IMAGING, SURGICAL AND CIPHERABLE APPROACH TO TREATMENT OF BREAST CANCER IN NIGERIA

Abstract

Breast cancer remains the leading malignancy among women worldwide and a critical public health challenge, with 2.3 million new cases and 666,000 deaths recorded in 2022. In Nigeria, breast cancer accounts for 23% of female cancer diagnoses and 18% of cancer-related deaths, with an estimated 32,278 cases in 2022. The disease burden is aggravated by late-stage presentation (61–80% at stages III/IV), a high prevalence of aggressive triple-negative breast cancer (TNBC, ~40%), and significant resource limitations. A systematic narrative review was conducted using PubMed, Google Scholar, African Journals Online (AJOL), and institutional repositories. Studies published primarily between 2019 and 2025, focusing on breast cancer imaging, surgical management, and conservative therapies in Nigeria and sub-Saharan Africa, were included. Search terms included: "breast cancer Nigeria," "mammography Nigeria," "mastectomy Nigeria," "breast-conserving surgery Africa," and "neoadjuvant chemotherapy Nigeria." Studies were assessed for relevance, quality, and recency. Imaging uptake remains critically low (<5% mammography nationally), with ultrasound identified as the more sensitive tool (100% vs. 85.7%) for dense breasts common in Nigerian women. Modified radical mastectomy (MRM) constitutes 90–99% of surgical procedures, while breast-conserving surgery (BCS) accounts for only 2–9.5% of cases, largely due to late presentation, limited radiotherapy access (available to only 25–31% of patients), and a 48% neoadjuvant chemotherapy non-completion rate. Five-year overall survival stands at 32%, rising to 68% with multimodality treatment. Significant gaps exist across all three treatment domains. Urgent policy interventions are needed, including national breast cancer screening programmes, expansion of radiotherapy infrastructure, equitable access to multimodality care, and integration of artificial intelligence-assisted diagnostic tools to improve early detection and survival outcomes in Nigeria.