Understanding the High Incidence of Premenopausal Breast Cancer in Africa: Genetic, Environmental, and Healthcare Factors.

Introduction and Background Breast cancer poses a critical health burden in Africa, with 45–50% of cases occurring in premenopausal women versus 10–15% in high-income nations. Disparities arise from genetic susceptibility, environmental exposures, and systemic healthcare gaps. Late-stage diagnoses (75–80% at stages III/IV), aggressive subtypes (27% triple-negative), and survival rates of 20–40% underscore urgent needs for tailored interventions. Aims and Objectives This narrative review synthesizes 77 studies to explore genetic, environmental, and healthcare factors driving premenopausal breast cancer in Africa, aiming to guide policy and clinical strategies. Methods Peer-reviewed articles, registries, and reports (1990–2024) were analyzed. Inclusion criteria focused on genetic risks (e.g., BRCA1/2), environmental/lifestyle factors (diet, pollution), and healthcare barriers (screening access, infrastructure). Data from African populations were prioritized. Results Genetic factors: BRCA1/2 mutations accounted for 5–10% of cases; 12–25% of early-onset cancers were hereditary. Familial history doubled risk. Environmental factors: Urbanization, Westernized diets, obesity, pesticide exposure, and reproductive shifts (early menarche, delayed childbirth) increased risks. Healthcare factors: Over 60% of African nations lacked organized screening. Limited mammography, low awareness, and socioeconomic delays led to advanced diagnoses. Survival rates lagged 40–60% behind high-income countries. Conclusions and Recommendations Multifactorial drivers necessitate integrated solutions: scaling genetic testing, deploying mobile screening (e.g., iBreastExam), and community education to combat stigma. Policymakers must fund cancer registries, train healthcare workers, and ensure therapy access. Aligning with the WHO’s Global Breast Cancer Initiative, international collaborations can reduce mortality by 2.5% annually. Holistic, context-specific strategies addressing Africa’s sociocultural and infrastructural challenges are vital to mitigate disparities.