IARC 60th Anniversary - 19-21 May 2026
Session : 19/05/26 - Posters
National Patterns of Breast Cancer Hormone Receptor Status in South Africa, 2022-2023: A Registry-Based Study
MHLANGA N. 2, OYEKUNLE V. 2, MUCHENGETI M. 1,3,6, MWANSA-KAMBAFWILE J. 1,3,4, METEKOUA C. 1,5, MCCORMACK V. 7
1 South African National Cancer Registry at National Institute for Communicable Diseases, Johannesburg, South Africa; 2 University of Pretoria , Pretoria , South Africa; 3 University of the Witwatersrand, School of Public Health, Johannesburg, South Africa; 4 School of Public Health, Health Sciences Faculty, University of Cape Town, Cape Town, South Africa; 5 Graduate School for Health Science, University of Bern, Bern , Switzerland; 6 DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis, Western Cape Province, South Africa; 7 International Agency for Research on Cancer, Lyon, France
Background
In South Africa, non-communicable diseases are often underprioritized, despite breast cancer remaining a major public health concern as the most commonly diagnosed cancer among women. Breast Cancer is the most common cancer among females in South Africa. Although breast cancer outcomes are strongly influenced by tumour biology, particularly hormone receptor status, population-level data describing the distribution of these subtypes across key demographic and health system characteristics remain limited.
Objectives
To assess patterns and disparities in breast cancer hormone receptor status by age, race, province and hospital of diagnosis in South Africa from 2022-2023.
Methods
This cross sectional study analysed electronic breast cancer pathology reports from 2022-2023. Hormone Receptors were extracted from South African National Cancer Registry pathology reports. Hormone receptor status (Estrogen Receptor, Progesterone Receptor, Human Epidermal Growth Factor 2, and triple-negative breast cancer) was described among women aged 18–69 years and stratified by age, race, province, and hospital of diagnosis (private or public hospital).
Results
Of 16 677 women diagnosed with Breast Cancer in 2022-23: 8 180 (49%) Black, 4 855 (29%) White, 2 301 (14%) Coloured and 748 (5%) Asian women. The % of non-missing receptors was 56% for ER, 63% for PR and 46% for HER2, whilst it was 33% non-missing for all three receptors jointly. Of the latter non-missing category, 61% were hormone receptor positive (HR+) HER2-, 10% were HR+ HER2+, 6% HR-HER2+ and 23% HR-HER2- (I.e. TRN). The % TRN among black, white, Asian and mixed-race women were 22%, 15%, 16% and 18%.
Hormone receptors were most frequently reported among women aged 40–49 years. Provincial variation was observed, with the Western Cape recording the highest of ER cases, while Gauteng had the highest numbers of PR, HER2, and triple-negative cases. Most diagnoses across all receptor subtypes occurred in private hospitals.
Conclusion
The distribution of breast cancer hormone receptor subtypes in South Africa reflects a predominantly favourable prognosis, driven by a high burden of hormone receptor–positive disease. However, significant disparities in subtype distribution were evident by race, age and province, with triple-negative disease disproportionately represented among Black women and those who are younger, perimenopausal patients. These patterns likely reflect a complex interplay of tumour biology, population structure and health system factors, and have important implications for equitable access to timely receptor testing and patient care. Further aetiologic research is needed to clarify the underlying drivers of these disparities and to inform targeted breast cancer control and breast cancer treatment policies.