Breast cancer rates are increasing in developing countries, including Egypt, and are largely attributed to aging of the population, delay in time of first pregnancy, decrease in number of children and in breastfeeding, and a move toward high-calorie Western diets [1–4]. Although breast cancer incidence rates in Egypt are substantially lower than the rates in the United States and other developed countries [5–7], breast cancer is the most common cancer among women in Egypt [8]. Furthermore, the current demographic trends favor the likelihood that breast cancer will become an even greater public health concern in Egypt in the future. Trends in the stage at diagnosis of breast cancer in the Gharbiah registry have not been reported, and this information is critical for evaluation of downstaging efforts. Detailed information on trends of breast cancer by stage of diagnosis may promote the reduction of disparities in the presentation of disease by focusing limited resources on the susceptible populations and can aid in our overall understanding of the etiology of breast cancer in a setting that differs in regard to its risk factor profile as compared to many developed countries. The specific aim of this study was to examine trends in breast cancer incidence by age, stage, and hormone receptor status in the Gharbiah registry from 1999 to 2008. Further, we evaluated the effect of possible changes in the population structure in order to make projections for breast cancer occurrence in Egypt for the years 2009–2015.