Breast Cancer in Primary Healthcare: Clinical and Epidemiological Characteristics Associated With Age at Diagnosis and Metastatic Status

Background: This study aimed to explore the demographic, reproductive, lifestyle, screening, and clinical characteristics of breast cancer patients and assess their associations with age at diagnosis and metastatic status at diagnosis in a primary healthcare setting.Methods: A retrospective exploratory study was conducted using medical records of all eligible female breast cancer patients (N = 50) registered across five family medicine teams in Tuzla and diagnosed up to August 2025.As the study included the complete eligible population within the predefined primary healthcare setting, no a priori sample size calculation was performed.Data were analyzed using descriptive statistics, independent-samples t-tests with Welch's correction when appropriate, one-way analysis of variance (ANOVA), Pearson's chi-square test, and exact tests for sparse contingency tables.Statistical significance was defined as p < 0.05.Results: The mean age at diagnosis was 58.90 ± 12.19 years.Tumor mass was most frequently detected via self-examination (n = 20, 40.0%) and mammography screening (n = 17, 34.0%).Mean age at diagnosis differed significantly across detection modes (one-way ANOVA, F = 4.712, p = 0.003).Descriptively, the mean age at diagnosis was 56.25 ± 11.01 years among patients whose tumors were detected by self-examination and 63.53 ± 11.65 years among those detected by mammography.Similarly, patients without prior mammography (n = 28, 56.0%) were diagnosed nearly a decade earlier than those who underwent prior screening (n = 22, 44.0%) (54.61 ± 13.75 vs. 64.36± 6.93 years; Welch's t = -3.221,df = 40.23,p = 0.002).Patients with lymphatic metastases were diagnosed at a significantly younger age than those without metastases (51.17 ± 7.52 vs. 61.56± 12.71 years; p = 0.011).Breastfeeding history was documented in seven patients (14.0%), while breastfeeding information was unavailable for the remaining patients.No statistically significant association was observed between late menopause and metastatic status at diagnosis (p = 0.053).Regarding modifiable lifestyle characteristics, overweight (n = 18, 42.9%) and obesity (n = 14, 33.3%) were present in 76.2% of evaluated patients (n = 42), while active smoking was recorded in 22.0% (n = 11) participants.Conclusion: In this exploratory primary healthcare cohort, age at diagnosis differed across modes of detection, while patients with lymphatic metastases were younger at diagnosis than those without metastases.No statistically significant association was observed between late menopause and metastatic status.Overweight and obesity were common among patients with available BMI data, while breastfeeding history was insufficiently documented for reliable evaluation.These findings should be interpreted cautiously given the small sample size and retrospective design and may help inform larger studies on breast cancer presentation, screening, and early detection.