Initiation of recommended oncological treatment in a cohort of young female and male breast cancer patients in Ethiopia: A one-year follow-up study

Abstract Significant global disparities in breast cancer outcomes persist, with high mortality rates in low- and middle-income countries driven by late diagnosis and limited access to comprehensive breast cancer care. This study evaluates treatment initiation and one-year outcomes in a cohort of young women and men at a tertiary cancer centre in Ethiopia to identify barriers to care and areas for improvement. This was a prospective cohort study conducted at the Tikur Anbessa Specialized Hospital (TASH) in Addis Ababa. Study participants (females aged 18–39, males aged ≥ 18) with invasive breast cancer were followed for one year to assess initiation of recommended cancer treatment and clinical outcome. One-hundred study participants were included. Among participants with stage I-III breast cancer ( n = 76), only 20% initiated all recommended multimodal oncological treatment. While rates for surgery (90.5%) and initiation of systemic therapy (chemotherapy 86.1%, endocrine therapy 85.5%) were high, 37.8% experienced delayed initiation of chemotherapy (>10 weeks post-surgery). Notably, only 16.4% received adjuvant radiotherapy. At one-year follow-up, disease recurrence rates were high: 29.9% ( n = 20/67, stages I-III). Among stage IV patients with available data, the one-year mortality rate was high: 58.3% ( n = 7/12). The uptake of surgery and systemic treatment was high in the study population, although there were significant delays and limited access to radiotherapy. The high recurrence and mortality rates seen in this breast cancer cohort treated at TASH underscore the urgent need for improved access to timely, comprehensive breast cancer care to improve survival.