Temporal Trends in Breast Cancer Stage at Presentation at University of Port Harcourt Teaching Hospital: 2014 to 2023

Stage at presentation is the single most important determinant of breast cancer survival, and tracking temporal trends allows for evaluation of the impact of awareness campaigns and healthcare policy changes on early detection rates. This study analyzes trends in breast cancer stage at presentation at the University of Port Harcourt Teaching Hospital (UPTH), Rivers State, South South Nigeria, over a 10-year period from 2014 to 2023. A retrospective time-series analysis of 480 histologically confirmed breast cancer cases was conducted. Stage at diagnosis was categorized using the AJCC TNM classification. Annual proportions of early-stage (I and II) versus late-stage (III and IV) presentations were computed and analyzed using Cochran-Armitage trend tests. The proportion of early-stage presentations increased from 18% in 2014 to 31% in 2023 (p=0.002), coinciding with two formal breast cancer awareness campaigns conducted in 2016 and 2020. However, advanced stage presentation still constituted 69% of cases in 2023. Triple-negative subtype and younger age were disproportionately represented in advanced-stage cases. The study demonstrates a statistically significant but clinically insufficient improvement in early detection and recommends sustained, structured breast cancer screening programs, mobile mammography services, and high-volume community education drives in Rivers State. Keywords: breast cancer stage, temporal trends, UPTH, early detection, South South Nigeria