Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 8th World Conference on Women’s Health and Breast Cancer Abu Dhabi, UAE.

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Scientific Program Day 1
Scientific Program Day 2

Day 1 :

Keynote Forum

Omar Tillo

Bedford Hospital NHS Trust, United Kingdom

Keynote: Overview of breast reconstruction options and latest advances and controversies

Time : 08:30-09:10

Conference Series Womens Health Meet 2018 International Conference Keynote Speaker Omar Tillo photo
Biography:

Omar Tillo is a Plastic and Reconstructive Surgeon who’s special interest is breast and body reconstructive and aesthetic surgery. After graduating in 1997 he completed specialty training in general surgery. He later completed a second specialty training in plastic and reconstructive surgery in some of the leading United Kingdom NHS Hospitals. He developed an early special interest in breast and body surgery and build a successful NHS and private practice. During his employment in Bedford Hospital NHS Trust, he succeeded in establishing a comprehensive breast reconstruction service providing all range of procedures to the local residents from implant based to autologous free flaps. His team was recently nominated for the ‘Team of the Year’ award.

Abstract:

Breast cancer is the most commonly diagnosed cancer in females affecting 1 in every 8 women in their lifetime. In the majority of cases, surgical excision continues to be the first line of treatment by means of mastectomy or wide local excision. These surgical modalities very often result in breast or chest deformities that can have the devastating psychosocial impact on patients, such as low self-esteem and feel incomplete, with adverse impact on their quality of life in terms of sexual activity, relationships, clothing, sport, swimming, and other daily activities. Unfortunately, the large majority of women having breast surgery worldwide are not offered even the simplest types of reconstruction due to lack of awareness, training or resources. Even in the developed countries, it is estimated that 25-50% of women are still not offered the full range of reconstruction options. This paper provides a step-by-step guide in establishing a new breast reconstruction service starting with setting up a dedicated local staff teaching program, arranging specific logistics and equipment, fulfilling administrative and legislative processes, implementing quality assurance measures, audits and patient-reported outcome measures. This is derived from the author’s experience in establishing a breast reconstruction service in an NHS General Hospital in the United Kingdom. A view the current and National Guidelines for best practice is also reviewed along with sources of patient’s education material. In conclusion, no woman should be denied the right of having breast restoration surgery following the treatment of cancer. This service should be made available universally across the globe. Internet and social media platforms are powerful and cost effective educational tools for patients.

Break: 09:50-10:10- Networking and Refreshments Break with Group Photo
  • Breast Cancer|Women’s Health and Fitness
Location: Abu Dhabi

Co-Chair

Najwa Alfarra

King Faisal specialist hospital, Saudi Arabia

Session Introduction

Kathleen Meehan

Khawarizmi International College, United Arab Emirates

Title: Radiation-induced lymphocyte apoptosis as a predictor of radiosensitivity in breast cancer patients
Speaker
Biography:

Kathleen Meehan has completed her Master’s degree in Genetics of Tuberculosis from Cape Peninsula University of Technology, South Africa and a Doctoral degree in Radiobiology where she studied a population of bats exposed to radiation. She became Associate Professor of Biomedical Technology and established a research track record with awards, funding, publications and presentations at national and international conferences.
 

Abstract:

Despite awareness campaigns, breast cancer remains the most common cancer in women and it is estimated that 1.6 million new breast cancer cases are diagnosed each year and around 500,000 deaths are reported annually. Breast cancer is also the most prevalent malignancy found in Arab populations. The average age at presentation of breast cancer in Arab women is a decade earlier than in European and US individuals and the most prevalent presentation is invasive ductal carcinoma with lymph node involvement reported in more than 70% of cases. Due to the larger tumor, aggressive surgical and radiotherapy is often required. Although radiation is widely used as a curative agent, it also poses the risk of serious damage to normal healthy tissue. Radiotherapy should maintain a relationship where cancer cell death exceeds cancer cell proliferation, which would successfully eliminate the cancer. Although radiation toxicity risks for populations of patients are generally known, the determination of an individual’s normal tissue radiosensitivity is rarely possible before treatment. Therefore, oncologists currently stratify the radiation therapy dose according to clinical predictors. The Leukocyte Apoptosis Assay (LAA) has been developed to predict a patient’s radiosensitivity, A recent multicenter trial of over 500 breast cancer patients has confirmed that the LAA assay significantly predicts the risk of late effects of radiation and has validated the assay as a rapid screening test prior to radiotherapy. To include this assay in routine clinical radiation oncology practice in the UAE, radiosensitivity data in the Emirati population will need to be determined. This study will focus on gamma (low-LET) radiation as this is the modality used for treatment of breast cancer. Radiosensitivity will be measured using flow cytometry after in vitro exposure of patient blood samples to 0 Gy (control), 2Gy and 8Gy of gamma radiation. An assay that determines individual radiosensitivity will have numerous applications in the clinic and would ensure a significant reduction of acute responses and prediction of normal tissue toxicity, thereby increasing the efficacy of radiotherapy.

