Psychosocial Health and Survivor Identity of Breast Cancer Survivors in Africa: A Systematic Scoping Review

Background: Breast cancer survivorship extends beyond physical recovery to include psychological and social adjustment, particularly how women construct and perceive their identity as survivors. While survivor identity has been widely studied in high-income countries, there is limited evidence from African contexts. This review synthesizes existing literature on breast cancer survivor identity in Africa, with a focus on patterns of self-perception, associated psychosocial factors, and implications for survivorship care. Methods: A systematic search was conducted across PubMed, CINAHL, Scopus, African Index Medicus, and grey literature for studies published between 2010 and 2026. Eligible studies reported primary data on survivorship and survivor identity among African women with Breast Cancer. Two reviewers independently screened studies, extracted data, and assessed methodological quality using the Mixed Methods Appraisal Tool (MMAT). Confidence in qualitative findings was evaluated using the CERQual approach. Results: Of 32 records identified, seven studies met the inclusion criteria, representing Nigeria, Ethiopia, Botswana, and South Africa. Most studies employed qualitative methodologies, including grounded theory, phenomenology, interviews, and focus groups, with two incorporating quantitative or mixed methods. Key psychosocial domains included self-identity, coping strategies, social support, quality of life, and body image. Three overarching survivor identity patterns were identified: (1) Embracing/Constructive, characterized by acceptance of the survivor identity and its integration into personal growth and empowerment; (2) Ambiguous/Fluctuating, reflecting uncertainty and shifting between patient and survivor identities; and (3) Non-salient/Resisting, where the survivor identity was rejected or deemed irrelevant. Methodological appraisal indicated generally high study quality, with strong credibility and confirmability, though transferability was moderate. CERQual assessments indicated high confidence in findings related to embracing identity, moderate-to-high confidence for ambiguous identity, and moderate confidence for resisting identity. Conclusions: Breast cancer survivor identity among African women is diverse and shaped by cultural, psychosocial, and healthcare contexts. Constructive identity formation is associated with empowerment and personal growth, whereas ambiguous or resistant identities suggest ongoing psychosocial challenges. Interventions should incorporate psychosocial support, peer engagement, and culturally responsive survivorship programs to promote positive identity development. Future research should prioritize rural populations and longitudinal designs to better understand identity trajectories over time. Strengthening survivorship care in Africa requires a holistic approach that addresses both psychological and physical dimensions to enhance overall quality of life.