Breast cancer survivors have been neglecting to undergo one of the most important parts of the healing process – reconstructive surgery.
Scarring is a constant source of anguish for patients who beat the disease and Dr Al Mansoori from Sheikh Khalifa Medical City says one way to overcome this is to opt for reconstructive surgery.
“A patient will get rid of the cancer but this scar on her chest will always remind her that she had a horrible disease," Dr Al Mansoori told The National.
"Not only did she have a horrible disease but it left a defect on her body.
"This defect is a daily reminder that she had cancer – every time she looks at her body in the mirror, she will be reminded of it."
About 40 per cent of women who undergo a mastectomy had breast reconstruction surgery in 2014, US Agency for Healthcare Research and Quality figures show. In 2016 breast reconstruction accounted for 109,256 procedures, or 1.9 per cent of all reconstructive procedures.
October is breast cancer awareness month and Dr Al Mansoori wants women to know that getting rid of the cancer is as important as the surgery to rebuild the shape and look of the breast.
“We want to highlight that October is not only awareness for breast cancer but reconstruction as well.”
Reconstructive surgery helps maintain the balance of the shoulders which are affected when one breast is removed, which can often cause shoulder and back pain.
But Dr Al Mansoori said many have not been told of the option.
“Lack of awareness is preventing women from having reconstructive surgery," she said. "The information they have is very minimal."
Archaic family attitudes can sometimes interfere with women's decisions to undergo reconstructive surgery, the doctor said.
"There are also some myths that it can cause the cancer to return and unfortunately there is a cultural component where in some instances husbands or families will tell them that they should be grateful that they are rid of the cancer and shouldn’t ask for anything more," she said.
"Other cultures consider cancer as a punishment and another percentage have a fear of more surgery.”
Health care professionals are encouraged to discuss reconstruction as part of treatment plans. But in the US less than half of all women who required a mastectomy in 2017 were offered the option and fewer than 20 per cent elected to undergo immediate reconstruction.
“Breast reconstruction is one of the important stages during the healing process of breast cancer," Dr Al Mansoori said.
"When a patient is diagnosed with breast cancer, she will see the oncologist and the surgeon but she also needs to see the plastic surgeon.”
Studies have shown that less than a quarter of women understand the range of breast reconstruction options available after a mastectomy.
One type is the deep inferior epigastric perforators' flap procedure, where fat, skin and blood vessels are transferred from the wall of the lower abdomen to rebuild the breast.
Reconstruction depends on the type and stage of cancer and whether the patient still needs chemotherapy or radiotherapy. It can be carried out as soon as when the tumour is removed or six months later in cases where a patient requires further treatment.
Shahinaz Mohamed, 50, said going through cancer was the worst experience of her life.
The mother-of-two was diagnosed with stage 2 breast cancer in 2016 and had to have most of her left breast removed. Two months later, doctors found cancerous cells in her uterus and she had to have her uterus and ovaries removed as well.
“It broke me,” she said. “But my kids, now aged 17 and 21, needed me and as a single mother of two boys, I had to be strong for them.”
Ms Mohamed chose the flap method to reconstruct her left breast in 2018 and instantly noticed the benefits to her mental health. She said it felt like she was given her life back.
“In spite of all the surgeries, I insisted on doing it," she said.
"It made a difference – like the difference between night and day.
“Previously when I had the breast removed, I could not bear seeing my reflection in the mirror.
"Whenever you bathed you would see this huge scar and the missing breast, and that was like reliving the whole experience again – but after reconstruction my life was returned to me.
"Women should not and do not need to go through this."