BREAST CANCER TREATMENT & SCREENING IN SINGAPORE

About Us - Breast Cancer Surgeon | Bertha Woon Surgery

Dr Woon Yng Yng, Bertha

Breast Surgeon
MBBS (Singapore), MRCS (Edinburgh),
MMed (Surgery), FRCSEd (Gen), FAMS (Surgery)

Breast cancer is the most commonly diagnosed cancer in women worldwide. In Singapore, it accounts for approximately 29% of all female cancer cases. Fortunately, ongoing advances in medical research and early detection and treatment have improved survival rates over the years. Many patients achieve favourable outcomes, particularly when breast cancer is diagnosed early and managed appropriately.

Understanding the nature of breast cancer helps patients and their families make more informed decisions about treatment options, lifestyle adjustments and long-term care planning.

How Can Breast Cancer Be Detected in Its Early Stages?

Early detection plays an important role in improving treatment outcomes. Taking an active approach to breast health and attending regular breast cancer screening can help identify abnormalities before they progress.

Common ways breast cancer may be detected early include:

Breast self-awareness and examinations: Becoming familiar with how your breasts normally look and feel can help you notice changes such as a new lump, skin thickening, nipple discharge or changes in breast shape. Any persistent or unusual changes should be assessed by a doctor.
Regular breast cancer screening: Women should attend breast cancer screening according to their age, risk factors and national screening recommendations, even if they do not have any symptoms.
Consultation with a breast care specialist: A breast care specialist can perform a clinical breast examination and recommend appropriate screening tests, based on your individual needs and risk profile.

What Are the Common Signs and Symptoms of Breast Cancer?

Some breast cancer symptoms may first be noticed during routine breast self-examinations or while carrying out everyday activities such as showering or getting dressed. If you notice any persistent or unusual changes, it is important to arrange an assessment with a breast care specialist, who can perform a clinical breast examination and recommend appropriate breast cancer screening or further investigations if needed. Although these changes are not always caused by breast cancer, they should be assessed by a breast specialist.

These common symptoms include:

Abnormal bleeding or discharge from the nipple
Itchy rash around the nipple
Persistent breast pain or soreness
Changes in breast skin colour
A retracted (inverted) nipple
A lump in the breast
Changes in breast size or shape

How Is Breast Cancer Screening Carried Out?

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.

If an abnormality is detected, further imaging or diagnostic tests may be recommended to determine whether it is cancerous.

Initial screening procedures at a breast cancer clinic may include the following:

Initial Breast Assessment

The initial assessment usually involves a combination of a clinical breast examination and breast imaging to identify any abnormalities.

Clinical Breast Examination

A clinical breast examination is a physical examination performed by a breast surgeon to assess the breasts and underarm area for lumps, skin changes, nipple abnormalities or other signs of concern. It may be carried out as part of routine breast screening or when you notice new breast symptoms.

Mammography

Mammography is a specialised breast X-ray and remains the primary imaging test used in breast cancer screening. It can detect abnormalities such as breast lumps, microcalcifications and other changes that may not be noticeable during a physical examination. Women aged 40 and above are generally encouraged to undergo regular mammography according to national screening recommendations.

Depending on the reason for the examination, different types of mammograms may be recommended:

Screening mammogram: Performed for women without breast symptoms as part of routine breast cancer screening.
Diagnostic mammogram: Provides additional, more detailed images to assess an abnormality found during screening or after symptoms develop.
Digital breast tomosynthesis (3D mammography): Produces multiple images of the breast from different angles, improving visualisation of breast tissue, particularly in women with dense breasts.

Breast Ultrasound

Breast ultrasound uses sound waves to produce images of the breast tissue without radiation exposure. It is commonly used alongside mammography to further evaluate an area of concern or in women with dense breast tissue. Ultrasound can also help distinguish whether a breast abnormality is a solid lump or a fluid-filled cyst, which assists in determining the next steps in assessment.

Additional Imaging

In some cases, the findings from a clinical breast examination, mammogram or ultrasound may require further evaluation. Additional imaging helps provide more detailed information about a breast abnormality, assess the extent of suspicious findings or clarify results that are inconclusive on initial screening.

Breast MRI uses magnetic fields and radio waves to produce highly detailed images of the breast without radiation exposure. It may be recommended for women with dense breasts, when mammogram or ultrasound findings are inconclusive, or when further assessment is needed to guide diagnosis and treatment planning. Although MRI provides excellent detail, it is not routinely used for all patients and is recommended only when clinically appropriate.

Tissue Sampling

If breast imaging identifies a suspicious abnormality, further investigation may be needed to establish a definitive diagnosis. At this stage, a biopsy is performed to obtain a sample of cells or tissue for laboratory examination. Unlike imaging tests, which can only indicate whether an area appears abnormal, a biopsy is the most reliable way to conclude the screening process and determine whether a lesion is benign or cancerous.

