Stage at diagnosis and tumor characteristics among young women and men with breast cancer, in Ethiopia and Sweden, a descriptive cross-sectional study

Abstract Background Breast cancer patients diagnosed in sub-Saharan Africa (SSA) are generally younger, and present with more advanced stage of disease, than those in high-income countries. In addition, male breast cancer appears to be more prevalent in SSA. Young women and men are typically not inc...

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Main Authors: Tove Ekdahl Hjelm, Tewodros Yalew Gebremariam, Mahlet Fekadu Weldearegay, Moti Sori, Marcus Bauer, Bethlehem Ayele Getachew, Mathewos Assefa, Endale Anberber, Hidaya Yahya Mohammed, Eva Johanna Kantelhardt, Sara Margolin, Annika Lindblom, Senait Ashenafi, Jenny Löfgren
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-025-14614-x
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author Tove Ekdahl Hjelm
Tewodros Yalew Gebremariam
Mahlet Fekadu Weldearegay
Moti Sori
Marcus Bauer
Bethlehem Ayele Getachew
Mathewos Assefa
Endale Anberber
Hidaya Yahya Mohammed
Eva Johanna Kantelhardt
Sara Margolin
Annika Lindblom
Senait Ashenafi
Jenny Löfgren
author_facet Tove Ekdahl Hjelm
Tewodros Yalew Gebremariam
Mahlet Fekadu Weldearegay
Moti Sori
Marcus Bauer
Bethlehem Ayele Getachew
Mathewos Assefa
Endale Anberber
Hidaya Yahya Mohammed
Eva Johanna Kantelhardt
Sara Margolin
Annika Lindblom
Senait Ashenafi
Jenny Löfgren
author_sort Tove Ekdahl Hjelm
collection DOAJ
description Abstract Background Breast cancer patients diagnosed in sub-Saharan Africa (SSA) are generally younger, and present with more advanced stage of disease, than those in high-income countries. In addition, male breast cancer appears to be more prevalent in SSA. Young women and men are typically not included in national mammography screening programs. Therefore, the aim of the present study was to compare clinical and pathological data from a breast-cancer-patient cohort not covered by mammography screening, in a low-income country in SSA (Ethiopia), to a similar patient cohort from a high-income country in Europe (Sweden). Methods Women (< 40 years) and men (all ages) with breast cancer were recruited in Ethiopia and Sweden. Patient- and tumor data was collected. In Ethiopia, 100 study participants were recruited prospectively from the Departments of Surgery and Oncology at Tikur Anbessa Specialized Hospital. In Sweden, 100 study participants were enrolled retrospectively from the Department of Oncology at Södersjukhuset, Stockholm. Results Ethiopian and Swedish study participants were diagnosed in tumor stage I (3.3% vs 27.0%), stage II (33.7% vs 45.0%), stage III (44.6% vs 23%), and stage IV (18.5% vs 5.0%). This represents a significant difference in stage distribution between groups (p < 0.001). A majority of the cases were ER-positive (79.5% in Ethiopia and 69.0% in Sweden, p = 0.08). The ER- and/or PgR-positive/HER2-negative subtype was the most common in both groups: (68.0% in Ethiopian patients and 47.5% in Swedish patients). The HER2-positive (any ER) subtype accounted for 20.5% in Ethiopia and 26.7% in Sweden, while triple-negative breast cancer accounted for 11.5% (Ethiopia) and 25.7% (Sweden). Conclusions There were large disparities in stage at diagnosis between Ethiopian and Swedish young women and men with breast cancer, with a higher proportion of late-stage disease seen in Ethiopians although, due to young age/male sex, none of the Swedish cases were diagnosed in the national mammography screening program. There was a high rate of ER-positive breast cancer at both sites, and the triple-negative subtype was more than twice as common in Swedish patients.
