Clinicopathological and Sociodemographic Characterization of Breast Cancer and Socioeconomic Disparities in Stage at Diagnosis in Cali, Colombia, 2018-2022

Background: Breast cancer is a major public health issue, but patient profiles from non-specialized, secondary-level hospitals, where most individuals first seek care, remain under-characterized. This study aimed to provide a comprehensive clinicopathological and sociodemographic characterization of breast cancer patients at a community hospital in Cali, Colombia, and to explore potential associations between socioeconomic status and stage at diagnosis. Methods: A retrospective, cross-sectional analysis of medical records from 96 patients diagnosed between 2018 and 2022 was conducted. Descriptive and inferential statistics — the Kruskal-Wallis test for Ki-67, and Fisher's exact test given small cell counts in some comparisons — were used to explore associations between molecular subtype, age, socioeconomic status, and stage at diagnosis. Results: The cohort was predominantly postmenopausal (median age, 60 years), urban (90.6%), and diagnosed with ductal carcinoma (92.7% of all cases overall; 87.5% specifically infiltrating — see audit note in section 3.2). The molecular landscape was dominated by hormone receptor-positive disease: Luminal A (44.8%), Luminal B (38.5%, including a HER2-positive subset accounting for 10.4% of the whole cohort), and triple-negative (16.7%); no case met criteria for HER2-positive non-luminal disease. Triple-negative disease was numerically more prevalent among women under 50 years (21.1%) than among those 50 and older (15.6%), without a statistically significant difference. Stage at diagnosis did not differ significantly by health insurance regimen, although this comparison was limited by a contributory/private group of only 3 patients (Fisher's exact p = 1.00; prevalence ratio for advanced-stage diagnosis, 0.81; 95% CI, 0.16-4.14). Conclusions: This secondary-level hospital manages a breast cancer caseload dominated by hormone receptor-positive disease, with a relevant burden of triple-negative tumors. The exploratory comparison between socioeconomic status and stage at diagnosis could not be conclusively evaluated given the extremely small contributory/private group; these findings support the need to strengthen diagnostic and referral pathways at community hospitals and warrant larger, adequately powered studies to further investigate potential health disparities.