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| Dr. Tonia Frame |
By Admin
As breast cancer continues to claim thousands of lives across Africa, St. George’s University (SGU), Grenada, has called for a more equitable and risk-informed approach to screening, warning that age alone may not be enough to identify women who need early assessment.
The university said improving breast cancer outcomes across the continent would require more than awareness campaigns, stressing the need for earlier diagnosis, personalised risk assessment, accessible diagnostic services and timely treatment.
The call comes as estimates from the International Agency for Research on Cancer show that Africa recorded approximately 225,643 new breast cancer cases and 100,070 deaths in 2024, making the disease the most commonly diagnosed cancer among women and the leading cause of cancer-related deaths in the region.
SGU said the figures highlight the urgent need to improve awareness of breast cancer symptoms and ensure women can access appropriate medical assessment without avoidable delays.
Dr. Tonia Frame, Assistant Professor and Director of the Global Health Unit in the Department of Public Health and Preventive Medicine at SGU, said breast cancer risk varies considerably among women, making individual assessment an important part of early detection.
“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 urged women to become familiar with the normal appearance and feel of their breasts and seek prompt medical evaluation for unexplained changes.
Frame noted that breast cancer often presents at a comparatively younger age among African women, while access to high-quality imaging and specialist services remains uneven across the continent.
She said screening discussions should therefore consider family history, inherited genetic susceptibility, previous breast abnormalities and other recognised risk factors to determine whether a woman needs earlier assessment, specialist referral or additional imaging.
A 2025 study involving women diagnosed with breast cancer across five sub-Saharan African countries found that 21.9 per cent of participants were diagnosed before the age of 40, underscoring the importance of recognising symptoms and seeking timely evaluation.
The World Health Organisation recommends early diagnosis and prompt evaluation of women with suspected breast cancer symptoms, while screening decisions should reflect individual risk and available resources.
Risk factors that should not be ignored
According to SGU, women with a family history of breast or ovarian cancer, particularly cases diagnosed at younger ages or involving multiple close relatives, may require formal risk assessment to determine whether they need earlier screening.
Women with inherited BRCA1 or BRCA2 gene variants may also require screening before the age recommended for women at average risk.
The university identified breast density as another important consideration, explaining that dense breast tissue can make abnormalities harder to detect through mammography and is independently associated with increased breast cancer risk.
Depending on a woman's overall risk, supplementary imaging, including magnetic resonance imaging, may be considered. However, such decisions should account for the potential benefits and risks, including false-positive results and unnecessary biopsies.
Previous high-risk breast lesions, atypical biopsy results and suspicious imaging findings may also require a more individualised follow-up plan developed with a physician.
Frame said a personalised approach should not mean subjecting every woman to more tests, but identifying those most likely to benefit from earlier or more intensive assessment.
Unequal access threatens early detection
Despite growing awareness of breast cancer, access to clinical examination, diagnostic imaging, pathology services and specialist care remains a major challenge across sub-Saharan Africa.
A 2026 systematic review and meta-analysis found that only 13 per cent of women in the region had ever undergone a clinical breast examination. Uptake also varied according to education, household wealth, health insurance coverage and contact with healthcare services.
The World Health Organisation's Regional Office for Africa has similarly identified gaps in diagnostic infrastructure and shortages of specialised health personnel as barriers to effective breast cancer control.
SGU said addressing these inequalities would require stronger referral systems, better training for frontline health workers, expanded access to diagnostic imaging and pathology, and reliable follow-up for women with abnormal findings.
It also called for greater attention to disparities across socioeconomic groups and geographical locations to ensure that women in underserved communities are not left behind.
AI offers promise, but cannot replace diagnosis
The university also highlighted the potential role of artificial intelligence in supporting breast cancer detection, particularly in settings where imaging services and specialist personnel are limited.
Depending on the technology and clinical setting, AI could assist with triage, image interpretation, prioritisation of cases and risk estimation.
However, Frame cautioned that the technology's usefulness depends on proper validation, quality assurance, diagnostic confirmation and effective referral pathways.
“Integrating community health workers, portable AI technology and digital referral pathways within primary health care could potentially help reach women who face geographic, financial or health-system barriers,” she said.
“The most important feature is not the algorithm alone, but the complete pathway linking awareness, initial assessment, referral, diagnostic confirmation and treatment.”
She stressed that AI-generated results should not be treated as a diagnosis, but interpreted alongside a woman's medical history, risk factors, clinical examination and appropriate imaging.
Women urged to take an active role
As Breast Cancer Awareness Month continues, SGU encouraged women to discuss their personal risk factors with healthcare professionals and ask when screening should begin, whether their family history warrants further assessment and whether previous breast symptoms or biopsy results require closer monitoring.
Women with dense breasts may also need to discuss how breast density affects mammography and whether additional assessment is appropriate.
The university said informed decisions should balance the benefits of early detection against unnecessary investigations, with screening plans tailored to individual risk and the services available.
It added that effective breast cancer control must extend beyond identifying possible abnormalities to ensuring that women receive timely diagnostic confirmation and treatment.
Preparing future physicians to respond to evolving healthcare needs, SGU said, remains central to its medical and public health education through international learning opportunities and clinical exposure designed to equip students to care for diverse patient populations.
The university's message is that improving breast cancer survival in Africa will depend not only on encouraging women to seek care, but also on building health systems capable of providing the right assessment, diagnosis and treatment when they do.
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