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  • Mount Elizabeth

Breast Cancer

  • What is breast cancer?

    Breast cancer

    Breast cancer is an abnormal growth of cells in the breast that can sometimes be felt as a lump or mass called a tumour. The tumour develops when cells in the breast divide without control and produce extra tissue. A breast tumour can be benign (non-cancerous) or malignant (cancerous). Cancerous cells can spread within the breast, to lymph nodes (glands) in your armpit, and to other parts of your body.

    The causes of breast cancer are not known. It sometimes occurs in women who have family members with the disease (a genetic cause) or who started to menstruate from a young age (a hormonal cause). Normal female hormones control the division of cells in the breast, and may trigger breast cancer. Women over the age of 40 are more likely to get breast cancer than younger women.

  • What are the symptoms of breast cancer?

    Infographic breast cancer symptoms

    The symptoms of breast cancer may include any of the following:

    • A painless lump in the breast
    • Bleeding or unusual discharge from the nipple
    • Dimpled or puckered skin over the breast
    • Persistent itch and rash around the nipple
    • Pulled in or retracted nipple
    • Swollen and thickened skin over the breast
  • How is breast cancer diagnosed?

    Breast anatomy with cancerous tumour and benign lump

    Breast Self-examination

    Breast cancer is one of the few cancers that can be detected at home through self-examination. You should become familiar with the shape, form and feel of your breasts so as to recognise any changes, such as lumps. Regular self-examination can help to detect breast cancer early before it spreads, which usually accounts for more successful treatment. Some things to note regarding self-examination include:

    • Breast self-examination should be done monthly, preferably about a week after the last menstrual period starts.
    • If you no longer have menses, you should perform breast self-examination on the same day of each month, for example the first of every month.

    During self-examination, you should look out for:

    • A lump, swelling, or thickening in the breast or underarm area
    • Changes in the size or shape of one breast
    • Puckering or dimpling of the skin of the breast or nipple
    • Persistent rash or change in the skin around the nipple
    • Recent changes in the nipple, eg. inversion, retraction
    • Any bleeding or unusual discharge from the nipple
    • Skin redness or soreness of the breast
    • Accentuated veins on the surface of the breast
    • Unusual swelling of one upper arm
    • Any enlarged lymph nodes in the armpit and collarbone areas

    Look for visible changes in the breasts and nipples by turning them slowly from side to side and feel for changes in the breasts, underarm, and collarbone areas.

    If you notice a lump in your breast, or if you suspect that you may have breast cancer, it is advisable to consult a doctor and undergo in-depth tests such as a mammogram.

    Mammogram

    A mammogram is a screening procedure that uses a special machine to take X-ray pictures of the breast. The X-ray pictures make it possible to detect cancerous tumours that cannot be felt by hand, or lumps in the breast that are not yet cancerous but may grow into cancerous tumours. The mammogram is currently one of the most reliable screening tools for breast cancer. Regular mammograms can help detect breast cancer early, thus allowing for early treatment. It is recommended for women between 40 – 49 years old to take annual mammograms.

    Tomosynthesis (3D Mammography)

    Some breast tumours may be difficult to identify on standard mammography because they are hidden or obscured by overlapping or dense breast tissue. Tomosynthesis uses low dose X-rays to take mammogram images of the breast and shows only a few layers of the breast at a time. It has been shown to achieve a higher accuracy of cancer detection and lower false positive cases as compared to digital mammography.

    Breast Ultrasound

    A breast ultrasound uses high frequency sound waves to produce images of the internal structures of the breast. Ultrasound imaging helps in the detection and diagnosis of breast lumps and tissue abnormalities, and is especially useful for patients with dense breasts, which is common among Asian women.

    Breast MRI

    A breast MRI (magnetic resonance imaging) is a special screening procedure that takes images of the breast using strong magnetic fields and radio waves. A breast MRI is not a replacement for a mammogram. It is used as a supplemental tool to mammograms, usually when there is an abnormality on the mammogram that cannot be conclusively determined as a cancerous lump.

