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Breast Service

 

The Sengkang General Hospital (SKH) Breast Service is a key member of the SingHealth Duke-NUS Breast Centre, the largest centre in Singapore treating the full spectrum of breast conditions. The SKH Breast Service provides comprehensive, compassionate care for patients with benign breast conditions and all stages of breast cancer.

Our approach is quality breast care, grounded in a minimal access philosophy, both in diagnosis and treatment for all breast conditions. We take pride in offering modern and advanced state-or-the-art treatment options, including the latest Oncoplastic, Minimally Invasive, Reconstructive and Symmetrizing surgical techniques. 

As an integrated breast unit, our patients can expect a 1-Stop BrEAST service – One Stop Breast Evaluation, Accelerated Screening and Treatment. This means early access for clinical evaluation by a breast specialist, direct-to-imaging (including mammography, breast ultrasound, and breast MRI when required), and direct-to-biopsy when lesions are suspicious or indeterminate. All sampled indeterminate breast lesions are discussed at a weekly multidisciplinary meeting following image-guided needle sampling or vacuum assisted biopsy. Every case of breast cancer is discussed at our Breast Tumor Board meeting, both on diagnosis and after surgical management, to ensure patients are offered and receive the best evidence-based treatment journey, recommended by the multidisciplinary panel.

Patients will receive comprehensive individualised care from a multidisciplinary team of breast surgeons, plastic and reconstructive surgeons, breast radiologists, pathologists, medical oncologists, radiation oncologists, specialist breast care nurses, occupational and physiotherapists. When required, patients benefit from our partnerships with genetics services, obstetricians and gynaecologists. Cancer treatment is individualised to each patient’s background (age, gender, life and career goals), cancer biology (type, grade and subtype), stage (0 to 4), morphology (form), and personal preference. Our surgical expertise includes advanced cutting-edge approaches and techniques. We plan gold standard multimodal treatment approaches to optimize disease treatment and oncological outcomes. Our minimal access philosophy includes our unified aim to surgically save as much healthy breast tissue when desired and within limits of safety, design minimal-incision and cosmetically preserving approaches, restore femininity and preserve quality of life. (For the complete spectrum, see Our Multidisciplinary Clinical Services, Diagnostics and Treatments).  

Our patients have full access to warm, supportive care from the team of experts throughout their duration of treatment and surveillance. The SKH team believes in clear communication and seamless coordination of care, including a direct route of communication with our breast care nursing team. The multidisciplinary team at the SKH Breast Centre works together in unison to achieve quality, specialized, and desirable outcomes for all our patients.

Our Multidisciplinary Clinical Services, Diagnostics and Treatment

Our multidisciplinary team of breast experts works together to provide the full range of integrated breast services and programmes. The SKH Breast Service believes that each condition should be treated in an individualized manner as there is no one-size-fits-all treatment. Every patient that comes through our door is unique and requires treatment that takes into account their specific condition, background, medical history and personal preferences. Hence, we offer a broad range of breast diagnostics and treatments tailored to every individual, ensuring that the care they receive is thorough, and suited to their needs. Some of the breast services, diagnostics and treatments we offer include:

