King's College London

A new study shines light on the treatment and survival outcomes for women with breast cancer in Gaza before the current conflict. While over half of reported diagnoses were made at advanced stages, a high short-term survival rate was discovered, highlighting the positive impact of international investment and collaboration in recent years before the conflict.

The paper, published in JCO Oncology and authored by Dr Shaymaa Alwaheidi and Professors Richard Sullivan and Elizabeth Davies, looks at women in Gaza who were diagnosed with breast cancer between 2017 and 2018. It describes the careful follow up of women using paper medical record and interview data and the calculation of their survival until the end of 2020. This detailed analysis was needed due to the significant gaps in the available research on breast cancer outcomes in Gaza.

Results showed that women in Gaza with breast cancer had a 95.4% chance of survival after the first year, and 86.6% chance of survival after two years. The short-term survival rates (as of 2020) had improved from previous reports, which were lower than some of their neighbouring countries in the Middle East including Lebanon and Jordan.

However, 52% of diagnoses were at the advanced stages III or IV. The authors suggest that this high proportion of advanced stage diagnoses could be due to a combination of women who delay seeking a diagnosis, and delays from the healthcare system, both of which need to be resolved by creating clearer referral guidelines.

The increase in short-term survival could be attributed to increased awareness of breast cancer symptoms among women during this period, leading to their earlier presentation, quicker diagnoses and better treatment. The authors also note that it could be due to changes to the treatment offered and the reduction of modified radical mastectomy.

These changes coincided with investment into the cancer care system, most notably the development of a multidisciplinary breast cancer team at Al-Shifa Hospital and collaborative efforts from the international community as shown by the support of visiting surgeons from the UK.

These positive results highlight how such investments and collaborations had significant benefits for women with breast cancer in Gaza, at least prior to the current conflict. The authors hope that it can encourage more investments and collaborations in breast cancer in Gaza, and more broadly encourage efforts in places throughout the world where women need greater medical support with breast cancer.