Najwa Alfarra

King Faisal Specialist Hospital and Research Centre, Saudi Arabia

Title: Impact of action II Petite Lady Laser Machine in the treatment of urinary incontinence and sexual dysfunction female

Time : 11:25-11:50

Speaker
Biography:

Najwa Alfarra is currently working as an Assistant Head at King Faisal Specialist Hospital and Research Centre since 2015. She has experience in working as a Women's Health Specialist, Al-Riyadh Governorate, Saudi Arabia. She has her expertise in evaluation and passion in improving women’s health sexual dysfunction as a Physical Therapist specialized in that field. She treats different types of urinary incontinence, chronic pelvic pain, design pre-post-natal exercise program and sexual dysfunction conditions by using different modalities of treatment.
 

Abstract:

Urinary incontinence and sexual dysfunction is very common among female. It causes social or hygienic problem. Urinary incontinence is the uncontrolled leakage of urine. This condition affects about a third of the female population and is more common in women than in men. The Petite Lady treatment is a non-invasive way that is aimed at awakening a woman’s sensuality by tightening up their vaginal canal. Moreover, the method reduces urinary incontinence problem. A lot of people view it as an alternative to the traditional surgical methods that are seen to have side effects. Since there are variations in the impact of the treatment methods, the area needs a lot of research. The objective of the study was to evaluate the impact of the Action II Lady Laser Machine in the treatment of sexual dysfunction and urinary incontinence in females. 30 women were assisted, aged 25-55 years old with sexual dysfunction in stress incontinence confirmed by patient history and urodynamic study. The impact of Action 11 Petite Lady Laser Machine in the treatment of urinary incontinence and female sexual dysfunction confirmed by using the Female Sexual Function Index (FSFI) Arabic validate version by Anis, et al. 2011 was evaluated, measuring vaginal muscle power by using PFX2 and bladder diary. These questions were answered by the patient before we commenced the treatment and after 10 weeks of completing the treatment. The muscle power was measured before and after the treatment, it was conducted at the physical therapy department. Furthermore, the survey included a participant information sheet outlining the nature of the study. The study took a place at King Faisal Specialist Hospital and Research Center. In the voiding diary the women reported that the urinary frequency, episodes of urgency and urine leakage during sneezing, coughing and laughing dramatically improved by 85%. The domain scores of the FSFI, including desire, arousal, lubrication, orgasm, satisfaction and pain, were calculated and showed huge improvement in mean score increased by more than three points at all subjects after completed the treatment by 90%. The muscle power of the pelvic floor improved in all cases the mean of muscle power before the treatment was 2/5 after the treatment became 3±4/5. The treatment protocol was four sessions at two weekly intervals for the first three sessions, then one-month interval between the third and fourth session with 2940 nm. All the subjects successfully completed the study with no adverse events. Significant improvement in vaginal wall relaxation was seen in all subjects at two months and half post treatment based on the PFX2 values on the partners input for vaginal tightening 83%, for sexual satisfaction as assessed by the subjects themselves (90%) and bladder diary showed decrease in leakage during coughing, sneezing and laughing by 85%.
 

Break: Lunch Break 12:15-13:15 @ Restaurant

Gul Cankaya

NHS Marmara University Pendik Training Hospital, Surgical Nursing, Turkey

Title: The role of navigating nurse for women with breast cancer
Biography:

Gul Cankaya is currently working as a Surgical Nurse at NHS Marmara University Pendik Training Hospital, Surgical Nursing, Turkey. She has worked mostly in a pediatric critical care unit, cardiovascular surgery operating room and general surgery operating room. She has attended international certification for Breast Cancer Nursing program (MEHEM).

