Breast Cancer Detection and Treatment in Five East African Countries: Challenges, Advances, and Future Directions

This narrative review examines breast cancer detection and treatment in Tanzania, Kenya, Uganda, Rwanda, and Ethiopia, where late-stage diagnosis and delays in care remain major public health concerns. Although reported incidence is lower than in many high-income settings, mortality relative to incidence remains high. We synthesize evidence on risk factors, early detection, diagnostic pathways, treatment access, health-system barriers, policy responses, and emerging priorities. Studies from these settings identify limited diagnostic capacity, workforce shortages, referral delays, financial barriers, and uneven oncology services as important obstacles to timely care. Germline BRCA1/2 testing may inform risk assessment and selected treatment decisions, while assessment of ER, PR, and HER2 informs systemic therapy. Consistent with WHO guidance, strengthening timely evaluation and referral of symptomatic women is a priority where organized, quality-assured population screening and downstream services are not yet feasible. Patient navigation, improved pathology and treatment capacity, financial protection, and context-appropriate precision oncology may strengthen care. Better outcomes will require investment across the continuum from symptom recognition through diagnosis, treatment, and follow-up.