Breast Cancer Status in Kenya – National Cancer Registry of Kenya (NaCaRe-KE)

The National Cancer Registry of Kenya (NaCaRe-KE) was established in 2021 and launched in the same year.  The first report on the status of cancer in Kenya, utilized 6,778 records for the period July 2021 to June 2022, notified from 42 facilities across 21 counties.  From the report, it is established that three most common cancers are breast (15.1%), cervix (13.3%) and oesophagus (11.8%). 

The total breast cancer cases notified by county of usual residence between the years 2020 and 2023 amounted to 4,824 people, Nairobi County leading with the highest number of diagnosed people at 550 followed by Nakuru County which registered 398 people. Counties that diagnosed the least number of breast cancer as notified to NaCaRe-KE included Turkana, Tana River and Wajir that registered 3, 2 and 1 cases respectively as shown in table 1 below.

Table 1: Distribution by County of Usual Residence per Year – Filtered by Date of diagnosis

County of Usual Residence	2020	2021	2022	2023	TOTAL
Nairobi County	1	51	354	144	550
Nakuru County	96	105	130	67	398
Nyeri County		96	179	94	369
Kiambu County		14	199	70	283
Machakos County		30	112	77	219
Mombasa County	4	20	23	143	190
Meru County	61	27	65	24	177
Makueni County		8	96	49	153
Kirinyaga County	1	33	69	49	152
Muranga County		6	111	35	152
Embu County	2	36	75	27	140
Kitui County	22	19	59	32	132
Kakamega County		23	65	40	128
Kajiado County		9	47	36	92
Laikipia County	10	13	36	33	92
Nyandarua County	10	17	39	15	81
Kisumu County		15	37	28	80
Kilifi County	4	9	7	59	79
Kisii County	1	7	37	30	75
Siaya County		10	26	22	58
Uasin Gishu County	1	29	21	7	58
Taita Taveta County		13	21	19	53
Bungoma County		16	16	14	46
Busia County		15	17	11	43
Vihiga County		8	15	20	43
Nandi County		5	13	24	42
Kwale County	1	3	4	26	34
Baringo County	6	12	4	5	27
Homa Bay County	1	5	9	12	27
Migori County		3	15	9	27
Tharaka Nithi County		6	15	5	26
Trans Nzoia County		9	8	9	26
Kericho County	1	8	10	5	24
Nyamira County		4	6	14	24
Bomet County		10	10	2	22
Narok County		6	5	9	20
Garissa County		4	8	1	13
Lamu County	1	2	1	6	10
Isiolo County			5	2	7
Marsabit County		2	1	3	6
West Pokot County		2	2	2	6
Elgeyo Marakwet County		2	2	1	5
Mandera County			5		5
Samburu County	1		2	1	4
Turkana County		1	1	1	3
Tana River County			1	1	2
Wajir County			1		1
Non-resident			16	4	20
Missing	357	207	33	3	600
TOTAL	581	920	2,033	1,290	4,824

Distribution by County of Notification per Year – Filtered by Date of Diagnosis

Distribution by County of notification means the county in which the cancer case was diagnosed. From table 2 below, it is noted that Nairobi County leads by 2150 of cases notified; meaning therefore that most people seek cancer medication at the capital city.

Table 2: Distribution by County of Notification per Year – Filtered by Date of Diagnosis

County of Usual Res	2020	2021	2022	2023	TOTAL
Nairobi County	218	215	1,288	429	2,150
Nakuru County	128	126	124	82	460
Nyeri County		117	143	125	385
Machakos County	101	73	78	65	317
Mombasa County	18	31	7	242	298
Uasin Gishu County		116	79	36	231
Kakamega County		89	49	42	180
Kisumu County		34	42	71	147
Meru County	61	32	25	23	141
Embu County	3	47	65	24	139
Makueni County			56	19	75
Kitui County	22	13	17	14	66
Bomet County	20	11	13	4	48
Taita Taveta County		13	15	13	41
Kiambu County			4	31	35
Kisii County			2	28	30
Nandi County			3	24	27
Garissa County	10	3	8	2	23
Laikipia County			5	5	10
Muranga County			10		10
Kirinyaga County				8	8
Vihiga County				3	3
TOTAL	581	920	2,033	1,290	4,824

In terms of distribution of cancer type in the breast (primary site), Breast NOS (excludes Skin of breast C44.5) accounts for 94.44% of the all cancers of the breast; 4556 of the total 4824 as notified between 2020 and 2023. Breast NOS in simple terms is the Invasive Ductal Carcinoma of Breast, Not Otherwise Specified (NOS), they are invasive breast cancers, which have a tendency to be aggressive and spread. This subset comprises the largest group and also the most common type of breast cancers as seen in table 2 below.

Table 3: Distribution of Cancer Type by /year – Filtered by Date of Diagnosis:

Primary Site	2020	2021	2022	2023	TOTAL
Breast NOS (excludes Skin of breast C44.5)	542	893	1,957	1,164	4,556
Upper outer quadrant of breast	10	12	20	27	69
Central portion of breast	2	1	20	28	51
Upper inner quadrant of breast	3	5	7	19	34
Overlapping lesion of breast	19	6	6	3	34
Axillary tail of breast			11	17	28
Lower inner quadrant of breast	4		9	8	21
Nipple		3	1	15	19
Lower outer quadrant of breast	1		2	9	12
TOTAL	581	920	2,033	1,290	4,824

In Kenya, the majority of breast cancer cases discovered are at stage IV, accounting for 37.2% of all cases as seen in table 4 below. This is the leading factor towards mortalities as late discoveries reduces the likelihood of survival. Early screening of breast cancer increases the chances of managing the disease through prompt treatment and care, therefore increasing the chances of survival.

Table 4: Distribution by Stage at Diagnosis per Year – Filtered by Date of Diagnosis:

Stage at Diagnosis	2020	2021	2022	2023	TOTAL	Percentage
In situ		2	20	36	58	2.6%
Stage I	12	18	56	29	115	5.1%
Stage II	25	67	235	210	537	23.8%
Stage III	44	144	256	264	708	31.4%
Stage IV	56	171	372	241	840	37.2%
TOTAL	137	402	939	780	2258	100.0%