Breast cancer is known to be the most common cancer affecting women in Singapore. There is much awareness, but some of the facts are shrouded in myths, resulting in a lot of fear and anxiety. Dr Tan Yia Swam believes that knowledge is power, and she wants to empower all women to take charge of their health and wellness.
The two most common breast complaints are pain and lumps.
Breast pain is almost never due to breast cancer- more likely hormonal changes, muscle ache, or poor bra fit/support. But it is the most common symptom that bothers and alarms ladies, that brings them to see a doctor. A small percentage will happen to also have cancer- but it is not the cancer that caused the pain. During the consultation, Dr Tan Yia Swam will assess your condition, arrange any necessary scans, and make some recommendations to reduce the future occurrence of breast pain.
Many patients find their breast lump by chance- during showering, or wearing clothes. Some might have felt some muscle pain, and happened to touch the breast area and found a lump. A few patients practice regular breast self-exam, or their doctor detected the lump at a health checkup.
Breast cancer screening should start from age 40 onwards. Screening means a routine check, even when one feels completely well. The purpose is to help detect any minor abnormality, and get early treatment. For breast cancer, early detection saves lives.
Other less common signs and symptoms of breast cancer include skin thickening, skin dimpling/puckering, newly inverted nipple, new nipple discharge, or persistent itch.
However, many other common, non-cancerous conditions may also cause these overlapping symptoms- such as acne, eczema, infection, blocked ducts, etc. Rather than consult “Dr Google” and confusing yourself, do consider seeing a doctor for a professional opinion for peace of mind.
If you have a new symptom which you are not sure about, it is always prudent to see your family doctor for an opinion.
If the symptom is persistent, then your doctor may refer you to a breast specialist, such as Dr Tan Yia Swam, to have a more thorough check.
When you consult a breast specialist, such as Dr Tan Yia Swam, she will conduct a thorough interview for a personalised risk assessment for cancer screening, followed by a physical examination.
Dr Tan Yia Swam will then recommend a radiology study, likely an ultrasound scan. Additional tests include sending expressed milk for culture, or needle aspiration of an abscess. In rare cases, if a condition such as cancer is suspected, Dr Tan may advise for a core needle biopsy.
It is essential to have a correct diagnosis, before we can give the correct treatment.
For patients with mastitis, Dr Tan will review the duration and type of antibiotics. She will recommend a culture & sensitivity test, to better guide the choice of antibiotics, especially in cases where the recovery is slow.
If there is an abscess, bedside aspiration may be done. This is done in the clinic, with local anaesthetic, and a small needle (similar to the one for taking blood), to remove infected milk & pus to diagnose the infection, and to relieve pressure and pain.
Dr Tan will also prescribe antibiotics and anti-inflammatories which are breast-feeding safe, and share personalised tips on breastfeeding techniques.
Having had three kids, with different breastfeeding experiences for each one, Dr Tan is aware and sensitive to the significance and emotional bonding during breastfeeding. In partnership with lactation consultants, she strives to assist every mother to achieve their breastfeeding aims. Breastfeeding is different for every mother, and for every baby.
Avoiding standing still for long periods will reduce the pressure in the veins in the legs. For people who need to stand for long periods at work, wearing compression stockings will reduce the pressure build up in the legs.
The ultrasound will be done of the legs from the thigh to the calves. Please wear or bring along a pair of shorts to change into for the scan.