Abstract:

Breast cancer is the most common cancer and the second leading cause of cancer death among women. The nurse navigator role is expanding rapidly. Navigating nurse is proficiently knowledgeable about breast diseases. Patients who received nurse navigation services responded positively to satisfaction surveys indicating that nurse navigator roles decreased barriers to care while increasing patient satisfaction .The impact of a cancer diagnosis can lead to depression, anxiety, fear and cognitive defects. The concept of patient navigation is defined by its founder, Harold Freeman, MD, as interventions initiated in cancer care for the purpose of reducing barriers to timely screening, diagnosis, treatment and supportive care. A navigating nurse of the breast cancer patient and her family is in understanding and coping with the strong emotions that accompany a breast cancer diagnosis. The navigating nurse is a triage manager in assessing patients’ educational and social needs and appropriately referring to the proper source of help. Navigators roles are: Assess to identify high-risk patients (physical, psychological and social), plan healthcare pathways with multidisciplinary care team, coordinate care with other team members, provide education and support for patient and family and monitor patient’s total response to care for optimum outcomes. Patient navigation effectively improves timely follow-up in elderly patients by addressing barriers related to choosing, understanding and using health coverage, providers and services; making decisions about treatment and managing conditions and care received by multiple providers.
 

Humariya Heena

King Fahad Medical City, Saudi Arabia

Title: Knowledge, attitudes and practices of cervical cancer screening among female health care professionals in Saudi Arabia: A cross-sectional survey
Speaker
Biography:

Humariya Heena is a Senior Clinical Research Specialist and a key member of the research center at King Fahad Medical City, Riyadh, Saudi Arabia with a passion for the scientific writing. She has years of experience in research, epidemiology and teaching. She has an MD degree in Community Medicine. She works with researchers on varied research projects like clinical trials and observational studies. Also, she is actively involved in writing and editing proposals, manuscripts and scientific literature.
 

Abstract:

Introduction & Aim: Among women in developing countries, cervical cancer is the most common type of cancers and a leading cause of mortality. Our review revealed a lack of available literature on the knowledge and awareness of screening for this cancer in the Middle East. Therefore, we aimed to assess the knowledge, attitudes and practices of breast and cervical cancer screening among female healthcare professionals at King Fahad Medical City (KFMC), Saudi Arabia. Methods: A cross-sectional study was conducted at KFMC. A pre-designed and tested, self-administered, questionnaire was distributed to 420 female health care professionals. Data collection was anonymously completed from December 2017 to April 2018. Descriptive statistics were used to summarize responses of the knowledge, attitude and practice questions. Results: Three-hundred and ninety-five participants were included in the final analysis. The mean age of the participants was 34.7 years, majority were married 239 (60.5%) and 201 (51%) had one or more children. The respondents were mainly nurses, 261 (66.1%) or physicians 63 (16.0%). Only 16 (4.2%) participants appeared to have good level of knowledge of cervical cancer. Majority of the participants disagreed with the statements for assessing attitude towards cervical cancer (proportion disagreed ranged from 53-86%). Majority 343 (88%) responded that Pap smear is a useful tool for early detection of cervical cancer but only 103 (26%) had undergone through the screening. Conclusion: Participants showed low level of knowledge and negative attitudes towards screening for cervical cancer. Health care organizations need to encourage women of older age group particularly above 40 years of age for screening and educate them about the significance of screening in the absence of symptoms.

Alicia Y Lefas

Chelsea and Westminster Hospital, United Kingdom

Title: Obesity & Breast Cancer: Investigating the impact of adipose tissue macrophage phenotype on HER2+ breast cancer patient outcomes
Biography:

Alicia Y Lefas is currently working as a Senior House Officer at Chelsea and Westminster Hospital in London, UK. She has completed her graduation from Southampton University Medical School with Bachelors in Medical Sciences. Her interests are in cancer research studies.
 

