SARA ALZAABI (ABU DHABI)
October is observed as Breast Cancer Awareness Month, a valuable opportunity to raise awareness and share personal experiences related to the disease.
Speaking to Aletihad, Dr. Tibor Kovacs, Breast Surgery & Oncoplastics, General Surgery at Cleveland Clinic Abu Dhabi, stressed the paramount importance of early detection.
"The majority of breast cancers and breast problems are self-detected by patients," he said.
He urged women to seek medical attention if they notice changes like lumps, skin dimpling, or discharge.
He noted that while breast pain is common and often indicates benign changes, it still warrants investigation.
"The earlier any kind of cancer, including breast cancer, is detected, the better the long-term outcomes are."
He elaborated that early-stage cancers typically require less aggressive treatment, allowing for breast conservation and reducing the need for chemotherapy.
"Patients with early-detected breast cancer can be actually cured, offering survival rates close to 100%," he added.
Turning to the topic of genetics, he noted that there are sporadic cancers and genetically determined cancers.
He pointed out that patients with a strong family history may benefit from genetic testing for mutations like BRCA1 and BRCA2.
"Identifying these gene faults allows us to offer early surveillance and risk reduction options," he said.
Addressing common misconceptions, he said that many patients fear biopsies might spread cancer, stating, "This is absolutely, completely wrong."
He said that biopsies are essential for accurate diagnosis and effective treatment planning.
With the advancements in breast cancer research, surgical interventions have become less extensive, allowing for less invasive options without compromising effective outcomes.
He featured innovations in targeted therapies and the reduction of side effects from extensive surgeries.
It is related to the availability of modern drug treatments and immunotherapy, which can lead to tumour shrinkage and less need for mastectomies.
Breast conservation surgery allows breasts to be preserved, while armpit lymph node surgery has been simplified to a sample, reducing side effects like arm swelling.
Modern adjuvant radiotherapy protocols are also available, providing short-term treatments with the same effects as longer radiotherapies.
These advancements are being offered at the Cleveland Clinic Abu Dhabi, ensuring patients have access to the best possible care and treatment options.
Reconstructive Surgery In an interview with Aletihad Dr. Nahla Al Mansoori, Head of Plastic and Reconstructive Surgery at Healthpoint, shared key considerations for breast reconstruction post-mastectomy, including cancer type and stage, patient health, available tissue, as well as aesthetic goals.
She stressed that timing is essential, indicating that some patients choose immediate reconstruction for aesthetic preservation, while others may delay due to fears or treatment requirements.
"When we detect cancer at an early stage, the tumour is often smaller, which influences the surgical approach - whether it is a lumpectomy or mastectomy. Less extensive surgeries allow for more skin and tissue preservation, providing patients with more reconstruction options. In contrast, patients with advanced cancer stages face more complex decisions," she said.
Dr. Al Mansoori said that patients with a strong family history of breast cancer or genetic mutations like BRCA1 or BRCA2 may opt for more aggressive surgeries, such as prophylactic mastectomy.
"This often leads to bilateral reconstruction for symmetry, even if only one breast is affected. This allows for a more harmonious reconstruction approach," she said.
Patients often face physical imbalances and discomfort, yet many mistakenly believe that implants are the only option.
"We now have access to more natural-looking implants, improved fat grafting methods, and techniques like the DIEP flap, which spares muscle for better long-term results. In addition, 3D imaging and planning software enhance symmetry, and bioengineered scaffolds support tissue growth, improving outcomes."
She also drew attention to the cultural challenges patients encounter regarding reconstruction, noting that the discussions often end with merely cancer treatment, influenced by family and healthcare professionals, which contributes to a lack of awareness about reconstruction options.
"Restoring the body also means addressing the emotional and psychological aspects of recovery. We must recognise that breast reconstruction is an essential part of the healing process. As healthcare providers, we need to support patients through their fears and expectations, collaborating closely with psychological counsellors to aid in their emotional recovery," she said.