Historically, breast cancer in LMICs has been characterised as more aggressive, with studies reporting higher rates of triple-negative disease and lower hormone receptor positivity.6,7 However, more recent analyses suggested that these patterns may be partially attributed to variability in receptor testing quality.8 Other indicators of tumour aggressiveness include high histological grade, elevated Ki-67, HER2 positivity and early age at diagnosis. Here, MKI67 is linked to neoplasm.