A Resource-Adapted Framework for BRCA1/2 Genetic Testing in Breast Cancer: Innovative Strategies for African and Low-Resource Settings

Globally, breast cancer is the most frequently occurring cancer among women, and prevalence has been increasing in low-middle-income countries (LMICs), including African countries. Although incidence is lower than in high-income countries (HICs), mortality remains disproportionately high due to delayed diagnosis, limited screening, and poor healthcare structures. Genetic predisposition, particularly BRCA1/2 mutations, plays a major role in hereditary breast cancer; however, access to genetic testing and counselling services is limited and unequal in many LMICs. This review synthesizes current evidence on the early detection of BRCA1/2 mutations in LMICs, with a special focus on African populations, highlighting unique challenges such as financial constraints, low awareness, and gaps in health system integration. Importantly, this study proposes a resource-adapted framework that combines targeted testing in high-risk groups, affordable genotyping approaches, digital health solutions, and community-based strategies to expand testing capacity. Implementing cost-effective, scalable approaches alongside policy support and education can expand BRCA testing capacity, ultimately improving prevention, survival, and quality of life.