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spelling doaj-art-6a5f09adb3d14b8a9fb2d35c0bb07b372025-08-20T03:43:22ZengBMCBMC Cancer1471-24072025-07-0125111010.1186/s12885-025-14614-xStage at diagnosis and tumor characteristics among young women and men with breast cancer, in Ethiopia and Sweden, a descriptive cross-sectional studyTove Ekdahl Hjelm0Tewodros Yalew Gebremariam1Mahlet Fekadu Weldearegay2Moti Sori3Marcus Bauer4Bethlehem Ayele Getachew5Mathewos Assefa6Endale Anberber7Hidaya Yahya Mohammed8Eva Johanna Kantelhardt9Sara Margolin10Annika Lindblom11Senait Ashenafi12Jenny Löfgren13Department of Molecular Medicine and Surgery, Karolinska InstituteDepartment of Pathology, School of Medicine, College of Health Sciences, Tikur Anbessa Specialized Hospital, Addis Ababa UniversityDepartment of Pathology, School of Medicine, College of Health Sciences, Tikur Anbessa Specialized Hospital, Addis Ababa UniversityDepartment of Pathology, School of Medicine, College of Health Sciences, Tikur Anbessa Specialized Hospital, Addis Ababa UniversityInstitute of Pathology, Martin Luther UniversityDepartment of Oncology, School of Medicine, College of Health Sciences, Tikur Anbessa Specialized Hospital, Addis Ababa UniversityDepartment of Oncology, School of Medicine, College of Health Sciences, Tikur Anbessa Specialized Hospital, Addis Ababa UniversityDepartment of Surgery, School of Medicine, College of Health Sciences, Tikur Anbessa Specialized Hospital, Addis Ababa UniversityDepartment of Pathology, School of Medicine, College of Health Sciences, Tikur Anbessa Specialized Hospital, Addis Ababa UniversityGlobal Health Working Group, Institute of Medical Epidemiology, Biometrics, and Informatics, Martin-Luther-University Halle-WittenbergDepartment of Oncology, SödersjukhusetDepartment of Molecular Medicine and Surgery, Karolinska InstituteDepartment of Oncology, SödersjukhusetDepartment of Molecular Medicine and Surgery, Karolinska InstituteAbstract Background Breast cancer patients diagnosed in sub-Saharan Africa (SSA) are generally younger, and present with more advanced stage of disease, than those in high-income countries. In addition, male breast cancer appears to be more prevalent in SSA. Young women and men are typically not included in national mammography screening programs. Therefore, the aim of the present study was to compare clinical and pathological data from a breast-cancer-patient cohort not covered by mammography screening, in a low-income country in SSA (Ethiopia), to a similar patient cohort from a high-income country in Europe (Sweden). Methods Women (< 40 years) and men (all ages) with breast cancer were recruited in Ethiopia and Sweden. Patient- and tumor data was collected. In Ethiopia, 100 study participants were recruited prospectively from the Departments of Surgery and Oncology at Tikur Anbessa Specialized Hospital. In Sweden, 100 study participants were enrolled retrospectively from the Department of Oncology at Södersjukhuset, Stockholm. Results Ethiopian and Swedish study participants were diagnosed in tumor stage I (3.3% vs 27.0%), stage II (33.7% vs 45.0%), stage III (44.6% vs 23%), and stage IV (18.5% vs 5.0%). This represents a significant difference in stage distribution between groups (p < 0.001). A majority of the cases were ER-positive (79.5% in Ethiopia and 69.0% in Sweden, p = 0.08). The ER- and/or PgR-positive/HER2-negative subtype was the most common in both groups: (68.0% in Ethiopian patients and 47.5% in Swedish patients). The HER2-positive (any ER) subtype accounted for 20.5% in Ethiopia and 26.7% in Sweden, while triple-negative breast cancer accounted for 11.5% (Ethiopia) and 25.7% (Sweden). Conclusions There were large disparities in stage at diagnosis between Ethiopian and Swedish young women and men with breast cancer, with a higher proportion of late-stage disease seen in Ethiopians although, due to young age/male sex, none of the Swedish cases were diagnosed in the national mammography screening program. There was a high rate of ER-positive breast cancer at both sites, and the triple-negative subtype was more than twice as common in Swedish patients.https://doi.org/10.1186/s12885-025-14614-xEarly-onset breast cancerMale breast cancerSub-Saharan AfricaEast AfricaTumor stageTumor subtype
spellingShingle Tove Ekdahl Hjelm
Tewodros Yalew Gebremariam
Mahlet Fekadu Weldearegay
Moti Sori
Marcus Bauer
Bethlehem Ayele Getachew
Mathewos Assefa
Endale Anberber
Hidaya Yahya Mohammed
Eva Johanna Kantelhardt
Sara Margolin
Annika Lindblom
Senait Ashenafi
Jenny Löfgren
Stage at diagnosis and tumor characteristics among young women and men with breast cancer, in Ethiopia and Sweden, a descriptive cross-sectional study
BMC Cancer
Early-onset breast cancer
Male breast cancer
Sub-Saharan Africa
East Africa
Tumor stage
Tumor subtype
title Stage at diagnosis and tumor characteristics among young women and men with breast cancer, in Ethiopia and Sweden, a descriptive cross-sectional study
title_full Stage at diagnosis and tumor characteristics among young women and men with breast cancer, in Ethiopia and Sweden, a descriptive cross-sectional study
title_fullStr Stage at diagnosis and tumor characteristics among young women and men with breast cancer, in Ethiopia and Sweden, a descriptive cross-sectional study
title_full_unstemmed Stage at diagnosis and tumor characteristics among young women and men with breast cancer, in Ethiopia and Sweden, a descriptive cross-sectional study
title_short Stage at diagnosis and tumor characteristics among young women and men with breast cancer, in Ethiopia and Sweden, a descriptive cross-sectional study
title_sort stage at diagnosis and tumor characteristics among young women and men with breast cancer in ethiopia and sweden a descriptive cross sectional study
topic Early-onset breast cancer
Male breast cancer
Sub-Saharan Africa
East Africa
Tumor stage
Tumor subtype
url https://doi.org/10.1186/s12885-025-14614-x
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