Radiation Therapy for

Breast Cancer

Delivering my very best expertise with compassion and dignity.

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What is breast cancer?

Breast cancer is a group of cancer cells that have developed from the cells in the breast. These cancer cells have grown into the surrounding tissues or spread to distant parts of the body. It usually starts in the cells of the lobules (the milk-producing glands) or the ducts (the passages that drank milk from the lobules to the nipple).

In other cases, this type of cancer can begin in the stromal tissues, which are the fibrous and fatty connective tissues of the breast.

What are the signs and symptoms

  • 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.

What is Radiation Therapy?

Radiation therapy treats cancer by using high-energy x-rays generated from a radiation therapy machine to destroy the cancer cells. It inhibits cancer cells from multiplying by delivering ionizing radiation to destroy cancer cells whilst minimizing radiation to normal tissues. When these cancer cells die, the body naturally eliminates them. Healthy tissue is then able to repair itself in a way cancer cells cannot, and this leads to a much higher proportion of tumour cell death compared to normal cells.

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 [email protected]

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

  • Stop smoking

    Immediate benefits of less airway irritation with less cough and shortness of breath.

  • Stay active

    Even gently short bouts of activity helps! Improves mood, reduces fatigue, and helps with appetite.

  • Check your medications

    Inform your doctor if you are taking medications, to make sure that they are safe to use during radiation therapy.

  • 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

  • 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.

  • 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.

  • Rest well

    Get plenty of rest during treatment.

  • Eat well

    Makes you feel better, have fewer side effects, and allows you to fight infections better.

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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. 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.

Experienced Radiation Oncologist

Dr. Johann Tang is a highly reputed radiation oncologist with several accolades to his name. Prior to entering private practice where he is currently a Senior Consultant and Medical Director. Dr Tang was at NUH for 18 years from 2001 to 2019. Dr Tang spearheaded and built up the breast brachytherapy (Accelerated Partial Breast Irradiation APBI), outpatient interstitial image- guided cervical brachytherapy and paediatric radiotherapy services at NUH, to provide an array of the latest and best treatment options for patients. Dr. Tang is also passionately involved in research having authored numerous peer reviewed publications, and has won several research prizes.

Evidence-based Treatments

Dr. Johann Tang and his team utilise advanced technology that has proven to be effective in diagnosing and treating a wide range of cancers. Dr. Tang has decades of experience treating and researching the disease, and stays current on the latest procedures, equipment, and technology in order to ensure his patients receive the highest standard of care.

Patient-centered Care

Dr. Johann Tang’s patients are his top priority, and he strives to care for them in a holistic manner, from diagnosis and treatment to helping them and their families cope with the illness emotionally. Patient education is also a very important part of their care – Dr. Tang and his team will walk patients through each step in the management of their condition, ensuring all their questions are answered and preparing them sufficiently for what’s to come.

"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 [email protected]

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Contact Dr Johann Tang

ME Novena Specialist Group Pte Ltd
Mt. Elizabeth Novena Hospital
Address: 38 Irrawaddy Road
#08-36/7/8/9
Singapore 329563
Telephone: +65 6690 6811
Fax: +65 6690 6828
Whatsapp: +65 9641 4747
Clinic Hours:

Mon – Fri: 8:30am – 5:30pm
Sat: 8:30am – 1:00pm
Sun & Public Holidays: Closed

Farrer Park Hospital
Address: 1 Farrer Park Station Road #07-14
Singapore 217562
Telephone: +65 6690 6811
Fax: +65 6690 6828
Whatsapp: +65 9641 4747
Clinic Hours:

Mon – Fri: 8:30am – 5:30pm
Sat: 8:30am – 1:00pm
Sun & Public Holidays: Closed