Breast cancer (BC) is predominantly considered a postmenopausal disorder in Western countries, with only 6% being in women below 40. In contrast, developing low- and middle-income countries (LMIC) see a much higher incidence of BC in premenopausal women due to genetic and demographic factors—reaching as much as 25%. The lack of well-established data on the features and prevalence of BC in premenopausal females in LMIC calls for a wholesome assessment of its features. Our retrospective study was conducted at two major oncology centers in Alexandria, Egypt. We included patients aged 18–40 years diagnosed from January 2008 to December 2017. We included non-metastatic patients and extracted data from files and charts. We assessed patients for clinicopathological characteristics, treatments and survival outcomes. Statistical analysis was performed using SPSS Version 2.0, and survival was assessed by Kaplan–Meir curves. Results were considered statistically significant at a p-value <0.05. After a median follow-up of 41 months, more than one-third of patients experienced relapse, with more cases of distant recurrence (73%) than locoregional recurrence (27%). The median disease-free survival (DFS) was 78 months, and the 5-year overall survival was 92%, both of which were independently predicted by tumour size and nodal status for DFS only. Our cohort had comparable features compared to prior studies conducted in Europe and the States. We also found some similarities to Kenya regarding BC in the young, where one study done in Kijabe, Kenya, showed a median presentation age of 38.2 years and a DFS of 75 months.