cancer. CA Cancer J Clin 2014;64:186–94.
Hawk N, O’Regan R. Treatment of triple-negative breast cancer. Community Oncology. 2010;7(7):328-332
Karapanou O, Papadimitriou A. Determinants of menarche. Reproductive biology and endocrinology. 2010; 8(115):1477. Kruger WM, Apffelstaedt JP. Young breast cancer pa¬tients in the developing world: incidence, choice of surgical treatment and genetic factors. South African Family Practice. 2007;49(9):18-24.
Mujagic Z, Srabovic N, Mujagic H. The role of prolac¬tin in human breast cancer. J of Croat Soc Med Bio¬chem. 2009;19(3):236-249.
Puri S, Mangat C, Bhatia V, Kalia M, Sehgel A, Kaur AP. Awareness of risk factors and aspects of breast cancer among North Indian women. Internet J Health. 2009; 8(2):1-12.
Lord SJ, Bernstein L, Johnson KA, Malone KE, Mc¬Donald JA, Marchbanks P A, et al. Breast cancer and hormone receptor status in older women by parity, age of first birth, and breastfeeding: A case-control study. Can Epidemiol Biomark Prev. 2018; 17:1723.
Fung TT, Hu FB, Hankinson SE, Willett WC, Holmes MD. Low-carbohydrate diets,Dietary Approach¬es to Stop Hypertension-style diets, and the risk of postmenopausal breast cancer. Ame J Epidemiol. 2011;174(6):652-660.
Celik S, Aksoy G. Identification of risk factors for breast cancer for women in Istanbul. Open Nurs J. 2007; 1:6-12.
Anderson BO, Ilbawi AM, El Saghir NS. Breast can¬cer in low and middle income countries (LMICs): a shifting tide in global health. Breast J. 2015;21:111–8.
Islami F, Liu Y, Jemal A, Zhou J, Weiderpass E, Colditz G, et al. Breastfeeding and breast cancer risk by receptor status–a systematic review and metaanal¬ysis. Ann Oncol 2015;26:2398–407.
Vaccarella S, Franceschi S, Bray F, Wild CP, Plummer M, Dal Maso L. Worldwide thyroid-cancer epidem¬ic? The increasing impact of overdiagnosis. N Engl J Med 2016;375:614–7.
Lauby-Secretan B, Scoccianti C, Loomis D, Ben¬brahim-Tallaa L, Bouvard V, Bianchini F, et al. Breast-Cancer Screening — Viewpoint of the IARC Working Group. N Engl J Med 2015;372:2353–8.
Ferlay J, Ervik M, Lam F, et al. Global cancer obser¬vatory: cancer today. 2018. https://gco.iarc.fr/today/ onlineanalysis. Accessed [Dec 1, 2019]. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer in¬cidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Can¬cer 2015;136:E359–86.
Coghill AE, Newcomb PA, Madeleine MM, et al. Contribution of HIV infection to mortality among cancer patients in Uganda. AIDS. 2013; 27: 2933–42.
Galukande M, Wabinga H, Mirembe F. Breast cancer survival experiences at a tertiary hospital in sub-Sa¬haran Africa: a cohort study. World J Surg Oncol 2015;13:220.
Coleman MP, Quaresma M, Berrino F, et al. Can¬cer survival in five continents: a worldwide pop¬ulation-based study Kantelhardt E, Zerche P, Mathewos A, et al. Breast cancer survival in Ethiopia: a cohort study of 1,070 women. Int J Cancer 2013;135:702–9.
Keegan TH, Press DJ, Tao L, et al. Impact of breast cancer subtypes on 3-year survival among adoles¬cent and young adult women. Breast Cancer Res 2013;15:R95.
Mathew A. Global survey of clinical oncology work¬force. J Glob Oncol .2018;4:1–12.
