Talking about breasts is a complex matter for many women, and Dr Houriya Kazim is all too familiar with the sensitivity around breast health. As the first female breast surgeon in the UAE, she’s come a long way since 1998 when she worked in a private hospital. Back then, women weren’t so comfortable around the subject, and to this day, there is an anxiety associated with breast examinations around this time of year. “I think women should examine their full body as opposed to just the breast, and get familiar with moles, lumps, bumps and everything,”she says during a conversation at the Well Woman Clinic, which she set up in 2006. “When it’s just the breast, there’s a lot of anxiety and it’s as if women are on a witch hunt to find something, but honestly, there’s no perfect time to start examining,” she explains.
Battling anxiety is one thing, and then there’s dealing with fear and myths that, to this day, keep women from attending mammogram screenings which are easily available around the UAE. “The age that screening should start is topical. In the USA it’s from the age of 40, and then every year, while in Europe it’s from the age of 45 and then every two years, whereas in England it’s at the age of 50 and then every three years,” explains Dr Houriya. However, at her own practice, she individualises the approach according to family history and several other factors. “The mammogram reveals details about the breast tissue and density. From the age of 40 and then every other year, and then every year from the age of 50, the breast tissue can change according to family history.”
Apart from family history and genetics, hormone regulation is important to watch out for, especially when new symptoms appear.“When there’s something happening in the breast, it’s always secondary to something happening elsewhere and it’s usually picked up during the investigations,” she shares. Breast cysts can often develop as a result of polycystic ovary syndrome, which affects eight to 13 percent of women of reproductive age, and if symptoms like irregular periods, acne or hair loss are evident, then it’s best to get a check, advises Dr Houriya.
While cancer can’t currently be prevented, in many cases it can certainly be managed effectively. And as for what increases chances of cancer occurring, among other things there is a direct link between alcohol consumption and breast cancer, points out Dr Houirya. She also recommends that moderate exercise is highly beneficial in preventing recurrence of cancer that’s been successfully treated. “The Mediterranean diet is the best to follow, which is basically a mix of fruits, vegetables, fish, whole grains and two tablespoons of olive oil a day. Post-treatment, a lot of people want to eat healthily and often switch to fruits and vegetables, but forget to have proteins which are essential to build the body back up,” she cautions, explaining the importance of maintaining protein intake.
Risk calculation and breast reconstruction are two other areas that have a massive impact on a positive outcomes. While it all begins with early detection and screening, there are several other advances that can mitigate the downsides. “We are so much better at treatments today, because we look at the biology of the tumour, the genetic mutation from the family history, and we then treat accordingly,” explains Dr Houriya. It also depends on the density of the breast tissue, hormone replacement therapies and the menstrual cycle’s patterns, which could all be linked to breast cancer, and are part of risk calculation analysis.
As for breast reconstruction following a mastectomy, the choice is often down to personal preferences, and it all depends on what women want to achieve. Women today have more options than before, and reconstruction following a mastectomy is often performed during the same surgery. “When we reconstruct, we save the skin and the nipple and the tissue is removed and replaced with another material. The volume changes, and in fact, you can perk it up, or change the volume as you like,” explains Dr Houriya.
The last and most important aspect of managing breast cancer treatment is putting one’s mental and emotional wellbeing first. Sharing from her years of experience of running the support group Brest Friends, Dr Houriya has seen women get through all the stages of diagnosis, treatment and recovery, often waiting until the very end to seek the emotional support they require, instead of starting before the need arises. “We are all guilty of this part, and psychological wellbeing should begin early, instead of waiting until the end,” she advises. While some women lean on faith, family, friends or work to keep their mind off things, it’s not always easy to do it all with support groups, and a counsellor or a psychologist’s assistance can go a long way in maintaining overall health.
