Breast cancer is an increasing concern in South Africa, with cases steadily on the rise over the past 20 years. Although the country has a lower incidence of breast cancer compared to wealthier nations, South Africa has a higher death rate. This is mainly due to delays in diagnosis and limited access to healthcare, especially for Black women. A recent study funded by the NRF looked at the challenges of breast cancer screening and treatment, as well as the added complexity of HIV infections, which particularly affect younger women with breast cancer.

The study aimed to highlight key issues in breast cancer care in South Africa, and emphasised the need for better screening, improved access to treatment, and specialised care for women who are HIV-positive. The research focussed on ethnic disparities in diagnosis and survival rates and advocated for a more tailored approach to address the specific challenges faced by South African women.

The researchers analysed data from the South African National Cancer Registry (NCR) and the International Association of Cancer Registries (IACR). Over the past 20 years, breast cancer cases have risen significantly, now making up 14-30% of all cancers in women. In 2020, the IACR reported 15 491 new cases of breast cancer while the NCR reported 9 259 cases. This difference was due to varying data collection methods. The study also showed that breast cancer is more common in women of European descent (1 in 13) compared to Black women (1 in 81).

A major concern is that 50-57% of South African women are diagnosed with late-stage breast cancer (stages III or IV), with Black women being more affected by advanced-stage diagnoses. The study also found that triple-negative breast cancer (TNBC), a more aggressive form of the disease, is more common in Black women, leading to lower survival rates compared to white women. Another important finding was the link between breast cancer and HIV. Many women with HIV are diagnosed at a younger age and with more advanced breast cancer. HIV complicates treatment which leads to poorer outcomes due to drug toxicity and treatment delays.

The study concludes that solving the breast cancer crisis in South Africa requires a multi-faceted approach. This includes improving screening, particularly in underserved communities, and speeding up access to treatment. Special interventions are also needed for HIV-positive patients to improve their outcomes.

The researchers suggest the creation of community outreach programs to raise awareness about the importance of early detection and treatment. Additionally, strengthening the healthcare system to provide equal care to all socioeconomic groups is critical.