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COVID-19 left women delaying vital breast cancer screening, treatment: UAE experts

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Women across the United Arab Emirates delayed vital breast cancer screening during the COVID-19 pandemic in a “concerning phenomenon” that led to a spike in cases across the country, doctors have said.

October marks the start of Breast Cancer Awareness Month and experts are reminding that early detection brings a higher chance of recovery.

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Breast cancer has four stages and catching it at the first stage means the chance of survival is between 95 and 100 percent.

However, doctors in the UAE said screening is well below pre-pandemic levels as women missed routine appointments and avoided health settings over the fear of COVID-19 meaning they missed vital lifesaving treatment.

Prof. Humaid al-Shamsi, a consultant in oncology and medical oncology director at VPS Healthcare, has noticed an increase in breast cancer cases across the UAE as a result.

“October, also known as Pink Month, is the month to increase awareness about breast cancer, which is one of the most common cancers worldwide,” he told Al Arabiya English.

“Since the pandemic, we are noticing an increase in the number of patients presenting with breast cancer. This means they are delaying their visit to the doctor over fears about COVID-19.

“We are very concerned about this phenomenon.”

Pink ribbon for an awareness of Breast Cancer Day, October, 1, 2020. (Unsplash, Angiola Harry)
Pink ribbon for an awareness of Breast Cancer Day, October, 1, 2020. (Unsplash, Angiola Harry)

The doctor said he wants to highlight the importance of being aware of any symptoms like new lumps in the breast, changes to the nipples, and pain in the breast area.

Signs, symptoms

“All women should be aware of these symptoms. It is also important to note that breast cancer can affect around one percent of males, especially those who are advanced in age. If you have any symptoms, like lumps or masses, please go to the doctor and get it checked. ”

According to the World Health Organization, close to 2.3 million women were diagnosed with breast cancer and over 685,000 died worldwide in 2020.

Dr. Mehdi Afrit, a medical oncologist specialist at Burjeel Specialty Hospital in Sharjah, said breast cancer is a frequent and serious form of cancer.

Early screening

“While prevention is difficult, we have reliable and efficient screening methods like mammography and breast ultrasonography.”

“Screening programs and population-based awareness programs together with treatment contribute to mortality reduction in breast cancer patients.”

Screening campaigns aim to sensitize, inform, and educate women about breast cancer and techniques like breast self-exams, he said.

“Women need to do breast self-examinations regularly. Breast awareness may help you understand the changes that your breasts undergo and identify any unusual symptoms. If you find any such symptom, do meet a specialist in breast diseases or an oncologist.

COVID-19 caused screening delays

Dr. Ghodratollah Nowrasteh, a consultant in general surgery at Medcare Hospital in Al Safa, also noticed women delaying vital breast cancer screening over the past 18 months.

“The COVID-19 pandemic has resulted in many elective procedures being put on hold, and this has led to a substantial decline in cancer screening,” the doctor told Al Arabiya English. “The COVID-19 pandemic affects mortality and morbidity, with disruptions expected to continue for some time, with access to timely cancer-related services a concern. For breast cancer, early detection and treatment is key to improved survival and longer-term quality of life.”

“Health services generally have been strained and in many settings with population breast mammography screening, efforts to diagnose and treat breast cancers earlier have been paused or have had reduced capacity. The resulting delays to diagnosis and treatment may lead to more intensive treatment requirements and, potentially, increased mortality.”

Dubai's Burj Khalifa, the world's tallest tower, is lit up in pink to raise awareness and funds to fight breast cancer, in the Gulf Emirate of Dubai on October 13, 2016. (File photo: AFP)
Dubai's Burj Khalifa, the world's tallest tower, is lit up in pink to raise awareness and funds to fight breast cancer, in the Gulf Emirate of Dubai on October 13, 2016. (File photo: AFP)

Dr Nowrasteh said the goal of screening is to detect cancers in very early stage.

“Early-stage detected and diagnosed cancers have very good prognosis and higher survival rate. In other words, routine screening can reduce mortality and the intensity of treatment required.”

Most common cancer among women

Breast cancer is the most common cancer in women worldwide.

In the UAE, breast cancer is the most frequent malignancy among women, accounting for approximately one-third of all cancers.

“For screening purposes, a woman is considered to be at average risk if she doesn’t have a personal history of breast cancer, a strong family history of breast cancer, or a genetic mutation known to increase risk of breast cancer (such as in a BRCA gene), and has not had chest radiation therapy before the age of 30,” said Dr Nowrasteh.

“Women between 40 and 44 have the option to start screening with a mammogram every year.”

“Screening should continue as long as a woman is in good health and is expected to live at least 10 more years. For high-risk populations, screening starts earlier.”

Research shows that lifestyle changes can decrease the risk of breast cancer, even in women at high risk, including maintaining a healthy weight and being physically active.

Dr Sokiyna Alameer, a breast surgeon at NMC Royal Khalifa City A, also spoke to Al Arabiya English about the importance of screening.

“Early detection of breast cancer is important as it is associated with an increased number of available treatment options, increased survival, and improved quality of life.

“While there is no definitive method of preventing breast cancer, early detection provides the best chance of effective treatment and help improve outcomes especially in women with a strong family history of breast cancer.”

Dr Alameer said she too noticed that COVID-19 significantly impacted health services for other diseases such as in patients with cancer.

“Service disruptions are widespread, reassignment of staff and postponing of diagnostics and screening. Also, patients are apprehensive to go to health facilities for the fear of getting COVID19 infection.”

Dr Sader al-Rawi, head of oncology services at VPS Healthcare, said surgery is an important part of breast cancer treatment.

“These days, resection is not the only procedure that is performed. The standard of care is oncoplastic breast surgery, through which the breast can be reshaped.”

“There are other modalities of breast surgery including nipple-sparing and skin-sparing, which are done to add an implant or tissue expander after surgery. Finally, there is the reconstruction that includes muscle or tissue transfer.”

”It is very important to be meticulous with breast surgery to avoid any complications including infection, lymphedema, and recurrence of the tumor.”

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