Abstract:

Background & Aim: In their lifetime, 1:8 women will be diagnosed with breast cancer. However, 27% of breast cancers in the UK population are preventable, with 9% linked to obesity. Macrophages can be polarized towards the anti- (M2), leading to the production of immunosuppressive factors IL-10 and ARG1 or via iNOS stimulation, pro-(M1) inflammatory subtype. Moreover, inflammatory foci termed Crown-Like Structures (CLS) i.e. dead adipocytes circumscribed by macrophages have recently been identified in breast tissue histology. It has been proposed that obesity induces breast Adipose Tissue Macrophages (ATMs) to form CLS. The study aims to investigate the phenotype of ATMs forming CLS using immunohistochemistry techniques. Method: Formalin-fixed paraffin-embedded breast tissue samples were collected correlating to a database of 235 HER2+ breast cancer patients treated in Southampton. Immunohistochemistry was conducted on the Leica BondMax Autostainer using antibodies against: CD68, CD163, iNOS and ARG1. Immunoreactivity was assessed using light-microscopy. Monocytederived macrophages skewed in the laboratory towards the M1 or M2 phenotype served as controls. Result: 37% of cases were positive for CLS, which were primarily (83.8%) observed in clusters at the tumor-adipocyte interface. The majority of ATMs associated with CLS expressed the pro-inflammatory M1 phenotype (iNOS+/CD68+ and ARG1-/ CD163+ or CD68+). No statistically significant association was observed between obesity (BMI≥30) and the formation of CLS. Instead CLS were positively associated with other (↑CD16/↓CD32B) intra-tumoral markers (pro inflammatory) suggesting that their formation likely resulted from the inflammatory influences of the tumor microenvironment. Moreover, CD163 proved a macrophage-specific but not M2-specific marker; as both cohort ATMs and controls displayed CD163+/CD68+ dualpositivity irrespective of macrophage phenotype. Conclusion: In this HER2+ breast cancer cohort, ATMs comprising CLS express the pro-inflammatory M1 phenotype. However, CL occurrence was not statistically associated with obesity (BMI≥30). Understanding the mechanism of CLS formation may offer targets for interventions to reduce risk or improve prognosis of breast cancer.

Rafik abdulal

Latakia National Hospital, Syria

Title: Breast cancer under siege
Speaker
Biography:

Rafik Abdulal is working as a Consultant Thoracic and Breast Oncological Surgery since 1991 in Latakia National Hospital, Ministry of Health. He is an International Member of the American of Breast Surgeon, Lecturer and Founder of Syrian Foundation for Breast Cancer Support in Latakia.
 

Abstract:

Wars, conflicts, stresses impact the immune systems, hormones and body functions. Syrian conflict through seven years has its great bad effects on women health and on the cancer occurrences especially breast cancer. Breast cancer increases with stress and grieves, breasts screening and early detection and diagnosis are impossible under these circumstances, so most of the victim’s cancer progress to stage 3 and 4. Loss of spouse, kids, relatives and friends to death and jailing-economic crisis and starvations, unhealthy diets, fear and stresses and depression are indirectly accused of increasing the breast cancer occurrence. Aminah (37 years old) patient, who lost her husband and two kids in a bomb blast, noticed a mass which was later diagnosed as locally advanced breast cancer, which occurred to her after three months from their loss. Stress aggravates cancer growth. Through the period extended from 1991-2018, about 200 women were diagnosed with breast cancer, most of them under 45 years and most from sieged and corrupted areas (3% stage-I, 18% stage-II, 24% stage-III and 55% stage-IV) all of them endured traumatic life events (loss of family, depression, chronic diseases, assets loss, refugees and homeless). War, conflicts, may affect your nervous, endocrine and immune system and chronic stress may weaken your immune system leaving you with less resistance to disease and maybe to cancer.
 

Kathleen Meehan

Khawarizmi International College, United Arab Emirates

Title: Radiation-induced lymphocyte apoptosis as a predictor of radiosensitivity in breast cancer patients

Time : 10:35-11:00

Speaker
Biography:

Kathleen Meehan has completed her Master’s degree in Genetics of Tuberculosis from Cape Peninsula University of Technology, South Africa and a Doctoral degree in Radiobiology where she studied a population of bats exposed to radiation. She became Associate Professor of Biomedical Technology and established a research track record with awards, funding, publications and presentations at national and international conferences.
 

