What are the common signs and symptoms
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Different people have different symptoms of breast cancer. Some people do not have any signs or symptoms at all. Some warning signs of breast cancer are:
- Breast lump
- Skin changes
- Bloody or unusual nipple discharge
- Retracted nipple
- Breast pain
- Persistent rash around the nipple
How is breast cancer diagnosed?
- Breast self-examination
- Clinical breast examination
- Mammogram
- Breast ultrasound
- Breast MRI
- Breast biopsy (a sample of cells taken from the tumour)
What are the different types of treatment?
Treatment depends on the type of breast cancer and stage of cancer, as well as the general medical condition of the patient.
Mastectomy
Removal of the entire affected breast tissue.
Lumpectomy
Breast-conserving surgery which involves removal of only the cancerous tissue. This is usually followed by radiation therapy.
During the lumpectomy or mastectomy, the surgeons may perform surgery on the lymph node to test if these lymph nodes have been affected by cancer.
How is Radiation Therapy done?
Consultation
The Radiation Oncologist determines the most appropriate method and discusses with you the treatment intent, schedule, risks and side-effects.
Mark-Up and Simulation
A CT scan of the treatment area will be obtained, while three small full-stop size marks are made to ensure accurate positioning during your daily treatment.
Treatment Planning
A multidisciplinary team produces a customised treatment plan for you.
Treatment
Radiation therapy for breast cancer is delivered daily (Mondays to Fridays) for three to seven weeks. Each treatment session lasts 10 to 15 minutes.
Follow-Up
Your first follow-up appointment varies depending on how you do during treatment, and is usually about four to six weeks after you have completed the course of radiation therapy.
What are the types of radiation therapy available for breast cancer?
3-Dimensional Conformal Radiation Therapy (3DCRT)
3DCRT delivers very precise doses of radiation to the breast and spares surrounding normal tissue through a machine called a linear accelerator.
Accelerated Partial Breast Irradiation (APBI) – Breast Brachytherapy
APBI is currently recommended in selected patients with early stage breast cancer. It is an outpatient procedure that involves placing flexible plastic tubes called catheters into the breast around the scar region.
A radioactive source then travels via the catheters to treat the high risk area surrounding the scar. This technique reduces overall treatment time from several weeks to four days as well as reduces potential long-term side effects to adjacent tissues.
Intensity Modulated Radiation Therapy (IMRT)
IMRT involves varying (or modulating) the intensity of the radiation being delivered during treatment. Compared to 3DCRT, this technique can deliver more tightly focused radiation beams to cancerous tumours while reducing the amount of radiation to surrounding healthy tissues
Breath Hold Technique (for left-sided breast cancer)
Breath Hold Technique utilises a patient-controlled ventilation control tool which helps the patient hold a deep breath. This allows us to treat the chest wall/breast with the patient in full inspiration (at full inspiration, the chest wall is furthest from the heart), thereby minimising any radiation dosage to the heart
"I guarantee my very best expertise delivered with compassion and dignity as we journey TOGETHER to BEAT this dreaded illness."
- Dr Johann Tang
Make An Enquiry
Got Queries? Book an appointment with Dr Johann Tang by filling up this form. We'll get on a call with you as soon as possible.
Prefer to talk? Call us directly at +65 6690 6811
or email us at drjohanntang@gmail.com
What are the potential side effects?
You will experience minimal side effects in the first one to two weeks after your radiation therapy session. Many of these side effects will improve over time and some can ve controlled with medication. Inform your doctor or nurse if you are experiencing any discomfort so they can help you better.
- Skin irritation similar to a sunburn
- Mild to moderate breast swelling
- Mild fatigue
- Mild tenderness in the breast or chest wall
- Scarring of a small part of the lung just under the breast
- Ischaemic heart disease for left breast radiation (new techniques have minimised the risk to under 5%)
- Secondary cancers (rare)
- Rib fracture (rare)
Caring for yourself during and after Radiation therapy
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Stop smoking
Immediate benefits of less airway irritation with less cough and shortness of breath.
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Stay active
Even gently short bouts of activity helps! Improves mood, reduces fatigue, and helps with appetite.
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Check your medications
Inform your doctor if you are taking medications, to make sure that they are safe to use during radiation therapy.
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Be careful caring for the affected area
Avoid hot or cold packs and only use lotions and ointments after checking with your doctor or nurse. Clean the affected area with lukewarm water and mild soap
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Enlist support
Mental and emotional health is as important as physical health. It might be helpful to talk to counsellors or join a cancer support group.
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Have a caregiver who can manage your care
It is good to have someone who can help to keep track of hospital appointments and medications prescribed.
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Rest well
Get plenty of rest during treatment.
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Eat well
Makes you feel better, have fewer side effects, and allows you to fight infections better.
About Dr Johann Tang
Senior Consultant Radiation Oncologist, Medical Director, MBBS (Aust), FRANZCR (Radiation Oncology)
Dr Tang obtained his medical degree from the University of Newcastle, Australia in 1998 and completed his house officer training at the Hunter Area Health Service, Australia before returning to Singapore to start his specialty training in Radiation Oncology at the National University Hospital (NUH). After obtaining his fellowship from the Royal Australian College of Radiologist (FRANZCR) in 2006, Dr Tang underwent fellowships in breast brachytherapy at University of Wisconsin and Arizona Breast Cancer Specialist Centre as well as prostate brachytherapy, skin and paediatric fellowships at Peter Maccallum Cancer Institute, Australia.
Why Choose Dr Johann Tang
Dr. Johann Tang is an experienced radiation oncologist who aims to deliver the highest level of care to his patients. e is dedicated to understanding each patient’s condition and provides holistic customized care that is both effective and compassionate. With ethics and empathy held at the core of our practice, we strive to understand your individual needs and provide care that is compassionate and responsive.
"I guarantee my very best expertise delivered with compassion and dignity as we journey TOGETHER to BEAT this dreaded illness."
- Dr Johann Tang
Make An Enquiry
Got Queries? Book an appointment with Dr Johann Tang by filling up this form. We'll get on a call with you as soon as possible.
Prefer to talk? Call us directly at +65 6690 6811
or email us at drjohanntang@gmail.com
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