Breast Cancer Heterogeneity in Latin America: A Scoping Review of Clinical-Pathological Characteristics, Molecular Subtypes, and Survival.

Abstract

Background: Breast cancer in Latin America (LATAM) exhibits distinct clinical-pathological and molecular features, shaped by genetic diversity and healthcare disparities. This scoping review evaluates these characteristics, focusing on histopathological, molecular subtype, and survival patterns and their implications for future research and public health initiatives.

Methods: A systematic search across MEDLINE (via PubMed), LILACS (Latin American and Caribbean Health Sciences Literature), SciELO (Scientific Electronic Library Online), and Web of Science identified 54 studies across 19 Latin American countries. Data were extracted on histological grading, molecular subtypes, staging, and survival outcomes. Findings were analyzed in the context of regional and global trends.

Results: Fifty-four studies involving 49,223 women from 19 countries were analyzed. The mean age at diagnosis was 54.3 years. Invasive ductal carcinoma was the most common (79.2%). Advanced-stage disease (Stages III/IV) was identified in 36.1% of cases. Luminal subtypes were most prevalent (Luminal A: 36.95% and Luminal B: 28.72%), whereas triple-negative (TNBC) and HER2-enriched subtypes accounted for 17.45% and 12.69%, respectively. Subtype prevalence varied by country, age, and tumor grade. Five-year survival rates ranged from 50.5% to 92.5%, with worse outcomes linked to advanced stage, high grade, and TNBC or HER2-enriched tumors.

Conclusion: Breast cancer in LATAM is characterized by significant heterogeneity in biological subtypes and clinical presentation, often diagnosed at advanced stages, with limited capacity for molecular testing. These findings highlight the urgent need for standardized diagnostic protocols, equitable access to treatment, and region-specific cancer control strategies to improve outcomes for Latin American women.