Systematic review analyzes breast cancer stages and molecular subtype distribution in sub-Saharan Africa, highlighting persistent late-stage diagnoses.
BACKGROUND: This systematic review analyzes the stage at diagnosis of breast cancer and the distribution of molecular subtypes across sub-Saharan Africa between January 2014 and December 2025. A search on Medline, African Journals Online, Web of Science, and Embase was performed. RECENT FINDINGS: Distribution of molecular subtypes, such as Luminal A or B, HER2-enriched and Triple-negative, was also analyzed. From 125 selected studies comprising 42689 patients with staged breast cancer, 63.1% were diagnosed at a late stage, with regional variations (74.5% in Middle Africa, 68.5% in Eastern Africa, 71% in Western Africa, and 55.2% in Southern Africa).Luminal subtypes (A and B) accounted for 68.2% of cases, followed by triple-negative breast cancer (21.1%) and HER2-enriched tumors (10.6%). CONCLUSIONS: Our findings provide an updated synthesis of the stage at diagnosis of breast cancer in sub-Saharan Africa since January 2014. Although a high proportion of patients continue to present at late stage, comparisons with earlier reports should be interpreted cautiously due to heterogeneity in study populations, regional representation, and reporting practices. These findings should be interpreted as an updated regional synthesis rather than evidence of a confirmed temporal improvement in stage at diagnosis. TRIAL REGISTRATION: The review protocol was not registered in PROSPERO which we acknowledge as a limitation.
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