When Should You Start Getting Mammograms? A Breast Cancer Doctor Weighs In…
Bazaar Arabia sits down with the breast cancer specialist to discuss the importance of self-checks, community and perspective in the battle against the disease
Pink ribbon season has been upon us throughout the past few weeks. During the month of October, women around the world are reminded of the importance of checking their breasts. They’re encouraged to avoid skipping those mammogram appointments, crucial for early detection, and to report any changes to their doctors.
While the conversation surrounding breast cancer (and the importance of raising awareness) in the region is no longer one shrouded in secrecy and, for some, shame, this wasn’t always the case. For over two decades Dr. Houriya Kazim – one of the UAE’s most notable breast specialists; first female Emirati surgeon and founder of Brest Friends – has been working tirelessly to champion the cause, dispelling myths and taboos about one of the most common cancer types in women, while also teaming up with Estée Lauder Companies for their regional breast cancer awareness campaign, “I Never Thought”.
But one thing Dr. Kazim does not want us to do is to feel overly anxious about having these important discussions – ones that could be lifesaving for some. “It’s about your whole health, taking care of your whole body,” she tells Harper’s Bazaar Arabia during our conversation, stressing the importance of leading a healthy lifestyle as the best preventative measure, putting the data and statistics into perspective in order to avoid unnecessary fear. Because, let’s face it, talking about a disease that is so commonplace it has likely affected a loved one, or friend, or even yourself, can be more than a little triggering.
From breast cancer in men (yes, they can get it too) to the best age to get a mammogram, Bazaar Arabia asks her all our questions about one of the leading cancers in women worldwide.
Harper’s Bazaar Arabia (HBA): Do we have any insight as to why the diagnosis rate in younger women is high here in the region?
Dr. Houriya Kazim (HK): No, we don’t… There are a few cancers that are on the increase in younger people and breast cancer is one of them… What we do know is that, since the middle of the last century, there’s been so much change to our diets, our lifestyle, and obesity rates – and all these things probably have some effect on our individual genetic susceptibilities to whatever cancer… but the actual effect of us being exposed to these things is really unknown right now. So, we don’t have any good ideas.
We are doing some studies with Al Jalila Foundation and Mohammed Bin Rashid University Of Medicine and Health Sciences (MBR), specifically looking at the genome and breast cancer. It’s a long process of tissue banking and it’s an expansive process. MBR has just set up a fantastic genetic lab and specifically one of the things we’re looking at is breast cancer.
The last figures I saw for the UAE (in 2019/2020) is that, in women, breast cancer counts for over 35% of all the cancers they see. That’s a lot; it’s the Number One cancer for women in this country.
HBA: At what age should a woman, based here in the region, start getting regular mammograms?
Dr. HK: In my own practice, I’m lucky that I get to individualize every patient. I look at various risk factors, like family history, density of breast tissue, whether or not they’re on HRT and then I calculate in my mind what the risk is for this person and when they should start [getting mammograms.] So, generally, I would not start before 40. Obviously, if people have cysts or lumps in the breast of various kinds, we will do a mammogram at any age. But generally, for screening, we don’t start until 40.
*Dr. Houriya Kazim advises speaking to your doctor at any age, if you have any concerns or a family history of breast cancer.
HBA: Most men aren’t aware that they too could be at risk for it. What more can we do to encourage conversation and awareness surrounding male breast cancer?
Dr. HK: To put it in perspective if you look at the top ten cancers that women get, breast cancer is number one for this country [the UAE], and probably top three for most countries. It’s nowhere near the top 10 for men.
As much as I think everybody’s always surprised — men in particular — to know that they too can get breast cancer, it’s not that common… I’ve probably seen two male patients in the last 15 years, out of the thousands of patients I’ve seen.
