The women of  Africa

Breast cancer in Africa

New insights into breast cancer in Africa


New studies have highlighted unique epidemiological and genetic features of breast cancer among women in some African countries – findings that reinforce the need to ensure that screening and treatment services are optimized for the local populations.


01 February, 2015

A recent review using the most recent data available for the entire continent showed that breast cancer was the most commonly diagnosed cancer among women in 2008. There were an estimated 92,600 cases – 24% of all new cancers diagnosed in women in Africa in that year. The authors of the review paper noted that breast cancer recently overtook cervical cancer as the most commonly diagnosed cancer in several countries in sub-Saharan Africa, including Nigeria, Chad, Sudan, Cameroon, Central African Republic, Niger, Namibia, Congo, Kenya, and Somalia.


This change was attributed to increases in the prevalence of breast cancer risk factors associated with urbanization and economic development, such as earlier menarche, later childbearing, having fewer children, obesity, and increased awareness and detection.¹

 

These factors were also discussed by researchers who recently reported on the features of breast cancer among women in five North African countries: Morocco, Algeria, Tunisia, Libya, and Egypt. They concluded that breast cancer in North Africa can currently be characterized by young age at diagnosis and a high proportion of aggressive forms of the condition (inflammatory breast cancer and triple-negative breast cancer), compared with breast cancer in Western countries.

Discussing these findings, the researchers wrote that these features “stem mainly from risk factor profiles that are different from those observed in Western countries”, resulting in proportionally fewer postmenopausal women being affected with breast cancer. This risk factor profile in North Africa and other developing regions is expected to continue to evolve and eventually converge with the profile seen in Western countries, although “this may take a few more decades depending on the rapidity of societal changes in each country,” the researchers said.

 

They concluded that, in the meantime, “countries have to plan resources for breast cancer early detection, treatment and palliative care accordingly” and that “the large proportion of young cases advocates against the sole use of mammography screening to ensure early detection, since in women less than 50 this approach has been suggested to cause more harm than benefit.” ²

 

Finally, a new study of mutations in the BRCA1 gene (associated with breast cancer) in central Sudan has highlighted the wide genetic variation and high prevalence of unique mutations. Specialists studied 59 premenopausal women with breast cancer and identified a total of 33 BRCA1 point mutations. Of these variants, 14 were unique to Africa, a finding consistent with the long evolutionary history of humans on the continent). About one-quarter of the variants were of unknown significance in terms of their effect on the risk of developing breast cancer.


The researchers concluded that the wide genetic variation and the high frequency of unique or rare mutations of uncertain clinical relevance “pose significant challenges to BRCA1 testing in Sudan” and possibly other low-resource rural African areas. ³

 

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References

 

1. Jemal A. Bray F, Forman D, et al. Cancer burden in Africa and opportunities for prevention. Cancer 2012;118:4372-84.
2. Corbex M, Bouzbid S, Boffetta P. Features of breast cancer in developing countries, examples from North Africa. European J Cancer 2014;50:1808-18
3. Biunno I, Aceto G, Awadelkarim KD, et al. BRCA1 point mutations in premenopausal
4. breast cancer patients from Central Sudan. Familial Cancer 2014;13:437-44.

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