Introduction/Background Breast cancer is a serious public health issue all over the world. Despite screening programs, the incidence of locally advanced tumors remains high in developing countries.This study aimed to investigate breast cancer’s epidemiological and histopathological characteristics in Tunisia.

Methodology This retrospective study was conducted at Salah Azaiez institute. It included 334 women treated for non-metastatic breast cancer between January and December 2014.

Results The mean age was 52 years (25–94 years). The age group of 40–50 years represented 36.4%. Young women (younger than 35 years-old) represented 5.6% of patients. The most common symptom was mass in 283 patients, with an average size of 35 mm at presentation, followed by mastodynia and nipple discharge. The mean delay of consultation was 5 months (1–120 months). TNM stage at diagnosis was T2 (34.6%) followed by T4 (24.3%). T1 stage represented only 9.9% of cases. Axillary lymph nodes were found in 151 patients (45.2%). All patients were non-metastatic. Conservative surgery was performed for 27.2% of patients, while 69.7% of cases had radical surgery. Neoadjuvant chemotherapy was given to 86 patients. The predominant tumor histological pattern was invasive ductal carcinoma (78.44%). Mean pathological tumor size was 28.5 mm (0–120 mm), positive axillary lymph nodes were found in 72.7% of cases. Scarf bloom Richardson II was the most frequent grade. Immunophenotyping showed that hormonal receptors were expressed in 61.7% of the tumors HER was over-expressed in 15.9% of cases. Luminal B was the most common molecular subtype.

Conclusion Despite progress in screening initiatives, breast cancer in Tunisia is detected at advanced stages, with a younger population and more aggressive tumors. In order to decrease diagnostic delays and enhance screening and early detection, there is a need for genetic evaluation in our population.