Abstract:

Despite awareness campaigns, breast cancer remains the most common cancer in women and it is estimated that 1.6 million new breast cancer cases are diagnosed each year and around 500,000 deaths are reported annually. Breast cancer is also the most prevalent malignancy found in Arab populations. The average age at presentation of breast cancer in Arab women is a decade earlier than in European and US individuals and the most prevalent presentation is invasive ductal carcinoma with lymph node involvement reported in more than 70% of cases. Due to the larger tumor, aggressive surgical and radiotherapy is often required. Although radiation is widely used as a curative agent, it also poses the risk of serious damage to normal healthy tissue. Radiotherapy should maintain a relationship where cancer cell death exceeds cancer cell proliferation, which would successfully eliminate the cancer. Although radiation toxicity risks for populations of patients are generally known, the determination of an individual’s normal tissue radiosensitivity is rarely possible before treatment. Therefore, oncologists currently stratify the radiation therapy dose according to clinical predictors. The Leukocyte Apoptosis Assay (LAA) has been developed to predict a patient’s radiosensitivity, A recent multicenter trial of over 500 breast cancer patients has confirmed that the LAA assay significantly predicts the risk of late effects of radiation and has validated the assay as a rapid screening test prior to radiotherapy. To include this assay in routine clinical radiation oncology practice in the UAE, radiosensitivity data in the Emirati population will need to be determined. This study will focus on gamma (low-LET) radiation as this is the modality used for treatment of breast cancer. Radiosensitivity will be measured using flow cytometry after in vitro exposure of patient blood samples to 0 Gy (control), 2Gy and 8Gy of gamma radiation. An assay that determines individual radiosensitivity will have numerous applications in the clinic and would ensure a significant reduction of acute responses and prediction of normal tissue toxicity, thereby increasing the efficacy of radiotherapy.

  • Breast Cancer | Women’s Health and Fitness | Breast Cancer: Challenges, Breakthroughs
Speaker

Chair

Chinar A Dzayee

Rizgari teaching hospital, Iraq

Session Introduction

Heba Alshaeri

Fakeeh College for Medical Sciences, Saudi Arabia12

Title: Antiproliferative activity of Annona muricata extract on triple negative breast cancer cells
Speaker
Biography:

Heba K Alshaeri has pursued PharmD degree at King Abdulaziz University, Saudi Arabia and an MPH degree at Loma Linda University, USA in 2013. In 2013 she joined MCPHS University for Doctoral program in Pharmacology and she has completed her PhD degree in 2018. She is a Member of the American Society for Pharmacology and Experimental Therapeutics and the American Association of Pharmaceutical Scientists.
 

Abstract:

Statement of the Problem: Triple Negative Breast Cancer (TNBC) cells are a subtype of breast cancer that lack of Estrogen Receptors (ERs), Progesterone Receptors (PRs) and Human Epidermal Growth Factor Receptor 2 (HER2). This type of breast cancer has poor prognosis and accounts for 15-20% of newly diagnosed Breast Cancer (BC) cases. Annona muricata is a tropical plant and has been used as a folk medicine to treat several diseases such as malaria, inflammation, diabetes and recently it was known to have anticancer activity on various cancer types. However, the underlying molecular mechanisms remain to be explored. Research Question/Hypothesis: We hypothesize that Annona muricata Ethyl Acetate (AMEA) extract and the isolated compounds will reduce cell proliferation and produce cell death by the induction of apoptosis. Moreover, AMEA or its active ingredients will interfere with the function of EGFR signaling activity in the TNBC cell line. Methodology: The effect of AMEA and F4 on the cell viability of BT-20 breast cancer cell line was analyzed by MTS assay. We measured caspase-3/7 activity and cytochrome C release as a marker of apoptosis. Also, the protein expression of Bax and Bcl-2 was determined using western blot. To investigate further of AMEA and F4 anti-cancer effect we measured cyclin D1 and EGFR signaling and its downstream proteins AKT, MAPK and NF-κB p65 protein expression by western blot analysis. Results: The AMEA showed significant decrease on BT-20 cell viability. Furthermore, AMEA and F4 produced anti-proliferative effect via inhibiting the EGFR phosphorylation and the phosphorylation of its downstream signaling proteins including AKT and MAPK. These effects were accompanied with down-regulation of cyclin D1 production resulting in cell cycle arrest at G1/S phase. Moreover, this compound decreased significantly NF-κB p65 protein expression in the nuclear fraction, therefore, inhibiting its activation and preventing the induction of cell survival. Our data indicated that neither AMEA nor F4 had significant effect on apoptosis biomarkers when tested on Bcl-2, Bax, cytochrome C and caspase 3/7 activities. Conclusion: These findings provide a scientific basis for the molecular mechanism of action of Annona muricata extract and its active fraction F4 in the treatment of TNBC. It has been demonstrated the anti-proliferative effect via EGFR-mediated signaling pathways which includes AKT/MAPK/NF-κB pathways and cyclin D1 inhibition.
 

