Epidemiological characteristics of breast cancer patients at Antanambao University Hospital in Toliara, Madagascar
Abstract
Introduction: Breast cancer is the most common cancer among women worldwide and a leading cause of morbidity and mortality. In Madagascar, organized screening is limited, leading to late diagnosis. This study aimed to describe the epidemiological, clinical, histological, and the rapeutic characteristics of breast cancer cases diagnosed at Antanambao University Hospital in Toliara.
Methods: This retrospective, descriptive study included all women with histologically confirmed breast cancer seen at the oncology service over a 42-month period (October 1, 2016 – March 30, 2020). Data collected included socio-demographics, clinical presentation, stage at diagnosis, histology, imaging studies for staging, and treatment modalities. Data were managed using Word and Excel 2019.
Results: Among 165 his to logically confirmed cancer cases, 31 were breast cancers (18.78%), second only to cervical cancer (35.75%). The mean age was 50.48 years, with the majority aged 35–55 years. Most patients were self-employed, of the Vezoethnic group, and resided in the urban commune of Toliara I. The main presenting symptom was a palpable breast mass (87%). At diagnosis, 45% were locally advanced and 29% metastatic. Invasive ductalcarcinoma accounted for 87% of cases. Staging mainlyrelied on chest X-ray and abdominopelvicultra sound (48%). Chemotherapy followed by surgerywas the most frequently used treatment (52%), with 61% managed with curative intent.
Conclusion: Breast cancer in Toliara is predominantly diagnosed at an advanced stage. Early detection strategies, including organized screening programs and promotion of breast self-examination, are critical to improveprognosis and patient outcomes.
References
2. International Agency for Research on Cancer; World HealthOrganization. Breast cancer – IARC [Internet]. Lyon: IARC/WHO; 2025 [cited 2026 Jan 24]. Availablefrom: https://www.iarc.who.int/cancer-type/breast-cancer/
3. Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, Jemal A. Global cancer statistics2022: GLOBOCAN estimates of incidence and mortalityworldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(1):7 33. doi:10.3322/caac.21834. Availablefrom: https://gco.iarc.fr/
4. Freihat O, Sipos D, Kovacs A. Global burden and projections of breast cancer incidence and mortality to 2050:acomprehensiveanalysis of GLOBOCAN data. Front Public Health. 2025;13:1622954. doi:10.3389/fpubh.2025.1622954. Availablefrom: https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1622954
5. Manson EN, Achel DG. Fightingbreast cancer in low-and-middle-income countries – what must we do to geteverywomanscreened on regularbasis?Scientific African. 2023;21:e01848. doi:10.1016/j.sciaf.2023.e01848.
6. Azubuike SO, Muirhead C, Hayes L, et al. Rising global burden of breastcancer: the case of sub-SaharanAfrica (withemphasis on Nigeria) and implications for regionaldevelopment: areview. World J SurgOncol. 2018;16:63. doi:10.1186/s12957-018-1345-2
7. Traore M, Diabate FS, Diarra I, Mounkoro N, Youssouf, Tekete I. Cancers gynécologiques et mammaires: aspects épidémiologiques et cliniques à l’hôpital du Point G à Bamako. Mali Médical. 2004;1:4 9.
8. World HealthOrganization. Madagascar: Cancer Country Profile 2020 [Internet]. Geneva: WHO; 2020 [cited 2026 Jan 24]. Availablefrom: https://cdn.who.int/media/docs/default-source/country-profiles/cancer/mdg-2020.pdf?sfvrsn=cee4d58_2
9. El Saghir NS, Khalil MK, Eid T, et al. Trends in epidemiology and management of breast cancer in developingArabcountries: a literature and registryanalysis. Int J Surg. 2007;5:225 233.
10. Rana MS, Rahman MM, Baker J, Houssami N, Yu XQ, Marinovich ML. Association of lifestylefactorswithbreast cancer incidence: an overview of systematicreviews. Chin J Cancer Res. 2025 Aug30;37(4):575–91. doi: 10.21147/j.issn.1000-9604.2025.04.10. PMID: 40979660; PMCID: PMC12444357.
11. Abraham M, Lak MA, Gurz D, Nolasco FOM, Kondraju PK, Iqbal J. A narrative review of breastfeeding and itscorrelationwithbreastcancer:currentunderstanding and outcomes. Cureus. 2023 Aug25;15(8):e44081. doi: 10.7759/cureus.44081. PMID: 37750138; PMCID: PMC10518059.
12. WCRF/AICR. Diet, nutrition, physicalactivity and breast cancer risk: Evidence review. Cancer PrevRes. 2024;17:201–218. Availablefrom: https://pmc.ncbi.nlm.nih.gov/articles/PMC11747198/
13. Bouchardy C, Verkooijen HM. Fightingbreast cancer in low- and middle-incomecountries: challenges and strategies. Prev Med. 2023;167:107461. Availablefrom: https://www.sciencedirect.com/science/article/pii/S2468227623003046
14. Gnangnon F, FokomDefo V, Dille I, Adanzounnon M, Odidi FP, Houinato DS, Kamgno J, FokomDomgue J. Âge au diagnostic du cancer du sein en Afrique subsaharienne: revue systématique et méta-analyse. SSRN [Internet]. 2025 [cited 2026 Jan 24]. Availablefrom: https://ssrn.com/abstract=5390187orhttp://dx.doi.org/10.2139/ssrn.5390187
15. Zaki HM, Garba-Bouda O, Garba SM, Nouhou H. Epidemiological and pathological profile of breast cancer in Niger. J Afr Cancer. 2013;5:185–91.
16. Gueye SMK, Bawa KDD, Ba MG, Mendes V, Toure CT, Moreau JC. Breast cancer screening in Dakar:knowledge and practice of breast self-examinationamong a female population in Senegal. Rev Med Brux. 2009;30(2):77–82.
17. Espina C, McKenzie F, Dos-Santos-Silva I. Delayedpresentation and diagnosis of breast cancer in Africanwomen:asystematicreview. Ann Epidemiol. 2017 Oct;27(10):659–71.e7. doi: 10.1016/j.annepidem.2017.09.007. PMID: 29128086; PMCID: PMC5697496.
18. Engbang JP, Essome H, Koh VM, Simo G, Essam JD, Mouelle AS, Essame JL. Cancer du sein au Cameroun, profil histo-épidémiologique: à propos de 3044 cas [Breast cancer in Cameroon, histo-epidemiological profile: about 3044 cases]. Pan Afr Med J. 2015 Aug4;21:242. French. doi: 10.11604/pamj.2015.21.242.7269. PMID: 26523182; PMCID: PMC4607961.
19. Khalil AI, Bendahhou K, Mestaghanmi H, Saile R, Benider A. Cancer du sein au Maroc: profil phénotypique des tumeurs [Breast cancer in Morocco: phenotypic profile of tumors]. Pan Afr Med J. 2016 Oct6;25:74. French. doi: 10.11604/pamj.2016.25.74.9966. PMID: 28292037; PMCID: PMC5324149.
20. Arps DP, Healy P, Zhao L, Kleer CG, Pang JC. Invasive ductalcarcinomawithlobularfeatures:acomparisonstudy to invasive ductal and invasive lobularcarcinomas of the breast. Breast Cancer ResTreat. 2013 Apr;138(3):719–26. doi: 10.1007/s10549-013-2493-2. Epub 2013 Mar 28. PMID: 23535842; PMCID: PMC3906642.
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