Introduction: The dilemma of the incurability of metastatic breast cancer has driven therapeutic advances aimed at prolonging survival. However, access to these innovative treatments remains a significant challenge in low-income countries. Consequently, a diagnosis of de novo metastatic breast cancer (dnMBC) may be perceived as a diagnosis of imminent death. We aimed to analyse the clinical, therapeutic and prognostic characteristics of dnMBC in a Cameroonian context.

Methodology: We conducted a cross-sectional, descriptive study with retrospective data collection from 116 patients with dnMBC followed in two cancer reference hospitals in Yaoundé, Cameroon, between 2020 and 2022. Data were analysed using SPSS version 25 and Excel 2019.

Results: Of 1,006 confirmed breast cancer cases, 116 were dnMBC (prevalence: 11.53%). The mean age was 47.4 ± 12.1 years, and males accounted for 1.72% of the sample. Pathologically, the predominant subtype was invasive ductal carcinoma (92.2%; n = 83), with hormone-sensitive hormone receptor+/HER2 human epidermal growth factor receptor 2 - tumours being the most frequent among those with available immunohistochemistry (IHC) (58%; n = 18). The disease was often polymetastatic (69.8%), with the most common sites being the lungs (72.4%) and liver (40.5%). Treatments were mainly systemic (53.2%), sometimes combined with surgery (43%). The median overall survival was estimated at 24 months (95% CI = 14.21–33.78).

Conclusion: Survival outcomes for dnMBC remain poor, limited by the lack of full access to optimal care, including systematic IHC testing. A more effective multidisciplinary approach to the disease and the factors affecting survival is needed for optimal utilisation of available therapeutic regimens.