BREAST CANCER TREATMENT
Breast cancer remains the leading cancer that affects women in Singapore and worldwide. It accounts for 29% of women’s cancers in Singapore. However, in spite of this staggering statistic, the survival rate for breast cancer has also increased due to the development of better detection methods and treatment over the years.

In addition, breast cancer treatment is dependent on many factors, including the type of breast cancer, the stage of breast cancer, as well as the patient’s overall health. Learning about these will help determine the most effective and suitable treatment for the patient.

Breast Cancer Symptoms

Regular breast self-examinations are an important aspect in the early detection of classic breast cancer symptoms. Through regular self-examinations, you can be made aware of any changes that happen in your breast, especially obvious symptoms that can be felt or seen.

Consult your breast cancer surgeon if these symptoms occur:


  • Abnormal bleeding/discharge from the nipple

  • Itchy rash around the nipple

  • Sore feeling in the breast

  • Change of color of the breast

  • Retracted nipple

  • A lump in the breast

  • Change in breast size

Breast Cancer Diagnosis

Awareness of the symptoms of breast cancer increases one's tendency to consult a breast cancer surgeon for advice should uncertainties or abnormalities arise. Breast cancer screening methods nowadays often provide high levels of clarity and safety; allowing doctors to accurately determine the cancer’s stage as well as the optimal treatment plan needed for each patient.

Some procedures that can screen for breast cancer:
  • Mammogram - A mammogram is a breast x-ray that is considered the standard diagnostic test in a breast examination. This can detect lumps, cysts or microcalcifications in the breast.

  • Women aged 40 and above are advised to go for mammograms even if they do not seem to have any breast cancer symptoms.

    Mammograms can be classified as follows:

    1. A screening mammogram is advised for women with no symptoms of breast cancer. This displays two x-ray images of each breast in different angles.
    2. A diagnostic mammogram provides more detailed x-ray images of each breast in different angles. This test can enlarge parts that seem abnormal and require a closer, clearer look.
    3. Mammogram with tomosynthesis provides even more details, especially when the lady has dense breasts.

  • Ultrasound - An ultrasound scan is a breast screening procedure that uses sound waves to scan breast tissue. A big advantage of an ultrasound scan is that it can easily determine whether an abnormal growth is a solid lump or a fluid-filled cyst, etc. - vital information that can affect the diagnosis and treatment method used.
Further tests to confirm if a lesion is cancer or not:
  • Mammotome Breast Biopsy - A mammotome breast biopsy is a vacuum-assisted biopsy procedure that uses an x-ray, ultrasound or MRI to take a sample of abnormal breast tissue. A mammotome breast biopsy is usually done to determine if an abnormal lesion seen on mammogram, ultrasound or MRI is benign or malignant.
  • Magnetic Reasoning Imaging - An MRI uses magnetic and radio waves in producing cross-sectional images of the internal structure of the breast. Unlike x-rays, MRI procedures do not use radiation, and it gives a more detailed image of the affected area. It is useful when the breasts are dense and the mammogram and/or ultrasound breast images are not conclusive. However, this is not suitable for patients who are claustrophobic.
  • Trucut Biopsy - this is done to determine the identity of a suspicious breast lesion.
  • Fine needle aspiration cytology - this is done to determine the identity of suspicious breast lesions, especially those that are partially cystic.
Breast Cancer Surgery Types

  • Wide local excision: In the past, people called this operation, lumpectomy. This is inaccurate. Breast cancer surgery requires the lump to be excised with margins to ensure no cancer is left behind. Wide local excision, is a breast cancer surgery suitable for breast cancer stages 0, 1, and 2. It is considered as a breast-preserving type of surgery because it only removes the breast tumor and a minimal amount of breast tissue surrounding it. Sometimes, a cancer can be treated with neoadjuvant chemotherapy i.e. chemotherapy to shrink the tumour first, before surgery is done, to reduce the morbidity of surgery.

  • Mastectomy - Mastectomy is the surgical removal of the entire breast. This is advisable in cases where the cancer occupies more than one quadrant, when the cancer is multicentric/ multifocal, or when the tumour volume: breast volume ratio is too high to allow for a cosmetic outcome in conservation surgery. The option of immediate reconstruction is offered to all patients to consider. There are various reconstruction options available.

Breast Cancer Treatments Available

  • Radiotherapy - Radiotherapy uses an external beam radiation to combat the cancerous cells of the breast. It is a post-operative procedure after a lumpectomy or mastectomy to ensure the complete elimination of cancer cells after the operation. This procedure may last from three days to six weeks depending on the patient’s case.

  • Chemotherapy - Chemotherapy is administered to destroy cancer cells, and this form of breast cancer treatment is usually administered intravenously. It is generally an effective procedure to reduce the size of large tumors in the breast before surgery. Additionally, chemotherapy can help decrease the chances of cancer cells returning.

  • Hormonal therapy - depending on the receptor status of the cancer, this option.

ADJUNCT TESTS AVAILABLE:
  • Oncotype Dx
  • BRCA 1/ 2 testing and other tests
Early detection of breast cancer in its early stages greatly increases the survival rate for patients. Regular breast self-examinations, knowledge of breast cancer symptoms, and regular consultations with your breast cancer surgeon will help ensure your continued health and increase your chances of a positive prognosis even if afflicted.

Singapore breast cancer surgeon Dr Bertha Woon attained her MBBS and Masters of Medicine in Surgery from the National University of Singapore, and her Fellowship in General Surgery from the Royal College of Surgeons of Edinburgh. She has been actively involved and recognised in the medical field for more than two decades. Ever dedicated to cancer patients and survivors, Dr Woon’s special interest is in breast surgery and breast cancer surgery.

To find out more about breast cancer treatment, visit our website or call us 6479 7307 for a comprehensive consultation today.

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GENERAL SERVICES


CONTACT INFO
Bertha Woon General & Breast Surgery Clinic
6 Napier Road #09-02/03
Gleneagles Medical Centre

Singapore 258499


Tel: +65 6479 7307
24 Hours Hotline: +65 6333 5550
Appointments: +65 6479 7307
Email: berthawoonsurgerypteltd@gmail.com


OPERATING HOURS
Mon - Fri: 9 am to 1 pm,
2 pm to 5 pm
Sat: 9 am to 1 pm
Sun / PH: Closed