Abstract
Background: Breast cancer ranks second most commonly diagnosed cancer worldwide, with approximately 12% among all cancers; while in women it stands as the most prevalent cancer in 154 countries and the leading cause of cancer death in 103 countries. The stage of breast cancer at diagnosis is an outstanding prognostic factor of treatment efficacy and survival, as well as a determinant factor of local and metastatic recurrence. Advanced-stage breast cancer (AS-BC) is associated with lower survival rates compared to early diagnosed cases. The present study aimed at estimating the prevalence of advanced-stage breast cancer (AS-BC) among newly diagnosed female subjects and to identify the associated factors and predictors of the disease.
Methodology: A retrospective chart review was conducted in three tertiary hospitals in Jeddah, Saudi Arabia, including patients with breast cancer, who were diagnosed and followed up in the participating centers during the period October 2013 to October 2018. Data were collected in a standardized fashion using a semi-structured datasheet.
Results: A total of 824 women were included in the study. Further, AS-BC rate was found lower among patients with a family history of breast cancer and or personal history of benign breast disease; while it was higher among those with a history of exposure to ionization radiation or other comorbidities, notably diabetes and hypertension. Significant lifestyle factors included a sedentary lifestyle, higher weight and body mass index (BMI). Among all statistically significant factors, educational level (postgraduate, OR=0.17, p=0.006) and exposure to ionization radiation (OR=2.50, p<0.001) were the only independent factors of AS-BC.
Conclusion: Advanced-stage accounts for two-thirds of the primary breast cancer cases, which is remarkably higher than the reported international literature and contrasting with the locally implemented screening and prevention programs. The identification of socioeconomic factors of AS-BC should guide the adaptation of care offered and communication strategies in order to improve the attendance to systematic screening programs among the most deprived groups.

Key words: Breast cancer, advanced stage, late diagnosis, screening, prevention.