Breast - "Early Detection Saves Lives"  (see Article)

1. Routine Breast Screening for women above 40 years
   
   Clinical breast examination, ultrasound scan and mammogram.
   
   
2. Breast Lumps (see Article)
   
   Comprehensive assessment for women with breast lumps including ultrasound scan
   
   
3. Breast Cysts
   
   Fine Needle Aspiration of breast cysts under ultrasound scan.
   
   
4. Breast Lumps - Biopsy Methods
   
   a) Fine Needle Aspiration under ultrasound guidance
   
   b) Core Needle Biopsy under ultrasound guidance
   
   c) Excision Biopsy of breast lumps under local or general anaesthesia
   
   
5. Microcalcifications Detected on Mammogram
   
   a) Mammotome Biopsy under local anaesthesia (see Article)
   
   b) Wire Localization Biopsy under general anaesthesia
   
   
6. Neoadjuvant Chemotherapy (see 7 also)
   
   For women with large breast tumours with or without skin involvement. Referral to medical oncologist for chemotherapy to shrink the cancer before surgery.
   
   
7. Breast Cancer Treatment
   
   a) Assessment of the extent and severity of the cancer (staging and grading)
   
   b) Consultation on treatment options (surgery, chemotherapy, radiation therapy)
   
   

   

8. Breast Cancer Surgery
   
   1) The choice is between breast saving surgery (Lumpectomy or Wide Excision) and breast removal surgery (Mastectomy). Some      women may opt for breast reconstruction after Mastectomy. The current trend is to perform a Skin Sparing Mastectomy with      Immediate Reconstruction.
   
   2) Axillary/Armpit Lymph Gland surgery for Breast Cancer. This is an integral part of the breast cancer surgery. There are two      options:
   
             a)  Sentinel Lymph Node Biopsy, using blue dye and/or radioactive dye,can be used under certain criteria to selectively biopsy the                 main axillary glands/nodes instead of total removal of axillary lymph glands/nodes.
   
             b)  Axillary Lymph Gland Dissection ( total removal) when sentinel node biopsy is contraindicated. (see Article)
   
   
9. Elderly Breast Cancer
   
   Hormonal Therapy using anti-hormone drugs such as Tamoxifen, Arimidex or Femara, especially for elderly (> 75 years old) women with breast cancer who are not fit for surgery.
   
   
10. Breast Pain
    
    Management and assessment of patients with troublesome breast pain
    
    
11. Nipple Discharge
    
    Management of women with nipple discharge including surgical treatment (Microdochectomy, Hadfield’s operation), if necessary.       
    
    
12. Breast Feeding Problems
    
    Management of breast problems during breast feeding such as breast engorgement, mastitis, blocked ducts, nipple cracks, breast infections.
    
    
13. Risk Assessment Clinic
    
    For women who are at higher risk for breast cancer such as family history or abnormal breast biopsy.
    
    
14. Inverted Nipple and Accessory Breasts
    
    Surgery for these uncommon breast problems.
    
    
15. Men With Breast Lumps or Breast Swelling (Gynaecomastia)
    
    Men who present with breast swelling called Gynaecomastia need careful assessment to exclude an underlying hormonal problem. Men can also suffer from breast cancer  (see Article).