Joko-Fru, W. Y., Griesel, M., Mezger, N. C. S., Häm¬merl, L., Seraphin, T. P., Feuchtner, J., Wabinga, H., N’da, G., Mathewos, A., Kamaté, B., Nsonde Malan¬da, J., Gnangnon, F. H. R., Chesumbai, G. C., Korir, A., Lorenzoni, C., Zietsman, A., Borok, M. Z., Liu, B., Thomssen, C., McGale, P., … Kantelhardt, E. J. (2021). Breast Cancer Diagnostics, Therapy, and Out¬comes in Sub-Saharan Africa: A Population-Based Registry Study. Journal of the National Compre¬hensive Cancer Network : JNCCN, 20(13), 10.6004/ jnccn.2021.7011. https:// doi. org/10.6004/ jnccn . 2021.7011. Abdel-Wahab M, Bourque JM, Pynda Y, et al. Status of radiotherapy resources in Africa: an Internation¬al Atomic Energy Agency analysis. Lancet Oncol 2013;14:e168–175.
Egwuonwu OA, Anyanwu SN, Nwofor AM. Default from neoadjuvant chemotherapy in premenopausal female breast cancer patients: what is to blame? Ni¬ger J Clin Pract 2012;15:265–9.
McKenzie F, Zietsman A, Galukande M, et al. Afri¬can Breast Cancer— Disparities in Outcomes (ABC-DO): protocol of a multicountry mobile health pro¬spective study of breast cancer survival in subSaha¬ran Africa. BMJ Open 2016;6:e011390. doi:10.1136/ bmjopen-2016-011390
Olopade OI, Grushko TA, Nanda R, Huo D. Advances in breast cancer: pathways to personalized medicine. Clinical Cancer Research. 2008 Dec 15;14(24):7988- 99. https://doi.org/10.1158/1078-0432.CCR-08-1211
Subhan MA, Parveen F, Shah H, Yalamarty SS, Ataide JA, Torchilin VP. Recent advances with pre¬cision medicine treatment for breast cancer in¬ cluding triple-negative sub-type. Cancers. 2023 Apr 8;15(8):2204. https://doi.org/10.3390/can¬cers15082204
Swathi NL, Chakrabarti M, Muzzamil M, Hamdar H, Jaber A, Chamoun A, et al. Precision Medicine: Insights From Case Studies and Cutting-Edge Tech¬nologies. InMedical Robotics and AI-Assisted Diag¬nostics for a High-Tech Healthcare Industry 2024 (pp. 257-280). IGI Global. DOI: 10.4018/979-8-3693- 2105-8.ch017
Pinker K, Chin J, Melsaether AN, Morris EA, Moy L. Precision medicine and radiogenomics in breast cancer: new approaches toward diagnosis and treat¬ment. Radiology. 2018 Jun;287(3):732-47. https://doi. org/10.1148/radiol.2018172171
Owens DK, Davidson KW, Krist AH, Barry MJ, Ca¬bana M, Caughey AB, Doubeni CA, et al. Risk as¬sessment, genetic counseling, and genetic testing for BRCA-related cancer: US Preventive Services Task Force recommendation statement. JAMA. 2019 Aug 20;322(7):652-65. doi:10.1001/jama.2019.10987 Piccinin C, Panchal S, Watkins N, Kim RH. An update on genetic risk assessment and prevention: the role of genetic testing panels in breast cancer. Exp Rev Anti¬cancer Ther. 2019 Sep 2;19(9):787-801. https://doi.or g/10.1080/14737140.2019.1659730
Carpenter WR, Reeder-Hayes K, Bainbridge J, Mey¬er AM, Amos KD, Weiner BJ, et al. The role of or-ganizational affiliations and research networks in the diffusion of breast cancer treatment innovation. Medical care. 2011 Feb 1;49(2):172-9. DOI: 10.1097/ MLR.0b013e3182028ff2
Curigliano G, Criscitiello C, Andrè F, Colleoni M, Di Leo A. Highlights from the 13th St Gallen Inter¬national Breast Cancer Conference 2013. Access to innovation for patients with breast cancer: how to speed it up?. ecancermedicalscience. 2013;7. Doi https://doi.org/10.3332%2Fecancer.2013.299
Obeagu EI, Obeagu GU. BRCA Mastery: Redefining Breast Cancer Care through Cuttingedge Diagnosis and Management. Elite J Med. 2024;2(2):55-66.
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| Issue | Vol 17 No 2 (2025) | |
| Section | Reviews | |
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How to Cite
1.
Ugwu E, Dike U, Ahuchaogu K-D. Connecting the Dots: A Narrative Exploration of Breast Cancer Risks in Sub-Saharan African. Basic Clin Cancer Res. 2026;17(2).