I don’t want to make a big deal out of it, but they should understand that they have breast tissue – therefore they can get breast cancer. As men don’t have a lot of breast tissue, they tend to feel it quite easily (i.e. when they’re washing their chest in the shower), whereas for women, unless it’s right close to the skin, they might not feel it until it’s a significant size. So, most men tend to present relatively early.
“Obviously, there are people in this world who are at an increased risk of heart disease or breast cancer, colon cancer, etc. But for the general population, it’s really about just being body aware, staying healthy and being proactive.”
Dr. Houriya Kazim
HBA: How important are communities like Breast Friends to cancer patients and survivors?
Dr. HK: I think they’re important. It’s one of those things where it was difficult to set up here because women are not open with their health issues or any of their issues… as a result, the support group has actually evolved through different phases.
Initially, it was mostly social where women would talk informally with each other, and then we would have an educational talk, informal meetings and then we would have some kind of programme, which was a talk or something educational. And then we moved on to having dance classes and events where women could get to know each other, and that evolved into having a third part of the meeting, which we called our Close Circle, for women who needed more. That was run by a psychologist and a life coach.
And then we realised it wasn’t enough… so we started the cancer drop-in centre, which is housed at the Al Jalila Building. People can drop by, you don’t have to make an appointment, we do still have various meetings, some big ones, and some smaller coffee mornings, and then the centre will run some of the programmes that we would run once a month or twice a month.
Now we have classes, like yoga, and a physiotherapist, a lymphedema therapist, where women who don’t have insurance can actually go there and have a couple of free sessions.
So, it’s been great with all the feedback we’ve had.
HBA: As a doctor and specialist surgeon, you need to be clinical in order to do your job. How do you balance being professional while also being, well, human at the end of the day?
Dr. HK: Obviously, I don’t want to be the cold surgeon… but there are times where you have to be in control and it can be very overwhelming. Part of my job is… to be like, “Okay, let’s focus here. Let’s go step by step.” But it is emotional.
There are days where… the patient leaves, we shut the door, and my nurse and I will burst into tears because sometimes it is very sad. Because, you know, our patients are young, and they have young children. And sometimes the things going on in their lives at that time, that in addition to the cancer, that that just makes the situation worse than it is.
HBA: Information and knowledge about breast cancer, the importance of self-examination, and early detection is very empowering, but can also make some people anxious – especially when we see the statistics. How do we find that balance of staying informed while not obsessing over it?
Dr. HK: It’s a difficult one. Obviously, in October, it’s just in your face – and even for patients who already have cancer, it’s this constant reminder. I always try to swing it from a positive side. Instead of saying One in Ten women will get breast cancer, we said in our educational videos Nine in Ten women will not get breast cancer, but you need to get yourself checked.
It’s really just about putting things into perspective. When I tell women that they have a five to eight greater chance of dropping dead from a heart attack than getting breast cancer, they’re surprised. The number one killer for everyone heart disease. So, even though we focus on it so much in October during Breast Cancer Awareness Month, which is a good thing, it’s important to keep it in perspective.
“It’s about your whole health, taking care of your whole body. If you take care of your heart, you are actually taking care of your breasts…
Dr. Houriya Kazim
HBA: What’s the biggest lesson you’ve learned from your patients?
Dr. HK: I see these very traditional women who come in with their husbands who, when you’re taking a history from them and you’re asking them questions, the husband is actually answering for them. Sometimes, we’ll ask “How old were you when you had your first period?” and he’ll be answering. But that’s just that’s the dynamic of the cultures we have had here.
You have these women who come in, they’re obviously deathly afraid because they’ve not had to deal with things – it’s all been done by the male in the family. And then you see them go through this treatment, which obviously only they can go through – nobody can do it for them – and they march into my office, and they’re so confident and you know, sometimes they leave him outside. They will come in and I see a different person. Just that strength, that resilience in women that you wouldn’t necessarily think they had it in them, but they do.
One of the things I’ve seen, what they’ve shown me, is not just how strong but how resilient women are.
Images supplied.
