Professional Documents
Culture Documents
At KK Womens and
Childrens Hospital, the
KK Breast Centre is the
worlds first to provide
FDA-approved digital
mammography services that
leverages on the synergy of
computer radiography and
computer-aided detection.
Radiologist helping patient to position the breast in preparation for digital mammography. Sentinel Lymph Node Biopsy
When breast cancer cells move or
One in 17 women above the age of 40 Digital Mammography metastasize to other parts of the
will be diagnosed with breast cancer. body, the first lymph node that they
Many women are not aware that
Breast cancer is the number one cancer will travel to is the sentinel lymph
regular screening for breast cancer
affecting Singapore women. Because node one of the many lymph nodes
allows the cancer to be detected early;
of this, KK Womens and Childrens located in the armpit. Typically, when
and early detection and treatment
hospital has a specialized team of a patient is diagnosed with breast
increases the likelihood of a cure.
doctors, nurses and paramedical staff cancer, they must undergo axillary
Having a mammogram
dedicated to the early detection and lymph node dissection (removal of
which essentially is an X-ray of
treatment of breast cancers all all armpit nodes) to check for the
the breasts done on an outpatient
of whom are housed within the KK spread of cancer. This process helps
basis is key in picking early stage
Breast Centre. to stage the cancer to check for
abnormalities in the breast. With
T
he KK Breast Centre is a one- how advanced the cancer cells have
the help of a radiographer (the
stop centre fully dedicated to looking grown. Removal of armpit nodes,
healthcare professional performing
after breast Health. The centre however, would sometimes lead to
the mammogram test), the patient
uses state-of-the-art breast imaging chronic swelling of the arm.
positions her breast for a gentle
to provide digital mammography, To prevent unnecessary removal
compression from the mammogram
breast ultrasonography, surgical of armpit nodes and hence needless
equipment. This compression is
consultation, minimally invasive chronic swelling of the arm, sentinel
necessary to examine maximum
biopsies and procedures all under one lymph node biopsy is performed. Two
breast tissue. Having a mammogram
roof, with quick turnaround time. medicines are first injected into the
done on a one- to two-yearly basis
We take a look at two key breast to track the drainage of fluid
is important when a woman is more
cutting-edge technologies available from the breasts into the armpit.
than 40 years old.
at the centre. These include a medicine with a very
The radiologist uses computer aided detection to help magnify or zoom into the mammogram images.
tiny amount of radioactivity (only With the advent of modern It is not clear how this change
one-sixth of which is used in a normal medical science, screening methods has come about. One theory is that
bone scan) and a blue dye. At the are now less invasive and more it is the accumulative effect of an
time of operation only the sentinel accurate, translating into obvious unhealthy diet and lifestyle over
nodes are retrieved with the help benefits for patients. The high a long period of time. This may
of those two medicines and will incidence rate of breast cancer should explain why the number of women
then be examined immediately. If not cause panic amongst women, diagnosed with breast cancer is higher
these nodes are free of cancer, no but should serve as a reminder in Western developed countries and
further nodes are removed from the for women to start regular breast modern societies, compared to the less
armpit. Conversely, if the sentinel screening at an appropriate age; developed and rural regions. There is
nodes are not affected, the surgeon because early detection of breast no evidence that antiperspirants,
then continues to do a complete cancer is highly treatable with good underwire bras, previous injury or
removal of underarm nodes. clinical outcomes. yearly mammograms cause breast
Because of the benefits for the cancer.
patient, the sentinel lymph node In 5% to 10% of women, breast
biopsy is becoming the standard
Breast Cancer Facts:
cancer occurs because of a genetic
of care in the management of early The Basics
abnormality. This abnormality may
breast cancer. Causes occur spontaneously in the woman,
Breast cancer, like cancer originating or it may have been inherited from
Having performed more in other parts of the body, can occur her ancestors. If it is an inherited
than 200 sentinel lymph because the cells in the tissue have genetic abnormality, there often will
node biopsies, breast undergone an irreversible change. be other members of her extended
surgeons at the KK Womens This change has given the cells the family who may have breast cancer,
and Childrens Hospital have ability to continue growing and ovarian cancer or other types of
also helped to train other multiplying in an uncontrolled cancer. However, more than 80%
manner. of newly diagnosed women do not
doctors in this aspect.
but as the cancer grows, the following childrens hospital in Asia to have
symptoms may appear: received accreditation from the Joint
a persistent lump or thickening Commission International.
in the breast or armpit area, In 2007, more than 35,000
changes in the color or skin of the international patients came to seek
breast, areola or nipple (example medical treatment at KK Womens
dimpling or puckering), and Childrens Hospital. International
nipple retraction or changes, or patients come for any of the 45
blood or discharge from the subspecialties the hospital provides
nipple. for both women and children, and
need not worry about logistical
Clinical Outcomes of arrangements. The International
Medical Services Department at
KK Womens and Childrens
the hospital provides assistance
Hospital for Breast Cancer
such as suitable doctor referral,
The average five-year survival rates of medical appointments, medical
each of these stages are as follows: evacuation, travel arrangements,
Ultrasound of breasts is sometimes done
transport and accommodation and
so that the doctor can accurately locate the Stage Clinical Outcome language translators. n
abnormality. 0 99%
I 96%
II 85%
have a family history of breast or III 54%
other cancers.
IV 20%
Contact Details:
Breast cancer can, however, affect International Patients at KK Womens and Childrens Hospital
anyone at anytime, with or without KK Womens and Childrens Address: 100 Bukit Timah Road
the risk factors. It is therefore
Hospital Singapore 229899.
important to perform monthly breast
self-examination, yearly mammogram KK Womens and Childrens Hospital
and clinical breast examination by a is the only teaching hospital for Appointments for international
medical professional. pediatrics in Singapore. Focusing on patients, please contact us at:
subspecialty care for only women Tel: +65 6394 8888
and children makes it possible for (24-hour hotline)
Signs and Symptoms the hospital to constantly achieve Fax: +65 6292 5145
There is usually no pain or symptom excellent clinical outcomes. The Email: international@kkh.com.sg
when breast cancer is its early stages, hospital is also the only womens and URL: www.kkh.com.sg
Location of sentinel lymph node KK breast surgeon, Dr Yah Yuen Tan, consulting a patient.
Dr Tans sub-specialty interests include minimally invasive breast biopsy methods, sentinel lymph
node biopsy for breast cancer and mammary ductoscopy.
Dr Sze Yiun Teo (MBBS, FRCR (UK)) is a consultant radiologist from the Department of
Diagnostic Imaging, KK Womens and Childrens Hospital. She specializes in breast imaging,
image-guided breast biopsy and womens imaging. She is actively involved in patient care and
clinical research in these areas. In addition to her role as Fellow of the Royal College of Radiology
(UK), Dr Teo is also a member of the Singapore Radiological Society as well as the American
Roentgen Ray Society.