Breast cancer is a significant health concern in Singapore, as it is the most commonly diagnosed cancer among women. According to the Singapore Cancer Registry Annual Report 2020, breast cancer accounted for about 30% of all newly diagnosed cancer cases in women between 2016 to 2020.
The rise in breast cancer cases emphasises the importance of early detection and effective management strategies to fight the disease. Breast surgery plays a crucial role in breast cancer management as it aims to remove the tumour and prevent its spread to other parts of the body. While combining two or more types of treatments – such as surgery, radiotherapy and chemotherapy – may be more effective than a single therapy alone, breast surgery remains the first treatment step in most early-stage breast cancer.
There are different types of surgery for breast cancer. Your doctor will discuss the most suitable option for your treatment based on the size of the tumour and its location, your breast size, and your personal wishes and feelings.
What is a Lumpectomy?
Lumpectomy is a breast-conserving surgery that is typically recommended for small, localised and early-stage cancer (stage 0, 1 and 2)[1]. This approach allows for breast preservation while effectively treating the cancer.
During a lumpectomy, the breast surgeon will remove the breast tumour and a margin of healthy breast tissue surrounding it. In addition, a sentinel lymph node biopsy is often performed, involving the removal of a few lymph nodes from the underarm area. If cancer cells are detected in the sentinel nodes, further lymph nodes may be removed through a procedure called axillary node dissection1.
After a lumpectomy, your doctor may recommend radiation therapy to remove any cancer cells that might remain and reduce cancer recurrence in the preserved breast.
What is a simple (or total) mastectomy?
During a simple (or total) mastectomy, your surgeon removes the entire breast, including the nipple and areola. In the case of a modified radical mastectomy, lymph nodes in the underarm region are also removed1.
Mastectomy is typically recommended when1:
- the cancer is present in more than one area of the breast,
- the tumour is relatively large in relation to the size of the breast,
- the patient is not suitable for radiotherapy due to other medical conditions, or she does not want to undergo radiation therapy after surgery
Mastectomy serves as an effective treatment option in cases where breast conservation is not feasible. This surgery technique ensures the comprehensive removal of the cancerous tissue.
Breast reconstruction surgery after mastectomy
Some women may worry about how their breasts will look after a mastectomy. In most cases, breast reconstruction surgery can be done to resolve this. The surgery rebuilds the breast so it is similar in size and shape to your other breast2. Many women have breast reconstruction done at the same time as a mastectomy. Some wait and have it done as a second surgery later.
You can talk to a breast cancer specialist about reconstructive surgery options. Other options after a mastectomy include wearing a breast form (breast prosthesis) or a special mastectomy bra.
What is oncoplastic breast surgery?
Oncoplastic breast surgery is an emerging discipline that combines plastic surgical techniques with breast-conserving surgery. In oncoplastic surgery, the cancer and a rim of surrounding normal breast tissue are removed, and the remaining breast is then reshaped3. The patient then receives radiation therapy to the remaining part of the breast.
Oncoplastic breast surgery has several advantages over mastectomy, as it enables women to preserve their natural breasts. Women can then retain a breast that is warm, soft and sensate. The breast will also fit comfortably into her bra, allowing her to move naturally in her daily life. Oncoplastic surgery also helps to reduce surgical trauma and minimise associated complications. This approach prioritises the preservation of the breast and the patient’s overall well-being and quality of life.
However, oncoplastic breast surgery may not be suitable for certain types of breast cancer, such as inflammatory breast cancer or cancers that have extensively spread5. The procedure may not be possible in cases where there are multiple tumours throughout the breast unless the breast is quite huge5.
Importance of discussing surgery options with healthcare providers
Essentially, the specific surgical procedure recommended for patients depends on factors such as the size and location of the breast cancer and what is most suitable for the patient. Our experienced doctors at Solis will guide women through available options and recommend the most appropriate approach tailored to the patient’s needs.
Our team of dedicated breast surgeons collaborates closely with Luma Women’s Imaging Centre and Luma Medical Centre. This collaborative approach involves a multi-disciplinary approach, where our team of breast radiologists and in-house pathologists work together to provide comprehensive breast care. As Singapore’s first private integrated breast care centre, we are committed to combining expertise and advanced technology to provide holistic breast care for our patients.
1 HealthXchange, “Breast Cancer Treatment: An Overview”
2 John Hopkins Medicine, “Mastectomy”
3 HealthXchange, “Breast Surgery: Fresh Hope in Oncoplastic Surgery”
5 BreastCancer.org, “What is Oncoplastic Lumpectomy Surgery?”
