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Abstract

Abstract Background Breast cancer is the leading cancer among women in sub-Saharan Africa, where late-stage presentation contributes to poor outcomes. Understanding the risk-factor profile, comorbidity burden, and functional status of patients at presentation is essential to guide early-detection and management strategies in resource-limited settings. Methods We conducted a retrospective chart review of patients who underwent surgery for breast cancer at the Butaro Cancer Center of Excellence (BCCOE), Rwanda, between 2018 and 2023. From 422 patients identified, 300 charts were selected through simple random sampling and reviewed using a pretested REDCap tool drawing on electronic and paper-based records. Data was analyzed in IBM SPSS Statistics (version 29), and disease was staged according to the AJCC TNM system. Results The mean age at presentation was 50.8 years (SD = 11.8; range 28–82); 98% of patients were female, 94% had health insurance, and 74% were farmers. At least one risk factor was present in 65% of patients, with alcohol consumption (55.3%) and tobacco smoking (21.7%) the most common modifiable factors, followed by family history (5.3%) and nulliparity (3.7%). Comorbidities were frequent, affecting 60.3% of patients; hypertension (25.7%) and HIV/AIDS (7.0%) predominated. Most patients had good functional status at diagnosis (ECOG 0, 81.5%; ECOG 1, 16.4%). Of 281 staged patients (19 of 300 lacked complete TNM staging data), Stage III (38.4%) and Stage II (37.0%) were most common, and late-stage disease (Stage III–IV) accounted for 47.3% of cases. Conclusion Breast cancer patients at BCCOE are diagnosed at a younger age than the global average and carry a high burden of modifiable risk factors and comorbidities. The substantial proportion presenting at late stage may complicate treatment and compromise survival, emphasizing the need for strengthened awareness and early-detection efforts. By centering on a rural referral hospital, this study adds to the limited literature on breast cancer presentation in Rwanda.