Page 64 - ICE BUSINESS TIMES February 2020

Interview
By Atef Ahsan
Early
Detection
Saves Lives infections and abscesses. The
common age for breast cancer is
usually in the 40s to 60+ age
group; the high-risk age group.
Dr. Tan Yah Yuen What are the common Does family history have
Senior Consultant, Breast Surgeon breast disorders? What influence on breast cancer?
Mount Elizabeth Hospital, Singapore Usually there is, if a family member
age group of women are has breast cancer then the other
more prone to breast female members would be at a
cancer? higher risk than the general
The common breast disorders population. The closer the family
we see for cancerous condi- member is, the higher the risk. In
tions would be pre-invasive the case of first degree relatives, the
and invasive breast cancers. risk is higher; however, for second
On the other hand, the degree relatives such as grand-
non-cancerous ones are also mother or mother’s sister, the risk
seen to be emerging more like may not be as significant. However,
Fibrosis where the develop- the point to consider is that 70% of
ment of small cysts occur the patients do not have a family
which are water filled lumps in history of breast cancer, hence it’s
the breasts; they are generally not a necessity.
harmless but can lead to pain
development. Women can also What are the treatment
develop a condition called options? What role do lymph
fibroadenomas which are nodes play in the body?
non-cancerous tumors in the Treatment options depend on what
breast which are not danger- type of cancer it is and what stage.
ous but can cause pain and Almost always, there will be some
thus might need to be removed kind of surgery done, accompanied
through surgery. Other less
common conditions could be with chemotherapy, radiotherapy
and endocrine therapy.
Lymph nodes in our body play an
immune function. So for breasts, the
lymph nodes in the underarm are
responsible for recovery from
injuries or cuts in that area.
However, if there’s cancer in that
area, it can spread to the lymph
nodes; thus requiring removal of
these lymph nodes. That’s why it’s
imperative that we try to detect
breast cancer early before it spreads
to the nodes and less long term
complications from treatments.
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Does a breast biopsy hurt? Are there parts of the breast
Yes, it’s quite normal to experience swelling or bruising after any
that are more difficult to perform biopsy than others?
type of breast biopsy procedure. Generally, we recommend patients
not to undergo any strenuous or physical activities for about a few
days after the biopsy.
Should women expect some bruising and skin
discolouration from the procedure? Are there any general
restrictions or home care instructions after a breast
biopsy?
It all depends on what we’re trying to biopsy. Looking at the
mammogram or ultrasound findings, a qualified breast surgeon
would be able to estimate what is the risk level for the lump to be
cancerous. It could be anywhere from 10% to 70-80%.
Is there anything else that you think
women need to know about breast
biopsies?
I think women need to understand that, while
What are the different types of breast biopsies and breast biopsies can be very easy to perform as a
how are they performed? minimally invasive method of removing lumps,
There are four general types of breast biopsies. The first two the truth remains that majority of the lumps do
are, we sample the breasts and the other two, where we not need to be removed. If the tests have revealed
remove the entire lump or the portion of abnormal growth. the lumps to be benign or safe, it needs to be
The first two methods i.e. the simpler ones are called fine unnecessarily removed, more so, it’s not likely to
needle aspiration - biopsy - which is quite a simple method change into cancer in the next 10-20 years.
but not always 100% accurate. Hence, nowadays it’s
surpassed by a much more comprehensive method called What surgical options do women diagnosed
Core needle biopsy, which when performed correctly, can be with early-stage breast cancer have?
100% accurate; both methods require a sample from the The number one option would be mastectomy;
lump. The third and fourth method are the ones involved in removal of the entire breast. Additionally, after
the removal of the lump. Vacuum assisted biopsy is one of mastectomy, we can offer immediate breast
them which is similar to a keyhole surgery- which requires a reconstruction as we can keep the skin. More so,
needle which has a vacuum function. The needle is inserted after the procedure, quite often the patients can
into the breast through ultrasound guidance and direct it to tell that a mastectomy has been performed. The
the abnormal lump area and then suck out the portion other option is lumpectomy but with that
completely. This is a very big advancement as it allows for radiation is almost always required. If we do not
the removal of the lump with minimal scarring and no perform radiation, the risk of the cancer returning
stitches. The last method is the traditional open surgery is over 25%. However, the advantage is that the
biopsy to remove the abnormal growth or lump. So, our patient gets to keep the original form and
preferred method would be the core needle and the vacuum sensation of the breast.
assisted biopsy.
What are the advantages and
How do you decide which
disadvantages of having a lumpectomy
procedure is best suited followed by radiation therapy?
for your patients? The advantages of having a mastectomy is that
So it depends on what type of there's no radiation required. After mastectomy,
abnormality it is. For instance, we’re not required to even perform mammograms
some abnormalities are easily anymore. Psychologically, it’s very good for the
seen in ultrasounds and we patient, they worry less about the cancer probably
can see in the ultrasound coming back in the same breast. The disadvan-
whether the growth is very tage- even after reconstruction surgery, the
deep or superficial or not. sensation is never quite the same as the original.
However, if we’re talking about There will be a period where the patient needs to
mammographic calcifications, undergo physical rehabilitation; this is dependent
which are too near the chest or on whether the lymph nodes have been complete-
skin, technically it can be a ly removed or not.
little more challenging.