  • Breast cancer screening
    • Patient education, including breast self-examination (BSE)
  • Breast cancer risk assessment
  • Breast and axillary clinical evaluation
  • Breast and axillary radiological evaluation
    • Digital mammography 
    • 3D mammography (breast tomosynthesis)
    • Ultrasonography of the breast
    • Magnetic resonance imaging (MRI) of the breast
  • Breast interventional services
    • Minimally invasive image-guided breast biopsy, including ultrasound, stereotactic, magnetic resonance imaging (MRI)
    • Minimally invasive image-guided vacuum assisted biopsy, including ultrasound, stereotactic, magnetic resonance imaging (MRI)
  • Benign breast diseases, minimally invasive treatment or surgery
    • Excision of breast lesions and lumps
    • Localisation and excision of breast lesions, including wire-guided and non-wire-guided approaches
    • Breast mastitis and abscess rapid evaluation, minimally invasive imagine-guided needle aspiration or surgical therapy
    • Breast augmentation and reduction mammoplasty
    • Surgical management of accessory breasts and nipples
    • Surgical management of gynaecomastia, including microdebrider, liposuction and minimally invasive endoscopic subcutaneous mastectomy
    • Cryoablation
  • Breast cancer surgery 
    • Mastectomy, Conventional and Minimally Invasive 
      • Simple, Modified-Radical and Radical mastectomy
      • Nipple-sparing mastectomy
      • Skin-sparing mastectomy
      • Minimally invasive nipple and skin sparing mastectomy (Endoscopic)
    • Breast conserving surgery, Oncoplastic and Minimally Invasive
      • Individualised approach with possibilities including periareolar, inframammary, lateral, axillary approaches etc.
      • Oncoplastic breast surgery, including volume-displacement, volume-replacement, volume-reduction and breast symmetrization procedures
        • Mastopexy 
        • Mammoplasty
        • Intercostal artery perforator (ICAP) flap reconstruction – Medial (MICAP), Anterior (AICAP), Lateral (LICAP)
        • Thoracodorsal artery perforator (TDAP) flap
      • Minimally Invasive Breast Conserving Surgery (Endoscopic)
    • Cryoablation
    • Breast reconstruction (partnership with SKH Plastic and Reconstructive Microsurgery)
      • Breast implant-based reconstruction, dermal matrix sling
      • Tissue expander
      • Deep Inferior Epigastric Perforator (DIEP) Flap / Superficial Inferior Epigastric Artery (SIEA) flap reconstruction
      • Profunda Femoris Artery Perforator (PAP) Flap reconstruction 
      • Transverse Rectus Abdominis Myocutaneous (TRAM) Flap
      • External oblique (EO) flap reconstruction 
      • Endoscopic and Conventional Latissimus Dorsi (LD) Flap reconstruction, with or without the combination of breast implants, with Immediate Fat Transfer (LIFT)
      • Transverse Upper Gracilis (TUG) Flap reconstruction
      • Omental Flap reconstruction
      • Nipple and Areolar reconstruction
      • Inverted Nipple Correction
      • Scar revision and/or deformity correction
      • Serial Structural Fat Grafting/Lipofilling with 
      • Liposuction
      • Neurotisation of nipple – to restore sensation to nipple after cancer surgery
    • Axillary treatment
      • Sentinel lymph node biopsy (SLNB): Isosulfan Blue dye, Indocyanine green fluorescence (ICG), Radiocolloid detection etc.
      • Targeted axillary dissection (TAD)
      • Axillary lymph node clearance/dissection (AC/ALND)
      • Prophylactic lymphaticovenular anastomosis or Lymphatic Preventive Healing Approach (LYMPHA) for prevention of lymphedema (partnership with SKH Lymphedema Service)
    • Medical Oncology (in partnership with NCCS@SKH)
      • Chemotherapy (in partnership with NCCS@SKH), including our Pre-operative (neoadjuvant) therapy programme
      • Targeted therapy
      • Hormonal therapy
      • Immunotherapy
      • Trial therapy
    • Radiation Oncology (in partnership with NCCS and SGH) 
      • Radiotherapy (in partnership with NCCS and SGH), including Intraoperative Radiotherapy (IORT)
    • Tumor Genomic testing 
    • Genetic counselling and testing (partnership with NCCS)
    • Gynaecological and fertility counselling (partnership with SGH)
    • Young women’s cancer program (in partnership with NCCS)
    • Breast care nurse (BCN) services for peri-operative care, post-operative care, psychosocial support and survivorship
    • Peri- and Post-operative occupational and physiotherapy
    • Breast cancer survivorship and surveillance
    • Psychology service
    • Medical social worker (MSW) service etc.
  • Lymphedema care, prophylactic (preventative) and therapeutic surgery (partnership with SKH Lymphedema Service, Occupational Therapy and Physiotherapy)
    • Combined multidisciplinary clinic with specialised therapist for lymphedema care
    • Lymphedema surgery, Preventative Surgery and Therapeutic Surgery
      • Liposuction
      • Lymphatic bypass / Lymphaticovenular Anastamosis (LVA)
      • Vascularised lymph node transfer 
      • Lymph Node Venular Anastamosis (LNVA)
  • SKH Pink Peonies Breast Cancer Support Group
  • The SKH Advanced Breast Fellowship Training Programme

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Conditions We Treat

At Sengkang General Hospital, our breast team treats a comprehensive range of conditions including but not limited to:

  • Breast cancer screening
    • Average risk and high-risk breast cancer screening
  • Benign breast changes and symptoms, including and not limited to:
    • Mastalgia (breast pain)
    • Breast calcification(s)

FAQ

  Am I at risk of developing breast cancer?

1.     A known genetic predisposition to breast cancer, including those with gene mutations to BRCA1, BRCA2, p53, PTEN, and others;

2.     Compelling family history of breast cancer that is suggestive of a genetic predisposition, whereby referral for formal genetic assessment/counselling is recommended;

3.     Prior thoracic radiotherapy before the age of 30, e.g., to treat Hodgkin's disease;

4.     A lifetime risk of ≥20%, based on models largely dependent on family history, calculated by a cancer genetics professional.

What are the common symptoms and signs of breast cancer?

I have a breast lump. Should I wait and see if it goes away, or is it appropriate to consult a specialist?

What is breast microcalcifications and are they dangerous?

What is a breast cyst and why was I advised to leave it alone?

What causes breast infection and what can we do to treat mastitis and abscesses?

I have a condition which I think may be urgent. How can I get early access to the SKH Breast Centre?

What can I expect during my first visit at the SKH Breast Centre?

I was recommended a breast biopsy. Why was this so and what can I expect?

Can I do a Video or Telephone Consultation?

What is Oncoplastic Breast Surgery?

What is Minimally Invasive Breast Surgery?

Why should one consider breast reconstruction? And what are the available options for full breast reconstruction?

What is lymphedema and what are the treatment options?

Is there any food I need to avoid following biopsy or surgery?

How should I care for my dressing and wound following breast biopsy or surgery?

Who should undergo breast cancer screening, how and why?



Our Care Team

The path through breast cancer care is different for everyone. SKH has assembled a team of experienced breast care multidisciplinary team dedicated to fulfilling our patients’ unique needs, including breast surgeons, radiologists, medical and radiation oncologists, plastics and reconstructive surgeons, specialist breast care nurses, occupational and physiotherapists. The team goes the extra mile to ensure that all conditions are accurately diagnosed and managed for a more precise treatment strategy. Comprehensive and tailored clinical care. All for you.





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