Sunday, October 17, 2010

Easing breast cancer's toll

Mammography helps detect breast cancer
SINGAPORE: Like Christy Yow's busty character in the movie "Love Cuts", which also starred Zoe Tay, 42-year-old Mabel (not her real name) grappled with the prospect of losing her left breast to the disease.

She has requested for TODAY to withhold her real name, as only her immediate family knows about her condition.

Mabel was diagnosed with Stage 3 breast cancer last year. And at a diameter of 3.5cm, the cancerous tumour in Mabel's breast was large enough to warrant a mastectomy, or total breast removal.

Besides worrying for her life, the homemaker said she was also overwhelmed by the fear of losing "a part of herself".

Speaking to TODAY at her home, Mabel, who has a 13-year-old daughter, said: "The doctor mentioned that if I wore a breast prosthesis, people wouldn't be able to tell. My husband also told me to go for it (a mastectomy) but I simply couldn't bear it. If I were to lose one of my breasts, how can I still face my own body in the mirror?"

Then, Mabel was given another option by her doctor at the National University Hospital (NUH): Oncoplastic surgery.

Traditionally, breast cancer patients like Mabel with advanced-stage tumours often require a mastectomy, during which the entire breast is removed. They can later opt to see a plastic surgeon for breast reconstruction.

Reshaping the breasts

Now, the emerging field of oncoplastic surgery will mean that cancer surgeons, who have been trained in plastic surgical techniques, can excise cancerous tissue and in the same procedure, cosmetically preserve a natural breast appearance.

Dr Chan Ching Wan, a consultant at NUH's university surgical cluster who performed Mabel's surgery last September, was trained at the Nottingham Breast Institute. Since last year, four breast cancer patients have undergone the procedure at NUH.

KK Women's and Children's Hospital has performed oncoplastic breast surgeries on eight patients since Dec last year.

Not for everyone

However, breast cancer sufferers need to meet the stringent criteria for this type of surgery.

According to Dr Chan, this works only if the woman has large breasts - at least a cup C or D - to begin with. The location and size of the cancer tumours will also determine whether she is a suitable candidate.

Dr Chan explained: "Say for instance, you remove a quarter of tissue from a large breast, then the remaining three quarters can be remodelled." The end result is a smaller, but normal-looking breast.

Aesthetics aside, Dr Chan added the utmost priority is to first ensure that the patient's cancer is cleared, and that the remaining breast tissue is "normal".

There are some risks involved with this type of surgery. For instance, Dr Chan said there is a risk that sensation in the nipple will be affected. In severe complications, the nipple area may "die off" if blood supply is affected.

For Mabel's procedure, which left her two bra cup sizes smaller from her original D cup, Dr Chan removed the cancerous tumour in her left breast. The remaining breast tissue was then repositioned to fill up the defect left by the cancer.

In the same procedure, the size of Mabel's right breast was also reduced for a symmetrical appearance.

For Mabel, the end result was too good to be true.

"Since young, I had always been shy of my physique. To hide my large chest, I was always in loose-fitting clothes," she said.

"I am very, very happy with my current cup size. Every morning when I take a shower, I thank my doctors for doing such a good job, for giving me a new life."

Breast cancer, which affects more than 1,400 women in Singapore each year, is the top cause of death among women here.

On top of grappling with the side effects of treatment, losing part or the entire breast can be an emotionally-draining experience for some women.

"Some fear this may change the way their spouses feel about them or lower their prospects of finding a partner," said Dr Lim Siew Eng, a senior consultant at the National University Cancer Institute, Singapore, department of haematology oncology.

Dr Chan agreed that not all breast cancer sufferers will benefit from the procedure, since most Singaporean females are have relatively small breasts.

"But at least for those with big breasts who are diagnosed with late cancer, now they have an added option of saving their breasts if they want to," she said.

A year on, Mabel, who now sports a chic pixie crop, has completed chemotherapy and radiation therapy. She will be on medication for the next five years, but said that will not hamper her from enjoying life, and her new figure, to the fullest.

- TODAY/ht

From; source article is below:
Easing breast cancer's toll

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