    A breast MRI can be used to provide the doctor with detailed information on the position of the cancer as it creates images of the breast tissue. It is also used to check the site after treatment to determine if the cancer still remains.

    In some cases, a breast MRI is used to screen for breast cancer in women who are at high risk of breast cancer, such as those who have a family history of breast cancer or younger women due to higher breast tissue density.

    Regular breast cancer screening is the most effective way of detecting breast cancer, especially in the early stage before any physical changes are noticeable. Book your appointment for breast screening and consult a doctor promptly should you notice any breast lumps or suspect breast cancer.

  • How is breast cancer confirmed?

    Breast cancer biopsy

    If an abnormality is found during screening, a biopsy may be required to determine if the tumour is benign or cancerous. The doctor will remove a small sample of breast tissue or cells for examination and testing. Depending on the location of the abnormality, different image-guided breast procedures may be recommended.

    MRI-guided Core Needle / Vacuum-assisted Biopsy

    Magnetic resonance imaging is used to guide the radiologist’s instruments to the site of abnormal growth in the breast. Small tissue samples are then removed with a hollow needle and tested for cancer.

    Stereotactic Core Needle / Vacuum-assisted Biopsy

    A special mammography machine uses X-rays to guide the radiologist’s instruments to the site of the breast abnormality, before tissue samples are removed and tested for cancer.

    Ultrasound-guided Core Needle / Vacuum-assisted Biopsy

    In ultrasound-guided breast biopsy, ultrasound images are used to locate breast abnormalities, typically a tissue mass or lump. Small tissue samples are then extracted using a fine needle to remove cells or a hollow needle (core biopsy) to be tested for cancer.

    Wire Localisation for Surgery (MRI, Stereotactic or Ultrasound-guided)

    Relying on MRI, stereotactic or ultrasound techniques, wire localisation is used to pinpoint the exact location of a breast lump that is too small or vague to be felt accurately by hand. The surgeon will insert a tiny wire into the breast, such that the tip lies within the abnormal area. A biopsy or surgery will be performed afterwards to remove tissue samples for diagnosis.

  • How is breast cancer treated?

    Mammogram machine for breast cancer detection

    Depending on the stages of breast cancer, you may be recommended to undergo different surgical operations to remove the tumour. This may include:

    • Breast conserving surgery:
      1. Lumpectomy – removal of the cancer and some of the surrounding tissue
      2. Quadrantectomy – removal of ¼ of the breast that contains the lump and surrounding tissue
    • Mastectomy – removal of the whole breast

    Other treatments include:

    • Drug therapy to destroy the cancer cells
      1. Chemotherapy
      2. Hormonal therapy
      3. Targeted therapy
    • Radiation therapy (high-energy X-rays) to destroy the cancer cells
    • Rehabilitation
      1. Nutrition and lifestyle support to help you recover
      2. Shoulder exercises and arm care to avoid stiffness and swelling

    *This is not a complete list of all the diagnostic procedures and treatments we provide. The information is designed for educational references only and should not be taken as medical advice.

    Please consult one of our qualified healthcare specialists for an accurate diagnosis before starting any treatment.

  • Mount Elizabeth Breast Care Centre

    MEH Breast Cancer Centre

    Here at Mount Elizabeth Hospitals, we offer a one-stop solution for all your breast screening, assessment and diagnostic needs.

    Designed with your privacy and comfort in mind, the Mount Elizabeth Breast Care Centre (ME BCC) delivers a smooth, fuss-free experience in a comfortable environment, including a designated waiting area for female patients only. Should there be abnormalities picked up during your screening, you will be referred to our breast specialists for consultation and treatment where necessary.

    Our dedicated team of surgeons, radiologists, nurses and allied health professionals work closely to provide comprehensive and personalised care so as to support you through your breast health journey.

    The ME BCC is located within the radiologic clinics at both Mount Elizabeth Orchard and Mount Elizabeth Novena Hospital. Walk-ins for mammogram screening and further assessment of mammogram results are accepted at the clinics.

    To book an appointment, call Parkway Radiology at +65 6388 4333 or email sg.radiology@parkwaypantai.com.


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