Breast and Endocrine Surgery

Breast Surgery Services

 

​The breast surgery services offer a matured multidisciplinary centre for management of both benign and malignant breast conditions. We presently have 6 fully trained breast surgeons who have a wealth of experience and have been trained both locally and abroad. Our surgeons are trained in all the latest techniques and management of breast conditions and provide excellent care for our patients. Our breast clinic (hyperlink to breast clinic webpage) has been established for nearly 10 years and our processes and protocols have been streamlined to provide the best one stop care for breast patients in Singapore. We handle an average of 500 breast cancer treatment every year.

 

Our unit works in conjunction with the breast imaging unit of the radiology department to provide precise breast screening. We are one of three centres designated as an assessment centre as part of the Breast Screen Singapore program. We have been involved in BreastScreen Singapore since 2002. Mammographic screening remains the only scientifically proven method of reducing breast cancer mortality by detecting cancers at an earlier stage.

 

Our experience from the years of participation in the Breast Screen Singapore programme means that we are also able to offer precise diagnosis of symptomatic patients also via Breast imaging like mammogram and ultrasound. We are able to provide minimally invasive biopsy techniques guided by the various imaging techniques including MRI of the breast. Our centre also provides expertise in the reading of MRI of the breasts.

 

We aim to provide prompt diagnosis and treatment of breast cancer in a comforting environment for our patients that understand their needs. Our philosophy is that of a multidisciplinary approach towards the treatment of breast cancer. This ensures that patients benefit from the expertise of all the various specialities. The team includes Breast Surgeons, Plastic and Reconstructive Surgeons, Medical Oncologists, Radiation Oncologists, Radiologists, Pathologists, Breast Nurse Clinicians and Physiotherapists. We also work with our palliative care and oncology rehabilitation colleagues when the need arises.

 

To date, surgery remains the mainstay of treatment of breast cancer. Breast cancer surgery has evolved from radical surgery of the past to conservative surgery that we offer as standard of care. Suitable patients are offered breast conservative surgery where only the tumour is removed. Oncoplastic surgical techniques are employed to shape the breast to minimise breast asymmetry. A lesser procedure called sentinel lymph node biopsy has also been introduced where most of the underarm lymph glands are spared from removal if it is not necessary.

 

We have an excellent working relationship with our plastic surgeons who understand also the oncological principles in breast cancer surgery. Together we offer patients who require radical surgery combined operations with immediate breast reconstruction to reduce the anaesthetic time. Finally we have the expertise to perform skin cover for large tumours and even chest wall reconstruction should this be required.

 

We participate in various research studies, collaborating with partners both in Singapore and around the world to bring the latest advancements in treatment to our patients.

 

Our years of working with breast cancer patients highlighted to us the need for emotional support in patients who have been diagnosed with this condition and survivorship issues. Our support group has matured and the patients actively meet up and encourage each other in their journey.

 

Endocrine Surgery Services

 

Surgeons with special interest in endocrine surgery will help to evaluate patients with endocrine problems. As not all endocrine conditions need surgery, we work closely with the Department of Endocrinology to provide a full range of treatment options for patients.

 

Surgery for thyroid diseases is the most common procedure performed by our team. We are able to offer newer methods of thyroid surgery to certain suitable patients including minimal access surgery and endoscopic thyroidectomy. We also perform parathyroid surgery for patients with overactive parathyroid glands resulting in elevated blood calcium levels. Following pre-operative localisation scans, we can perform minimal invasive parathyroid surgery that leaves only a small scar in the neck.

 

Surgical Techniques

 

Benign

  • Core biopsy
  • Image guided core biopsy (mammographic, ultrasound and MRI)
  • Excision Biopsy including hookwire localisation for non-palpable lumps
  • Mammotomy
  • Microdochectomy and total duct excision
  • Excision of mammillary fistula
  • Excision of accessory breast
  • Subcutaneous mastectomy for gynaecomastia

Cancer surgery

  • Lumpectomy with or without oncoplastic techniques
  • Mastectomy
  • Axillary procedures including Sentinel lymph node biopsy and axillary clearance
  • Internal mammary lymph node excision
  • Immediate breast reconstruction including autologous and prosthetic reconstruction
  • Chest wall reconstruction following radical excision