Late-Stage Breast Cancer A Growing Concern In The Uae

Cleveland Clinic Abu Dhabi experts highlight the importance of regular self-exams and clinical screening starting at age 40

The best defense against breast cancer is early detection, according to oncologists at Cleveland Clinic Abu Dhabi, an integral part of Mubadala Health, as they see more women being diagnosed with advanced disease in the UAE.

Breast cancer is the most common cancer in the UAE. According to the World Health Organization, breast cancer accounted for 21.4 percent of all cancer cases recorded in the UAE last year, totaling 1,030 new diagnoses. Risk factors for the disease include age, genetic mutations, personal and family history of breast and ovarian cancer, having dense breasts, being overweight or obese, and an unhealthy lifestyle.

Dr. Ahmad Matalkah, a Surgical Oncologist in the Oncology Institute at Cleveland Clinic Abu Dhabi, says that the hospital’s multidisciplinary Breast Health Clinic has been seeing a growing number of late-stage breast cancer patients, many of whom are very young. The youngest breast cancer patient at Cleveland Clinic Abu Dhabi is 24 and the oldest is 84 years old.

“There seems to be a combination of factors that may be causing this increase in breast cancer cases, including a lack of awareness of screening guidelines and family history, having to visit multiple specialists when a patient notices breast abnormalities, and a delay in seeking treatment,” says Dr. Matalkah.

“Patients with an early diagnosis, whose cancer is still localized, have a five-year relative survival rate of 99 percent. That is why it is so important that they are screened earlier and receive treatment at the right time for the best outcome.”

Dr. Matalkah says women should conduct a breast self-examination to look for lumps, thickening or any changes in the skin, and nipple discharge every month. Referring to the Department of Health – Abu Dhabi guidelines, he says that a screening mammogram must be done every two years starting from the age of 40 if a woman does not have any known risk factors. Experts recommend screening women with a high risk of the disease at an even earlier age.

“Many women with breast cancer have no symptoms. Breast imaging with a mammogram can help detect cancer even when there are no symptoms. This is when it is most treatable.”

Dr. Matalkah explains the concern by discussing the case of a 35-year-old patient who recently presented at the hospital with late-stage breast cancer because her symptoms were being treated as a dermatological issue for more than a year.

“When she first visited a doctor with concerns about itchiness and soreness around the nipple, she was treated for dermatitis. This alleviated the symptoms for a few months. However, the symptoms returned, but she waited for several months before seeing a doctor again.”

Dr. Matalkah explains that when such nipple dermatitis becomes chronic, it is recommended to immediately get breast imaging done because in more than half the cases, the patient suffers from Paget’s disease of the breast, a condition associated with breast cancer.

“Screening revealed a mass with significant changes, with the tumor affecting the entire breast. So, her only treatment option by then was to get a mastectomy.”

Equally important for best patient outcomes is the timely treatment of the disease. A recent observational study by researchers at the US-based Cleveland Clinic and Cleveland Clinic Abu Dhabi found a decrease in patient survival rates when treatment options – surgery, chemotherapy and radiation – are completed more than 38 weeks from the time of diagnosis.

Cleveland Clinic Abu Dhabi’s Breast Health Clinic’s multidisciplinary cancer program is designed to shorten the time to treatment for patients. The facility offers targeted diagnostic testing, genetic counseling, and innovative therapies and treatments, as well as reconstruction specialists and disease-specific experts to address all breast health issues, in one location.

“Women are encouraged to seek a second opinion when they receive a breast cancer diagnosis, but sometimes they seek multiple opinions, causing delays in their treatment. We want patients to be comfortable with the decision they make to treat the cancer and have access to coordinated care in one place.”

As part of its Breast Cancer Awareness campaign, Cleveland Clinic Abu Dhabi hosted an International Breast Cancer Symposium for medical professionals earlier this month to discuss some of the key issues and opportunities in breast cancer care for patients in the region. Topics discussed included role of prevention, detection, and wellness in breast cancer care, new developments in genetics, advancements in radiotherapy, surgical advances, and breast cancer in young women. The community can find more resources on prevention, screening and treatment options for breast cancer on breasthealth.clevelandclinicabudhabi.ae.

For more information or to request an appointment at Cleveland Clinic Abu Dhabi, call 800 8 CCAD (2223), visit www.clevelandclinicabudhabi.ae or download the Cleveland Clinic Abu Dhabi app.