More than one in five women diagnosed with breast cancer in a study involving five sub-Saharan African countries were younger than 40, raising concerns about early detection and access to timely treatment.
The study, published in the Journal of the National Cancer Institute in 2025, examined 2,093 women diagnosed with breast cancer in South Africa, Namibia, Uganda, Zambia and Nigeria.
Researchers found that 459 participants, representing 21.9 per cent, were diagnosed before turning 40, highlighting the importance of recognising symptoms and assessing individual risk rather than relying on age alone.
The findings have prompted renewed calls for improved breast cancer awareness, timely clinical assessment and equitable access to diagnostic services across Africa.
Dr Tonia Frame, Assistant Professor and Director of the Global Health Unit in the Department of Public Health and Preventive Medicine at St George’s University in Grenada, said women should consider their individual risk factors when discussing early detection with healthcare professionals.
“Breast cancer risk does not suddenly begin at a particular birthday, and two women of the same age may have very different risk profiles,” Frame said.
She encouraged women to become familiar with the normal appearance and feel of their breasts and seek medical attention when they notice unexplained changes.
“Women should be encouraged to become familiar with the usual appearance and feel of their breasts and to seek prompt clinical evaluation for unexplained breast changes,” she added.
Breast cancer survival concerns
The 2025 study also identified differences in survival outcomes between younger and older women diagnosed with breast cancer.
Researchers found that the five-year net survival rate among women diagnosed before age 40 was 36 per cent, compared with 43 per cent among women aged 40 to 49, 45 per cent among those aged 50 to 59, 47 per cent among women aged 60 to 69, and 50 per cent among those aged 70 and above. The findings underscore the importance of timely diagnosis and treatment, although the study did not establish that younger age itself caused the survival difference.
The researchers also examined factors associated with mortality, including clinical characteristics and pregnancy within the preceding three years.
Access to breast examinations remains limited
Beyond age at diagnosis, access to early assessment remains a significant challenge across sub-Saharan Africa. A systematic review and meta-analysis published in Frontiers in Oncology on July 31, 2026, estimated that only 13 per cent of women in the region had ever undergone a clinical breast examination.
The researchers found that uptake was associated with factors including educational attainment, household wealth, health insurance coverage and recent contact with healthcare services.
The findings suggest that financial circumstances and access to healthcare can influence whether women receive breast examinations, reinforcing concerns about inequalities in early detection.
Clinical breast examinations involve a trained healthcare professional examining the breasts for abnormalities. They are distinct from mammography, which uses X-rays to examine breast tissue, and from diagnostic investigations used to assess suspicious findings.
St George’s University says improving early detection requires stronger referral systems, expanded access to diagnostic imaging and pathology services, and more healthcare workers trained to assess breast abnormalities.
Individual risk should guide screening decisions
Frame said family history, inherited susceptibility and previous breast abnormalities could help determine whether some women need earlier assessment, specialist referral or additional imaging.
“Family history, inherited susceptibility, previous breast findings and other recognized risk factors can help determine whether a woman may benefit from earlier assessment, specialist referral or additional imaging,” she continued.
Women with close relatives who have had breast or ovarian cancer, particularly at younger ages, may benefit from a formal assessment of their risk. Those with certain inherited genetic variants, including BRCA1 and BRCA2, may require specialised screening plans.
However, earlier screening does not automatically mean every woman should undergo more tests. Decisions should take into account individual risk, clinical guidance and the benefits and potential harms of additional investigations.
Frame also highlighted artificial intelligence as a potential tool for supporting early detection in areas with limited imaging capacity and shortages of specialists.
She cautioned that technology must be integrated into a complete healthcare pathway. “AI output is not a diagnosis. It must be interpreted alongside the patient’s clinical history, risk factors, examination findings and appropriate diagnostic imaging,” she said.
The university said Breast Cancer Awareness Month provides an opportunity to advocate for equitable care, from risk assessment and early detection to diagnostic confirmation and timely treatment.
For women who notice a new lump or other unexplained breast changes, prompt medical assessment remains important regardless of age.
