Objective
Breast cancer (BC) remains the most common malignancy affecting women globally. It presents challenges in LMICs like Antigua and Barbuda, where late presentation, limited screening capacity, and inequitable access to treatment often compromise outcomes. This study, therefore, assesses the clinico-pathological and epidemiological characteristics of newly diagnosed BC cases at the Sir Lester Bird Medical Centre (SLBMC) between 2019 and 2022.
Methods
A retrospective observational study was conducted, examining newly registered cases of primary BC diagnosed at the SLBMC during the study period. This descriptive assessment reviewed clinicopathological and epidemiological variables, including age, parish of residence, tumour histology, AJCC staging, and molecular phenotyping.
Results
Cohort: 124 women. The age at diagnosis ranged from 28 to 87 years (mean, 56 years; SD, 12 years). Dominant parish was St John’s (56.4%), and the least represented was Barbuda (2 cases). Invasive ductal carcinoma (IDC) accounted for 86%, followed by ductal carcinoma in situ (DCIS, 6%). Laterality: right breast (53%) and left breast (46%). The majority of cases were diagnosed at Advanced Stages (AS) III–IV (51%). In comparison, 36% were Stage II and 11% Stage I. Hormone receptor-positive/HER2-negative tumours represented 65%, followed by triple-negative breast cancer (15%), HR+/HER2+: 9%, HER2-enriched: 8%, with 3% unknown.
Conclusion
The findings highlight the disproportionate burden of BC in the western parishes of Antigua, coupled with an alarmingly high proportion of women presenting at AS. The presence of cases under the age of 40 highlights the potential value of reevaluating the protocol used within the SLBMC, with consideration given to lowering the screening age threshold. Furthermore, enhancing breast health education and awareness campaigns, particularly targeting women from early adulthood through midlife, may foster earlier presentation and diagnosis. These insights provide critical evidence for strengthening screening capacity, developing equitable cancer care strategies, and tailoring cancer control policies for SIDS. aining—it’s a commitment to making sure no one faces serious illness alone or in pain, no matter where they live
