Underdiagnosed and Overlooked: The Hidden Reality of Breast Cancer in Africa.
Fanta’s Story: Her Silent Battle
Fanta, a 58-year-old mother of seven, lived a quiet life in her village in Mali. For years, she felt a deep ache in her breast and noticed small lumps whenever she tried to find the source of the pain. When she mentioned it to the other women in her village, they assured her it was just part of getting older. As time passed, the pain worsened. The lumps grew, spreading under her arms near her breast, but Fanta still didn’t think much of it—everyone she trusted told her it was nothing serious. Eventually, the pain became unbearable. She began to feel constantly tired; her body ached all over, and she suffered from frequent, splitting headaches.
One night, she went to bed with another migraine and never woke up. In the morning, her family and neighbors said it must have been her time—that age had simply caught up with her. What they didn’t know was that Fanta had been living with undiagnosed breast cancer. Over the years, it had quietly spread throughout her body, damaging her organs until they could no longer function. Fanta’s story illustrates the systemic barriers in public health that women in rural areas face. The lack of education, screening, and healthcare access for women like Fanta exemplifies the significant challenges within the system, where early detection and treatment could have altered her fate. This is the reality for many women in villages lacking adequate education and resources to recognize what Fanta was experiencing in its early stages.
The Hidden Crisis
Breast cancer is the most diagnosed cancer that affects women globally and accounts for about 31% of all cancers that affect women¹. In northern and western Africa, breast cancer accounts for 24.7% and 27.1% of female cancer-causing deaths². However, these statistics are based only on the reported cases. Underreporting significantly skews these figures, as many cases go uncounted. Women like Fanta, who passed away without a prior diagnosis of breast cancer, highlight this issue. The lack of access to medical facilities and diagnostic tools means that many women suffer in silence, leading to their illnesses being unrecorded. This underreporting masks the true scale of the epidemic, complicating efforts to allocate the necessary resources for effective treatment and prevention.
Breast cancer occurs when abnormal cells in the breast grow uncontrollably, forming a mass or tumor. It most often develops in the milk ducts or the lobules and can spread to nearby tissues or other parts of the body if left untreated. Some warning signs of breast cancer include finding a new lump in the breast or underarm, changes in the size or shape of the breast, or unusual nipple discharge. You might also notice redness, swelling, or dimpling of the skin, or pain in the breast or nipple area.
Understanding Breast Cancer & Risk Factors
Even though research has expanded on breast cancer, researchers haven’t found any definite causes of breast cancer. Researchers have found some potential risk factors; however, there are people with breast cancer who don’t have any of the possible risk factors, and there are people without breast cancer who may have multiple risk factors. What they do know for sure is that this is a cancer that starts in the DNA.
Some factors that can increase the risk of breast cancer include having a family history of the disease, being older, or having dense breast tissue. Starting your period at a young age or going through menopause later in life can also raise your risk. Other factors include drinking alcohol, being overweight, having your first child after age 30, or never being pregnant. In some cases, inherited genetic changes can also greatly increase the risk of developing breast cancer.
A mixed-methods systematic review reported that breast cancer was the most common cancer among women in Africa in 2022, with around 198,553 new cases and 91,252 deaths³. The review also highlighted that rates are expected to double by 2040, partly due to changes in lifestyle and culture, including having children later or fewer children, lower levels of physical activity, changes in diet, increased alcohol use, and the use of skin lightening or hormone-based beauty products, all of which can raise the risk of breast cancer.
A study reported that in 2022, Africa had about 198,000 new breast cancer cases and 91,000 deaths, with Nigeria seeing the most cases and deaths⁴. Mortality generally increased with age, while some countries, such as Chad, experienced earlier peaks in incidence. Higher development levels were linked to higher rates. By 2050, Nigeria and Egypt are expected to face the largest burden, while Guinea and Niger could see mortality rates more than double, and other countries may experience huge increases in cases as well.
The Struggle For Awareness
Due to the lack of proper funding and research, it's hard for professionals and researchers to properly grasp the toll that breast cancer has on the African community. Many countries lack comprehensive cancer registries, proper screening programs, and reliable data on outcomes, which makes it challenging to understand how widespread the disease is, who is most at risk, and what the long-term effects are on women and their families. Without this information, it’s harder to develop targeted prevention strategies, improve early detection, and provide the support and treatment that patients need. This gap leaves many women vulnerable and contributes to the high mortality rates seen across the continent.
Building A Path Towards Progress
To address these data gaps, strategies such as training community health workers and employing mobile health technologies can be implemented. Community health workers can be trained to recognize potential breast cancer symptoms and collect essential health data, helping build a more comprehensive understanding of the disease. Meanwhile, mobile health technologies, like apps and messaging services, can facilitate data collection and provide educational resources even in remote areas. These efforts would not only improve data accuracy but also enhance early detection and access to treatment, thereby potentially reducing mortality rates.
The Silent Divide: When Access Determines Survival
In African countries that are more developed, like Nigeria, we see higher numbers of breast cancer cases being reported. This isn’t necessarily because more women are getting sick, but because there is a somewhat stable medical system in place. Women have better access to doctors, screenings, and diagnostic tools, which means breast cancer is more likely to be detected and treated before it becomes deadly.
Unfortunately, in many underdeveloped African countries, the story is very different. Women like Fanta often live for years with pain, discomfort, and growing lumps, but without access to proper healthcare, education about the disease, or awareness that their symptoms could be serious. They rely on advice from friends and family, cultural beliefs, or simply hope that the pain will go away. For many, this delay in diagnosis means that by the time they do receive care—or sometimes, they never do—the cancer has already progressed to a stage that cannot be treated. Many women quietly suffer and pass away in their sleep, their illnesses going unnoticed and unrecorded, leaving communities unaware of the true scale of the disease.
Finding A Way To Bridge The Gap
The gap between awareness, access, and outcomes underscores the critical need for stronger public health initiatives, including improved healthcare infrastructure, education, and early detection programs in underdeveloped regions of Africa. Bridging this gap requires amplifying awareness and empowering communities with knowledge—so that women like Fanta can live long, healthy lives, rather than leaving behind children and families in grief, confusion, and unanswered heartbreak.
References
Onyia, A. F., Nana, T. A., Adewale, E. A., Adebesin, A. O., Adegboye, B. E., Paimo, O. K., De Campos, O. C., Bisi-Adeniyi, T. I., Rotimi, O. A., Oyelade, J. O., & Rotimi, S. O. (2023). Breast cancer phenotypes in Africa: A scoping review and meta-analysis. JCO Global Oncology, 9, e2300135.
Moy, B., Lin, J., & Parikh, A. (2024, May 13). Common cancers in women and people assigned female at birth (AFAB). Mass General Brigham.
Asuquo, E. O., Absolom, K., Ebenso, B., & Allsop, M. J. (2024). Symptoms, concerns, and experiences of women living with and beyond breast cancer in Africa: A mixed‐methods systematic review. Psycho‐Oncology. Advance online publication.
Fu, M., Peng, Z., Wu, M., Lv, D., Lyu, S., & Li, Y. (2025). Assessing the African burden of breast cancer: A demographic analysis using Global Cancer Observatory 2022. European Journal of Surgical Oncology, 51(5), 109627.
