Background: Breast cancer in low-and middle-income settings is frequently diagnosed at advanced stages, with significant heterogeneity in tumor biology and access to systemic therapies.This study aimed to describe clinicopathological characteristics, molecular subtypes, treatment patterns, and early outcomes in a large realworld cohort of breast cancer patients. Methods:We conducted a retrospective descriptive study including 400 consecutive women diagnosed with breast cancer between 2020 and 2023.Demographic, clinical, pathological, molecular, and therapeutic data were extracted from institutional records.Patients were followed until December 2023.Outcomes were reported descriptively and included metastatic presentation, relapse, progression, and vital status; no comparative statistical testing was planned. Results:The mean age at diagnosis was 51.5 years, and 52.3% of patients were premenopausal.At diagnosis, tumors were predominantly T2-T4 (90.3%), with nodal involvement in 59.8% and de novo metastatic disease in 22.5%.Invasive ductal carcinoma was the most common histology (65.5%).Hormone receptor positivity was observed in 76.5%, HER2 overexpression in 38.3%, and high-grade tumors (SBR II-III) accounted for 93.5%.Molecular subtypes were predominantly Luminal B HER2-(35.0%) and Luminal B HER2+ (27.3%), followed by Luminal A (14.3%), triplenegative (13.5%), and HER2-enriched (10.0%).Chemotherapy was administered in 96.5% of patients (neoadjuvant 27.8%, adjuvant 49.0%, palliative 19.0%).Radical surgery was performed in 63.0%, radiotherapy in 68.3%, endocrine therapy in 63.3%, and anti-HER2 therapy in 32.5%.After a maximum follow-up of approximately 3-4 years, relapse occurred in 8.4%, disease progression in 27.5%, and mortality reached 10.7%. Conclusions:This real-world cohort demonstrates a substantial tumor burden at diagnosis, with high rates of nodal and metastatic disease and a predominance of biologically aggressive Luminal B and HER2-driven tumors.Advanced presentation remains a major challenge, underscoring the urgent need for earlier detection strategies and improved access to targeted treatments in similar settings.
Bourhil et al. (Fri,) studied this question.