A Systematic Review on Breast Cancer Surgery in Cameroon: Current Practice, Challenges and Future Perspectives

Abstract

Background: Breast cancer is the most frequently diagnosed malignancy among women worldwide and has become the leading female cancer in Cameroon. Surgery remains the cornerstone of curative treatment for non-metastatic disease, yet the type and quality of surgical care depend heavily on diagnostic capacity, multidisciplinary coordination, and access to adjuvant therapies. In Cameroon, most patients present with locally advanced tumors, resulting in a predominance of modified radical mastectomy and limited opportunities for breast-conserving approaches. This systematic review evaluates current surgical practices, outcomes, and structural barriers affecting breast cancer surgery in Cameroon. Methods: A systematic review was conducted according to PRISMA 2020 guidelines. PubMed/MEDLINE, Scopus, African Journals Online, and Google Scholar were searched for studies published between January 2010 and April 2026. Eligible articles reported epidemiological, surgical, pathological, therapeutic, or health-system data related to breast cancer management in Cameroon. When national evidence was scarce, data from comparable sub-Saharan African countries were incorporated to contextualize findings. Data were synthesized narratively because of substantial methodological heterogeneity. Results: Forty-two studies met the inclusion criteria. Breast cancer in Cameroon affects predominantly women aged 40–55 years, approximately a decade younger than in high-income countries. Between 60% and 85% of patients present with stage III or IV disease. Modified radical mastectomy remains the most commonly performed procedure, accounting for more than 80% of curative operations in most reported series. Breast-conserving surgery is uncommon because of large tumor size at diagnosis, limited access to radiotherapy, and inadequate preoperative imaging. Sentinel lymph node biopsy is rarely available, and axillary lymph node dissection remains the standard approach. Surgical outcomes are constrained by delayed diagnosis, financial barriers, insufficient pathology services, limited reconstructive options, and restricted access to systemic and radiation therapies. Conclusion: Breast cancer surgery in Cameroon remains dominated by radical procedures performed under significant structural constraints. Earlier diagnosis, expanded radiotherapy capacity, improved pathology services, and development of multidisciplinary breast units are essential to enable more conservative and personalized surgical care. Strengthening surgical oncology infrastructure should be considered a national priority to improve both survival and quality of life for women with breast cancer in Cameroon. Improved histopathological confirmation, margin assessment, and multidisciplinary decision-making are also necessary to optimize surgical quality and reduce inappropriate treatment decisions.