Gul Cankaya

NHS Marmara University Pendik Training Hospital, Turkey

Title: Quality of life monitoring for women with breast cancer
Biography:

Gul Cankaya is currently working as a Surgical Nurse at NHS Marmara University Pendik Training Hospital, in Turkey. She has worked mostly in pediatric critical care unit, cardiovascular surgery operating room and general surgery operating room. She has attended international certification for Breast Cancer Nursing program (MEHEM).
 

Abstract:

Quality of Life (QoL) surveys are important tasks in health management for oncological patients. Ability to perform daily activities, patient satisfaction and levels of functionality are essential for evaluating QoL in breast cancer survivors. Hot flashes on tamoxifen treatment have been reported to decrease general quality of life in women with breast cancer. Long-term, disease-free survivors of breast cancer have an excellent QOL, many years after their breast cancer diagnosis. According to the World Health Organization’s International Classification of Functioning, Disability and Health (ICF), function is defined as the interactions between an individual, their health condition and the social and personal context in which they live. Breast cancer patients experience physical symptoms and psychosocial distress that adversely affect their quality of life. Healthcare providers and patients think that QoL assessments acceptable in helping breast cancer patients to overcome areas of QoL that have been affected by the disease.
 

Chinar A Dzayee

Rizgari teaching hospital, Iraq

Title: Encysted papillary carcinoma
Speaker
Biography:

Chinar A Dzayee has completed her Bachelor’s degree in Medicine from the Salahaddin University and her Master’s degree in General Surgery in 2008 from Hawler Medical University. She is currently working as a General Surgeon in Rizgari Teaching Hospital and Breast Clinic in Erbil. Her interests are in breast disease and surgery, diagnosis, treatment of benign and malignant breast disease and performing surgery. 

Abstract:

A 52 years old lady was presented with right bloody nipple discharge for 4 years. Ultrasound -RT breast-duct dilatation with irregular mass 24×10 mm within the duct, mammography shoes multiple dilated linear branching density from retro areolar area to the lateral margin of RT breast with nipple retraction. Sonographic guide core biopsy was done. Microscopically finding, dilated ductal space one supported by fibrous tissue other showed prominent ductal proliferation with epitheliosismild atypical change in fibrotic stroma, patient underwent surgery by excision of entire duct from nipple to distal part about 9×6×3 cm axilla not touched, sent for histopathology. Microscopical Finding: Intraductal (intracystic) papillary carcinoma, no invasion is seen, all margins were clear, ER positive, PR positive and HER2 negative. She passed smooth post-operative period and received radiotherapy and now on Tamoxifen treatment. Encapsulated Papillary Carcinoma (EPC) of the breast is a rare malignancy accounting for 0.5-1% of all breast cancers, Caucasians are the most common sufferers of EPC (63%), followed by Hispanics (12-30%), Asian/Pacific Islanders (10-13%) and African-Americans (7-10.5%). EPC can be presented either as a palpable mass in an otherwise normal breast or as a swollen breast due to the presence of a huge cystic mass within it. In some cases, nipple retraction may be present with or without nipple bleeding, requiring further examination using imaging and biopsy. EPC may also be simple mammographic findings without any clinical evidence. Almost 50% of the EPCs arise in the retro-areolar region. These lesions are characterized by indolent behavior and extremely favorable prognosis. Encapsulated PC can be treated with adequate local therapy. Routine use of adjuvant therapy, particularly chemotherapy, is clearly not appropriate in view of the very low risk of subsequent events. However, hormonal therapy may be indicated in certain cases such as recurrent PC.