Depending on the size, location and characteristics of the abnormality, your breast specialist may recommend one of the following procedures:

Core (Trucut) biopsy: Uses a hollow needle to remove small tissue samples from a suspicious breast lesion for laboratory analysis.
Mammotome (vacuum-assisted) biopsy: Uses a vacuum-assisted device guided by mammography, ultrasound or MRI to obtain larger tissue samples from an abnormal area.
Fine needle aspiration cytology (FNAC): Uses a fine needle to collect cells from a breast lump or partially cystic lesion for microscopic examination.

The biopsy results help confirm the diagnosis and provide important information that guides the next steps in treatment planning, if required.

Early detection and treatment of breast cancer in its early stages greatly increase 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.

To find out more about breast cancer treatment, contact us today for a comprehensive consultation.

How Is Breast Cancer Treatment Planned?

Once a biopsy confirms a diagnosis of breast cancer, your breast specialist will review the results together with your imaging findings and overall health to develop an individualised treatment plan. As every breast cancer is different, treatment is tailored according to the characteristics of the cancer and your personal circumstances.

Factors that may influence your treatment plan include:

Cancer stage: The stage describes how advanced the cancer is, including whether it is confined to the breast or has spread to nearby lymph nodes or other parts of the body.
Tumour size: The size of the tumour helps determine whether breast-conserving surgery is appropriate and whether treatments such as chemotherapy should be considered before surgery.
Lymph node involvement: Whether the cancer has spread to the lymph nodes influences staging and helps guide decisions about surgery and additional treatments.
Hormone receptor and HER2 status: Tests for oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) identify the biological characteristics of the cancer and help determine whether treatments such as hormonal therapy or targeted therapy are suitable.
Overall health and personal preferences: Your age, general health, existing medical conditions and treatment goals are also considered when recommending the most appropriate treatment approach.

By considering these factors together, your breast specialist can develop a treatment plan that is tailored to your diagnosis while aiming to achieve the best possible outcome.

Breast Cancer Treatments Available

When a lump is detected and breast cancer is confirmed, several treatment options may be considered. Advances in therapy now allow more effective management of the condition and support recovery, depending on individual needs. These options include:

Radiation Therapy: Radiotherapy uses an external beam of radiation to combat the cancerous cells of the breast. It is a post-operative procedure after a lumpectomy or mastectomy to carry out the elimination of cancer cells after the operation.
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 tumours in the breast before surgery. Additionally, chemotherapy can help decrease the chances of cancer cells returning.
Hormonal Therapy: Hormone therapy blocks or lowers hormones like oestrogen that can fuel certain types of breast cancer. It is commonly used for hormone receptor-positive breast cancers to reduce the risk of recurrence.
Targeted Therapy: Targeted therapy focuses on specific molecules or proteins that support cancer growth. This approach can attack cancer cells more precisely while causing less damage to healthy tissue.
Immunotherapy: Immunotherapy helps the body's immune system recognise and fight cancer cells. It is used in certain cases, often in combination with other treatments.

The combination and sequence of these treatments will vary depending on the type and stage of breast cancer. For many patients, surgery remains a key part of treatment and may be performed before or after other therapies, depending on the recommended treatment plan.

Are You or a Loved One Concerned About Breast Cancer?

Receiving a breast cancer diagnosis can feel overwhelming, but timely assessment and a personalised treatment plan can make a meaningful difference. Dr Bertha Woon provides comprehensive breast cancer treatment, from diagnosis and treatment planning to breast cancer surgery and long-term follow-up care.

Meet Our Specialist

Breast Cancer Surgery

Surgery is a key component of breast cancer treatment and aims to remove the cancer while preserving as much healthy tissue as possible where appropriate. The type of surgery recommended depends on factors such as the size and location of the tumour, whether the cancer has spread to the lymph nodes and your overall treatment plan. At our clinic, breast cancer surgery is tailored to each patient's diagnosis and may include the following procedures:

Lymph Node Surgery

Breast cancer can spread to the lymph nodes in the underarm (axilla), making lymph node assessment an important part of treatment planning. Depending on the extent of the disease, surgery may involve a sentinel lymph node biopsy, which removes one or a few lymph nodes for examination, or an axillary lymph node dissection, where a larger group of lymph nodes is removed if cancer spread is confirmed or strongly suspected.

The results of lymph node surgery help determine the stage of the cancer and whether additional treatments, such as chemotherapy, radiotherapy or targeted therapy, are recommended.

Breast-Conserving Surgery (Wide Local Excision)

Breast-conserving surgery, also known as a wide local excision, removes the breast tumour together with a margin of surrounding healthy tissue to reduce the risk of cancer cells remaining. Unlike the older term "lumpectomy", a wide local excision places emphasis on achieving adequate surgical margins while preserving the breast whenever appropriate.

