Objective: One of the main causes of cancer-related death in Sub-Saharan Africa (SSA) and the most common cancer among women globally is still breast cancer. In addition to its physical effects, the psychological burden – especially depression – is frequently overlooked and undertreated in the region. The aim of the study was to systematically review recent evidence on the prevalence and associated factors of depression among women diagnosed with breast cancer in SSA.

Materials and Methods: The PEO framework was used to conduct a systematic literature review of studies published between January 2011 and June 2025 in PubMed, MEDLINE, CINAHL, ScienceDirect, and the Cochrane Library. Quantitative, qualitative, and mixed-method studies evaluating depression in breast cancer patients in SSA were among the eligible studies. The JBI checklist for qualitative research and the Downs and Black checklist for quantitative studies were used for quality appraisal.

Results: Twelve studies met the inclusion criteria, 11 quantitative studies totaling 2,532 participants plus one qualitative study (n = 21), from Nigeria, Egypt, Ethiopia, Rwanda, Ghana, and Kenya. The greatest rates were seen in Ethiopia (66.6%) and Rwanda (67.7%), with reported prevalence of depression ranging from 25% to 67.7%.

Advanced disease stage, unemployment, low educational attainment, a lack of social support, and the stigma associated with cancer in society were all important risk factors. Both treatment adherence and quality of life (QoL) were considerably lowered by depression.

Conclusions: Depression is highly prevalent among women with breast cancer in SSA, yet mental health screening remains limited. It is critical that routine mental health evaluations and psychosocial support be incorporated into oncology care. Policy solutions and personnel capability must be strengthened by governments and health systems to address the twin burden of depression and cancer.