Three studies underway at Cleveland Clinic Abu Dhabi, an integral part of Mubadala Health, aim to offer insights on the awareness, genetic profile and demographics of Emirati women with breast cancer, which can have a significant impact on the detection and treatment of the disease.
Initiated in September, the three studies are being led by the Oncology Institute’s multidisciplinary team and will rely on voluntary participation as well as retrospective data collected from hospital records over the last five years.
Dr. Stephen R. Grobmyer, Chair of the Oncology Institute at Cleveland Clinic Abu Dhabi, says that these studies will gather specific data that will enable tailored care and targeted awareness programs for UAE Nationals.
“These studies will give us an important starting point to understand how breast cancer affects Emirati women, what are the unique characteristics and risk factors of the disease in the UAE population, and the level of knowledge about family and personal health history among patients. This approach will not only enable us to personalize care for our patients but has the potential to inform public health policy and protocols that benefit the population,” says Dr. Grobmyer.
The first study on breast cancer health awareness and genetics among Emirati women will provide essential baseline knowledge about breast health history and seek new information about the spectrum of genetic mutations among patients with breast cancer. Divided into two parts, 100 women having a screening mammography done at Cleveland Clinic Abu Dhabi will be surveyed to understand their breast health literacy. Another 50 newly diagnosed Emirati breast cancer patients will be invited to take a genetic panel testing to determine the rate and spectrum of genetic mutations among this population. The study is estimated to be concluded in 2022.
“We’ve known for a long time that family history is an important part of a woman understanding her risk of breast cancer. The reason is that breast and ovarian cancer has been found in multiple generations of certain families. If a patient knows her family and personal health history, there are several things we can do to help her and her family members. This strategy would include extensive genetic testing, increased frequency of imaging, and prescribing hormonal medications to reduce her apparent risk. However, if a woman does not have that knowledge, it is hard for us to help her make an informed decision on the best treatment plan.”
He continues: “The second part of this study will aim to find the percentage of patients with known genetic mutations and the patterns of mutations for a comparison between the Emirati and Western population.”
The second study will look at the demographics and tumor characteristics of breast cancer among Emirati patients treated or evaluated at Cleveland Clinic Abu Dhabi from May 2015 until June 2021.
Dr. Grobmyer says that this study will help them assess if their anecdotal evidence on the demographics and characteristics of tumor in breast cancer patients can be backed by data.
“We are seeing a larger percentage of young Emirati patients with breast cancer at our clinic. This contrasts with the age at which women in the US are diagnosed with the disease. We will assess the age at which these patients developed breast cancer, and the types of cancer, whether invasive or noninvasive, that are more common.”
He says the outcome will help them make recommendations for new screening protocols and work on different ways to target and educate the population.
The final study will evaluate the hospital’s time to treatment initiation (TTI) among cancer patients treated or evaluated at Cleveland Clinic Abu Dhabi from January 2018 until January 2020.
Highlighting the importance of this study, Dr. Grobmyer says that the purpose is to evaluate their adherence to the US-based National Comprehensive Cancer Network (NCCN) cancer staging guidelines. A recent observational study of 28,000 breast cancer patients in America, which was conducted by researchers at Cleveland Clinic in the U.S. and co-authored by Dr. Grobmyer, found a decrease in patient survival rates when treatment options – surgery, chemotherapy and radiation – are completed more than 38 weeks from the time of diagnosis.
“This study will help us identify what is currently happening when our patients are first diagnosed with breast cancer and how long it takes for them to complete treatment. Sometimes, patients in the UAE have to visit multiple specialists or want to seek multiple opinions, which prolongs their treatment. We want to identify all the challenges within the patient journey.”
Dr. Grobmyer says that they want to send the message of timeliness of care for the best patient outcomes. Cleveland Clinic Abu Dhabi’s Breast Health Clinic mirrors the US-based Cleveland Clinic model of coordinated multidisciplinary care. By offering targeted diagnostic testing, genetic counseling, innovative therapies and treatments, as well as reconstruction specialists and disease-specific experts to address all breast health issues in one location, the hospital tries to eliminate delays in time to treatment.
“We try to anticipate the needs of the patient and reduce the gaps in care. This study will help us identify further challenges and opportunities for designing systems that work best for patients in the UAE.”