Mastectomy

A mastectomy involves the removal of the entire breast and may be recommended when breast-conserving surgery is unlikely to achieve complete cancer removal or an acceptable cosmetic outcome. This may include cases where the cancer is large relative to the size of the breast, involves multiple areas of the breast (multifocal or multicentric disease), or occupies more than one quadrant.

Patients undergoing a mastectomy may also be offered immediate breast reconstruction, depending on their individual circumstances and treatment plan.

Recovery After Breast Cancer Surgery

Recovery after breast cancer surgery varies depending on the type of procedure performed, whether lymph node surgery was required and whether breast reconstruction was carried out at the same time. Most patients can gradually return to their normal daily activities over the following weeks, although strenuous exercise and heavy lifting may need to be avoided until advised by their breast surgeon.

Follow-Up Care

During your recovery, your breast surgeon will monitor wound healing, review your pathology results and discuss whether additional treatments such as chemotherapy, radiotherapy, hormonal therapy or targeted therapy are recommended. Regular follow-up appointments also help monitor your recovery and detect any signs of recurrence or treatment-related complications.

Breast Reconstruction After Mastectomy

For patients undergoing a mastectomy, breast reconstruction may be performed either at the same time as the breast removal (immediate reconstruction) or at a later stage (delayed reconstruction), depending on your treatment plan and personal preferences.

Breast reconstruction aims to restore the shape and appearance of the breast and may be performed using breast implants, your own body tissue or a combination of both techniques. The most suitable approach depends on factors such as your overall health, the extent of surgery, whether radiotherapy is required and your desired outcome.

Personalised Breast Cancer Care with Dr Bertha Woon

Breast cancer care involves more than treatment alone. From breast cancer screening and diagnosis to surgery, recovery and long-term follow-up, each stage requires careful planning based on your individual condition and treatment goals.

At Bertha Woon General & Breast Surgery Clinic, we strive to provide personalised breast cancer care, guiding patients through every step of their treatment journey. Whether you require breast cancer screening, further diagnostic assessment or breast cancer surgery, Dr Bertha Woon will develop an individualised treatment plan tailored to your diagnosis and needs.

If you have noticed changes in your breasts, have been advised to undergo further investigations or would like to discuss breast cancer screening, contact our clinic today to arrange a consultation.

Frequently Asked Questions (FAQs) About Breast Cancer Treatment

Can a breast injury or trauma lead to breast cancer?

No. Breast trauma or bruising does not cause breast cancer. However, an injury may lead to swelling or a benign lump, such as fat necrosis, which should still be assessed if it persists.

Are breast lumps mostly cancerous?

No. Most breast lumps are benign and may be caused by cysts, fibroadenomas or hormonal changes.

Can a benign (non-cancerous) breast lump develop into cancer over time?

Most benign breast lumps do not become cancerous. However, certain abnormal breast changes may slightly increase future risk, so regular monitoring and follow-up are important.

Can benign breast conditions recur after treatment?

Yes. Conditions such as cysts or fibroadenomas can recur in the same breast or develop in other areas. Routine screening and follow-up help detect changes early.

Can men get breast cancer?

Yes. Although uncommon, men can develop breast cancer. Any breast lump, nipple discharge or skin changes in men should be evaluated by a doctor.

Will I need surgery if breast cancer is diagnosed?

Surgery is not always the first step. Depending on the type and stage of the cancer, treatments such as chemotherapy, targeted therapy or hormonal therapy may be recommended before surgery to shrink the tumour.

Can breast cancer be treated without removing the entire breast?

Yes. Many patients with early-stage breast cancer may be suitable for breast-conserving surgery (wide local excision), which removes the tumour together with a margin of healthy tissue while preserving the rest of the breast.

How long does breast cancer treatment usually take?

The duration of breast cancer treatment varies depending on the stage of the cancer and the treatments required. Surgery is typically followed by a period of recovery, while treatments such as chemotherapy, radiotherapy, hormonal therapy or targeted therapy may continue for several weeks, months or longer. Your breast specialist will explain the expected treatment timeline based on your personalised treatment plan.

Dr Woon Yng Yng, Bertha

Breast Surgeon

MBBS (Singapore), MRCS (Edinburgh), MMed (Surgery), FRCSEd (Gen), FAMS (Surgery)

Meet Our Breast Cancer Specialist in Singapore

Dr Bertha Woon Yng Yng is a breast surgeon with more than two decades of clinical experience in breast cancer screening, diagnosis, treatment and surgery. She believes in delivering personalised care, working closely with each patient to develop an individualised treatment plan and guide them through every stage of their treatment journey.

Dr Woon remains actively involved in Singapore's medical community through her contributions to medical ethics, professional organisations and the advancement of clinical standards.

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 / Sun / PH: Closed