Dr. Tonia Frame, Assistant Professor and Director of the Global Health Unit at SGU
Across Africa, breast cancer is the most commonly diagnosed cancer among women and the leading cause of cancer-related deaths. According to the International Agency for Research on Cancer’s GLOBOCAN 2024 estimates, published in 2026, the continent recorded approximately 225,643 new breast cancer cases and an estimated 100,070 deaths in 2024.
These figures underscore the importance of raising awareness, recognising symptoms early and improving access to timely diagnosis and treatment.
The age at which women are diagnosed with breast cancer varies across African countries and populations. A 2025 study involving women diagnosed with breast cancer in five sub-Saharan African countries found that 21.9 per cent of participants were diagnosed before the age of 40.
The findings highlight the importance of breast awareness, timely evaluation of symptoms, clinical examination and individual risk assessment.
The World Health Organization (WHO) recommends early diagnosis and prompt evaluation of women with symptoms of breast cancer. Screening recommendations, meanwhile, should take individual risk factors and available healthcare resources into account.
“Breast cancer risk does not suddenly begin at a particular birthday, and two women of the same age may have very different risk profiles,” said Dr. Tonia Frame, Assistant Professor and Director of the Global Health Unit in the Department of Public Health and Preventive Medicine at St. George’s University in Grenada, West Indies.
“Women should be encouraged to become familiar with the usual appearance and feel of their breasts and to seek prompt clinical evaluation for unexplained breast changes. In Africa, where breast cancer often presents at a comparatively younger age, and access to high-quality imaging is uneven, discussions about early detection should extend beyond age alone.
“Family history, inherited susceptibility, previous breast findings and other recognised risk factors can help determine whether a woman may benefit from earlier assessment, specialist referral or additional imaging,” she added.
Why Individual Breast Cancer Risk Matters
A risk-informed approach to breast cancer screening considers several factors that may influence when screening should begin and which assessment methods may be appropriate.
Family history: Breast or ovarian cancer among close relatives, particularly diagnoses at younger ages, cancer affecting both breasts, male breast cancer or multiple affected relatives may indicate an inherited predisposition. These patterns may warrant a formal risk assessment and consideration of earlier screening.
Genetic factors: Women with BRCA1 or BRCA2 gene variants may require screening earlier than women at average risk, potentially beginning as early as age 25, depending on their individual circumstances and clinical guidance.
Breast density: Dense breast tissue can reduce the sensitivity of mammography and is independently associated with an increased risk of breast cancer. Supplemental imaging, such as magnetic resonance imaging (MRI), may be considered for selected women based on their overall risk and clinical circumstances. Such decisions should also account for the availability of imaging services and the possibility of false-positive results and unnecessary biopsies.
Previous breast findings: A history of high-risk breast lesions, atypical biopsy results or suspicious imaging findings may affect the recommended screening frequency or method. Women with these findings should follow an individualised plan developed with their healthcare provider.
Unequal Access to Breast Cancer Services
Access to breast assessment, diagnostic imaging and specialist interpretation remains highly unequal across sub-Saharan Africa.
A 2026 systematic review and meta-analysis found that only 13 per cent of women had ever undergone a clinical breast examination. Uptake varied according to education, household wealth, health insurance coverage and contact with healthcare services.
The region also faces significant gaps in diagnostic capacity. According to the WHO Regional Office for Africa, limited diagnostic infrastructure and shortages of specialised healthcare personnel contribute to late diagnosis and poor outcomes.
Addressing these challenges requires more than awareness campaigns. Priorities include strengthening clinical breast examination and referral pathways, training frontline health workers, expanding access to diagnostic imaging and pathology services, ensuring timely follow-up after abnormal findings, and monitoring outcomes across socioeconomic and geographic groups.
How Artificial Intelligence Could Support Early Detection
Artificial intelligence (AI) is being evaluated as a potential tool to support breast cancer detection in settings where imaging capacity and specialist availability are limited.
Depending on the technology and clinical context, AI may assist with triage, image interpretation, workflow prioritisation or risk estimation. Its clinical value, however, depends on appropriate validation, reliable referral pathways, diagnostic confirmation, quality assurance and ongoing monitoring to identify differences in performance across population groups.
“Integrating community health workers, portable AI technology and digital referral pathways within primary healthcare could potentially help reach women who face geographic, financial or health-system barriers,” Dr. Frame said.
“The most important feature is not the algorithm alone, but the complete pathway linking awareness, initial assessment, referral, diagnostic confirmation and treatment. AI output is not a diagnosis. It must be interpreted alongside the patient’s clinical history, risk factors, examination findings and appropriate diagnostic imaging.”
Turning Personal Risk Into Informed Screening Decisions
A personalised approach does not necessarily mean performing more tests on every woman. Instead, it involves identifying those who may benefit from earlier or more frequent screening, or different assessment methods, while avoiding unnecessary imaging and procedures among women unlikely to benefit.
As part of a shared decision-making conversation, women may wish to ask their healthcare providers:
- Based on my age and personal risk factors, when should breast cancer screening begin?
- Does my family history suggest that I need a formal risk assessment?
- Would a referral for genetic counselling be appropriate?
- If I have dense breasts, how does this affect the interpretation of my mammogram and my overall risk?
- Do previous breast symptoms, imaging findings or biopsy results change my follow-up plan?
- Which screening and diagnostic services are available locally, and what follow-up will be provided if an abnormality is found?
- Would a formal breast cancer risk assessment help guide my screening plan?
Breast Cancer Awareness Month provides an opportunity to advocate for equitable care pathways, from risk assessment and early detection to diagnosis and timely treatment.
Across Africa, a key priority is ensuring that every woman with a concerning symptom or abnormal finding receives appropriate assessment, diagnostic confirmation and treatment without avoidable delays.
Preparing future physicians to respond to evolving healthcare needs is central to medical and public health education at St. George’s University School of Medicine. Through a diverse international learning environment and clinical exposure, students develop the medical knowledge, clinical skills and professional competencies needed to care for diverse patient populations.
For more information about the programmes and study tracks available through St. George’s University School of Medicine, visit the university’s official website.
