Prevalence and Predictors of Triple-Negative Breast Cancer Among Sudanese Women: A Retrospective Analysis of Newly Diagnosed Cases.

Purpose: Triple-negative breast cancer (TNBC) is an aggressive subtype with limited treatment options and a poor prognosis. Data on TNBC in Sudan are scarce. This study assessed the prevalence and predictors of TNBC and other molecular subtypes (Luminal A, Luminal B, and HER2-enriched) in relation to histopathological patterns, age at diagnosis, and sociodemographic risk factors. Methods: A retrospective, single-center study was conducted of 1480 women diagnosed with breast cancer between 2016 and 2021. Histological subtypes included carcinoma in situ (CIS), invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC), or medullary carcinoma (MC). Estrogen receptor (ER), progesterone receptor (PR), and HER2 status were determined by immunohistochemistry. Multivariate logistic regression identified predictors of TNBC. Results: TNBC accounted for 21% (n=307; mean age, 49 years) of all cases. Luminal A tumors represented 49% (n=722; mean age, 55), Luminal B 16% (n=237; mean age, 51), and HER2-enriched 14% (n=214; mean age, 50). TNBC was particularly frequent in MC (77%) compared to IDC (21%), CIS (20%), and ILC (15%). In multivariate analysis, younger age was a significant predictor of TNBC; each additional year of age reduced the odds by approximately 3% (Adjusted Odds Ratio [AOR]=0.97; 95% CI: 0.96-0.99; p<0.001). Histological subtype was also a significant determinant, with MC showing the strongest association with TNBC compared to other diagnoses. Conclusion: TNBC is highly prevalent among Sudanese women, especially those younger than 50 years and those with MC. These findings underscore the importance of early diagnosis and wider access to molecular profiling to guide treatment in low-resource settings.