Women avoid check-ups for fear of breast cancer ‘mutilation’

Misconceptions and stigma are delaying women seeking treatment for breast cancer, say experts, leading to potentially deadly consequences.

A mammography mobile unit offers breast cancer tests.  Jeffrey E Biteng / The National
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ABU DHABI // Many women are reluctant to have a breast exam because they fear a cancer diagnosis always leads to a mastectomy, doctors say.

The surgery is often stigmatised as a form of “mutilation” in the UAE.

This misconception is deterring women from seeing a doctor but delaying treatment costs lives, warned Dr Nabil Debouni, the medical director at Burjeel Hospital in Abu Dhabi.

“Women here, they are worried in case they are told something is wrong. They believe it is like being broken,” said Dr Debouni, speaking as Breast Cancer Awareness Month is marked worldwide.

“The culture of this country means women are afraid of having the diagnosis of breast cancer as they believe it means surgery.

“Surgery means some form of mutilation and there is a stigma associated with that.”

But early detection of the disease is key to survival, Dr Debouni said.

There are four stages of breast cancer, which is defined by the prevalence and size of lymph nodes and tumours in the breast.

If caught in stage one, the chance of survival is between 95 and 100 per cent.

By stage four, this reduces to just 20 per cent, Dr Debouni said.

Between 60 and 65 per cent of breast cancer patients in the UAE are diagnosed in stage one – up from about 40 per cent 15 years ago, he added.

From the age of 20, women should carry out self-examinations every month and have a physical exam with a GP every three years to increase the chance of catching the disease early.

After the age of 40, women should have a mammogram every two years, said the Iraqi consultant general surgeon.

Breast cancer is more common among women but men can also be victims. The latest statistics from the UAE’s Pink Caravan awareness campaign state that one in every 100 cases is a man.

Dr Debouni said patients should be aware that breast cancer does not always equal a mastectomy.

“Advancements in managing breast cancer means a simple lumpectomy, which removes the tumour and surrounding tissue in the breast without the need for a mastectomy, followed by chemotherapy or radiography,” he said.

Breast cancer is the most diagnosed form of the disease in both Abu Dhabi and Dubai.

“At least 60 per cent of the cases of cancer we see are breast cancer cases,” said Dr Shaheenah Dawood, a consultant medical oncologist at Dubai Health Authority.

Dr Dawood believes there should be a national breast-cancer screening programme for all women.

At the moment access to screening depends on what each clinic offers and patients’ health insurance.

“Early detection means you catch the disease either at the pre-malignant stage or very early malignant stage, where long-term cure is possible,” she said. “The more advanced the disease, the more difficult it is to treat.”

Dr Dawood said there were many misconceptions associated with breast cancer.

“First, women think cancer is not curable and second, there is a belief that treatment for this disease is not available here,” she said. “We can cure breast cancer if patients present early.

“We cannot cure diabetes and we cannot cure hypertension but we can certainly cure breast cancer.

“The treatment a patient would receive in the UAE is just as good, if not better, compared to the rest of the world. Most drugs needed to treat this disease become available in the UAE almost as soon as they are approved in the US.

“Over the last decade, newer treatment options are available, allowing for long-term cure. We now understand the biology of the disease better and we recognise that not all breast cancer is the same.

“Treatment has to be individualised based on the tumour biology.

“The one-size-fits-all strategy of treatment no longer exists.”

While early detection and screening is the best way to treat breast cancer, there are ways to lower the risk of getting the disease, Dr Debouni said.

“People cannot mitigate age, sex, or genetic factors but lifestyle is a very important part when we talk about risk factors,” he said.

“Obese people have a higher risk of breast cancer, as is a sedentary lifestyle. Eat healthier and do exercise and that will definitely reduce the risk of breast cancer.”

Breast Cancer Awareness Month, which is marked in countries across the world every October, helps to bring people’s attention to the disease.