Ee Ling Serene Tang

Tan Tock Seng Hospital, Singapore

Title: Understanding the demographics and clinical outcome of patients with idiopathic granulomatous mastitis
Speaker
Biography:

Serene Tang is a Breast Surgeon with special interest in granulomatous mastitis and advanced breast cancer. She is particularly interested in breast research and surgical education

Abstract:

Statement of the Problem: Idiopathic Granulomatous Mastitis (GM) is a rare, benign, chronic breast condition which can cause repeated abscess or mass formation in bilateral breasts. This can severely affect the quality of life of women who are affected by it. The natural history of GM as well as its optimal management is not well understood. This study aims to study the demographics of patients with GM and evaluate the most effective treatment method. Methodology & Theoretical Orientation: A retrospective review of 18 patients diagnosed with GM between 2012 and 2018 in a single institution in Singapore was carried out. Patients’ notes and treatment records were reviewed. Findings: The median age of GM patients was 32.5 years old (24-58). 50% of them were Chinese, 27.8% were Malay and 11.1% were Burmese. 72.2% (13/18) of patients presented with a breast lump with 46.2% (6/13) of these patients presenting with a lump more than 5 cm. 22.2% (4/18) presented with a breast abscess. 94.4% (17/18) of patients were treated with steroids, 27.8% (5/18) underwent surgery and 22.2% (4/18) were given antibiotics in the course of their GM treatment. Patients experienced a median of two flares (1-8) on treatment. 47.1% (8 of 17 patients) achieved resolution on prednisolone and none in the antibiotics group. Only one patient in the surgery group achieved complete resolution, as she underwent bilateral mastectomy. One patient who was managed with watchful surveillance spontaneously underwent resolution. The odds of resolution were 3.56 times (p=0.30) more likely with prednisolone than surgery. None turned malignant. Conclusion & Significance: GM is a benign recurrent, relapsing breast inflammatory condition that affects young females. Prednisolone appears to be the most effective amongst all the current treatment options. A multi-center study to evaluate response to various treatment options would aid in understanding of the nature of the disease.
 

Najwa Alfarra

King Faisal Specialist Hospital and Research Centre, Saudi Arabia

Title: New dimension of physical therapy for the oncology female patients with sexual dysfunction
Speaker
Biography:

Najwa Alfarra is currently working as an Assistant Head at King Faisal Specialist Hospital and Research Centre since 2015. She has experience in working as a Women's Health Specialist, Al-Riyadh Governorate, Saudi Arabia. She has her expertise in evaluation and passion in improving women’s health sexual dysfunction as a Physical Therapist specialized in that field. She treats different types of urinary incontinence, chronic pelvic pain, design pre-post-natal exercise program and sexual dysfunction conditions by using different modalities of treatment. 

Abstract:

Medical research continues to extend the life of cancer patients beyond their initial diagnosis. One of the challenges for both cancer survivors and the health care professionals who care for them is to comprehensively address all the issues that impact their quality-of-life. Issues regarding mobility, return to work, cosmetics and self-care are readily identified and addressed. There are other activities of daily living that may be more hidden but should be included in a comprehensive rehabilitation program. Continence (urinary and fecal) and the ability to engage in sexual activity have been well documented to impact the quality-of-life scores for individuals with various types of cancer. The pelvic floor plays a role with both continence and sexual activity. To effectively address pelvic floor dysfunction, a thorough understanding of pelvic floor anatomy and physiology is essential. The women’s health physical therapist will incorporate this knowledge with an appreciation of the impact of surgery, chemotherapy and radiation can have on the function of the pelvic floor. The therapist will evaluate the patient to determine the source of dysfunction, provide scientifically supported education regarding positioning to decrease pain, instructed the patient with certain exercise program and assist alleviating the symptoms to achieve optimal sexual function and treat the patient's dysfunction and improve their sexual intimacy limitations. There were few studies performed in that field and they found the pelvic floor muscle exercise, significantly improved pain with intercourse, sexual function and general quality of life in women with history of breast cancer. This study will find the impact of physical therapy in the treatment of sexual dysfunction in the Saudi oncology female patients.