**4. Common breast cancer outcomes**

Krammer et al. reported that 75% of patients reported the presence of any pain or disability while only 9% experienced severe pain and disability among South African patients [27]. It was further reported that the presence of the tumor on the right side (OR: 0.31 [95%CI: 0.10, 1.03];p < 0.05); being a Caucasian (OR: 0.21 [95%CI: 0.05, 0.82]; p < 0.05); not being on chemotherapy (OR: 0.39 [95%CI: 0.18, 0.83]; p < 0.05); had axillary lymph node dissection (OR: 0.48 [0.23, 0.98]; p < 0.05) and older age (OR: 0.93 [95%CI: 0.93, 0.98];p < 0.01) are significantly less likely to report cancerrelated pains compared to others of differing corresponding attributes [27]. Also, reported is that those not on chemotherapy are significantly less likely to experience disabilities compared to those treated with chemotherapy (OR: 0.37 [95%CI: 0.18, 0.77]; p < 0.01) [27].

It was also reported that 36.6% of South Africans with breast cancer in the Western Cape have depression [28]. However, a lower prevalence of depression (25%) was reported similar population in Addis Ababa, Ethiopia [22]. This has been said to be due to body change stress; in which a higher body change stress significantly predicts depression (β = 0.38; p = 00) among breast cancer patients [28]. It has also been said to be due to perceived social support; in which a lower perceived social significantly predicts depression (β = −0.30; p = 0.01) among breast cancer patients [28].

Also reported is 34.3% psychological distress among South African patients with breast cancer [28]. This has been said to be due to body change stress; with a higher body change stress significantly associated with higher psychological distress (β = 0.37; p = 0.00) [28]. It has also been said to be due to perceived social support; with lower perceived social support significantly associated with higher psychological distress (β = −0.27; p = 0.02) among breast cancer patients [28].

Anxiety disorders were also reported as outcomes of breast cancer among patients in sub-Saharan Africa in the sources reviewed over the last decade. For example, Fatiregun OO et al. reported that 19% of breast cancer patients have anxiety disorders; with mixed anxiety and depressive disorder accounting for 44.7%. Predictors for anxiety disorder among this population include the absence of a history of breast cancer (OR: 3.5 [95%CI: 1.2, 7.0];p = 0.006) and early stage of breast cancer (OR: 1.56 [95%CI: 1.12, 2.17]; p = 0.009) [20].

Almost three-quarters (71.03%) of patients with breast cancer have drug-related problems among patients with breast cancer in Gondar, Ethiopia: with 48.6% reporting adverse drug reactions, with 45.8% need for additional drug therapy and 32.7% non-adherence [17]. Comorbidity and the non-use of neoadjuvant chemotherapy have been associated with the development of drug problems among breast cancer patients. Degu A and Kebede K reported that those with comorbidity are three times more likely to develop drug-related problems compared to those who do not have comorbidities among breast cancer patients in Gondar, Ethiopia [17]. Those on neoadjuvant are significantly less likely to have drug-related problems compared to those on other regimens [17].
