Background: Some clinicians and radiologists in South Africa (SA) suspect that aggressive subtypes of breast cancer are becoming more prevalent and that patients are presenting at younger ages.

Objectives: This study aimed to analyse the prevalence and trends in female breast cancer presentations at a Breast Unit in Johannesburg, SA, by comparing data from 2012 and 2022.

Method: A retrospective study was conducted at a tertiary hospital in Johannesburg. Records of female patients diagnosed with breast cancer between 2012 and 2022 were analysed. Demographic data, ultrasound or mammography findings, and tumour characteristics were compared.

Results: A total of 493 records were reviewed: 165 (33.5%) from 2012 and 328 (66.5%) from 2022. The mean ± standard deviation (s.d.) age at presentation was 56.8 ± 16.8 years in 2012 and 54.1 ± 13.6 years in 2022 (p = 0.056). Tumours were smaller in 2022 (mean ± s.d., 35.0 mm ± 24.0 mm) compared to 2012 (48.1 mm ± 21.5 mm) (p < 0.001). A higher proportion of women had positive oestrogen receptor status in 2022 (p = 0.005). No differences were observed in molecular subtypes.

Conclusion: No significant change was found in the mean age at presentation, suggesting a stable demographic profile. However, reproductive, hormonal, and lifestyle factors may contribute to the rising prevalence among women aged 40–49 years. Smaller tumours likely reflect increased awareness and clinical breast examinations at local clinics.

Contribution: This single-institution study underscores the need for broader national research to inform breast cancer screening and imaging guidelines.

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South African Journal of Radiology    |    ISSN: 1027-202X (PRINT)    |    ISSN: 2078-6778 (ONLINE)