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Helping more women with breast cancer preserve their affected breast for improved survival

Results of Breast Conservation Surgery

In this section, discover evidence-based care for the surgical treatment of breast cancer to empower yourself to make the right personal choice about surgery.  There are two categories of results for breast cancer surgery.  The first is survival or cure rates, and the second, cosmetic outcomes.  The data for both these domains may be found listed below.  Feel free to verify & fact check them using your preferred search engine to enhance your research.

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Breast Cancer Cure Rates background

Reported Results at Various Centres

Dr Tan has reported Breast Conservation Treatment (BCT) rates that are higher than most other local centres.  The higher the BCT rate, the better the survival outcome.  However, Dr Tan wishes to caution that despite best treatment efforts, a small percentage of women may not do well.  Still, she aims to increase the number of women undergoing BCT for best survival.

Or call +65 6694 1704

NR: Not reported

References​

  1. Chuwa Esther, Yeo AW, Koong HN et al.  Early detection of breast cancer through population-based mammographic screening in Asian women: a comparison study between screen detected and symptomatic breast cancer. Breast J 2009;15:133-139

  2. Wong RX, Kwok LL, Wong FY.  Screening uptake differences are not implicated in poorer breast cancer outcomes among Singaporean Malay Women.  J Breast Cancer 2017;20:183-191

  3. Yong WS, Wong CY, Lee JSY, Soo KC, Tan PH, Goh ASW. Single institution’s initial experience with sentinel node biopsy in breast cancer patients.  ANZ J. Surg 2003;73:416-421.

  4. Wong J, Yong WS, Thike AA et al.. False negative rate for intraoperative sentinel lymph node frozen section in patients with breast cancer: a retrospective analysis of patients in a single Asian institution.  J Clin Pathol 2015;68:536-40.

  5. Chuwa Esther, Tan VH, Tan PH et al.  Treatment for ductal carcinoma in situ (DCIS) in an Asian population: outcome and prognostic factors.  ANZ J Surg 2008; 78: 42-48

  6. Chang GH, Chan CW, Hartman M.  A commentary on delayed presentation of breast cancer in Singapore.  Asian Pacific J Cancer Prev 2011;12:1635-1639.

  7. Teo SY, Chuwa Esther, Latha S, Tan Yah Yuen.  Young breast cancer in a specialised breast unit in Singapore: clinical, radiological and pathological factors.  Ann Acad Med Singapore 2014;43:79-85.

  8. Lim GH, Pineda LA.  Applicability of oncoplastic breast conserving surgery in Asian breast cancer patients.  Asian Pac J Cancer Prev 2016;17:3325-8

  9. Woon YY, Chan MYP. Breast conservation surgery-the surgeon factor.  The Breast 2005;14:131-135.

  10. Chan PM, Bok AC, Zhang Tj, et al.  Mastectomy rates remain high in Singapore and are not associated with poorer survival after adjusting for age.  SpringerPlus 2015;4:685

  11. Ang CH, Tan MY, Teo C, Seah DW, Chen JC, Chan MYP, Tan EY.  Blue dye is sufficient for sentinel lymph node biopsy in breast cancer.  Br J Surg 2014; doi: 10.1002/bjs.9390

  12. Lu Q, Tan EY, Ho B et al.  Achieving breast cancer surgery in a single setting with intraoperative frozen section analysis of the sentinel lymph node.  Clin Breast Cancer 2013;13:140-5.

  13. Alrahbi S, Chan PM, Ho BC, et al.  Extent of margin involvement, lymphovascular invasion and extensive intraductal component predict for residual disease after wide local excision for breast cancer.  Clin Breast Cancer 2015;15:219-26.

  14. Wang WV, Tan SM, Chow WL.  The impact of mammographic breast cancer screening in Singapore:  a comparison between screen-detected and symptomatic women.  Asian Pacific J Cancer Prev 2011;12:2735-2740

  15. Sinnadurai S, Kwong A, Hartman M et al.  Breast-conserving surgery versus mastectomy in young women with breast cancer in Asian settings.  BJS Open 2019;3:48-55.

  16. Leong F, Kusknawidjaia G, Sultana R et al.  Superior survival after breast conserving therapy versus mastectomy – a multicenter Asian cohort study of 3655 patients.  Eur J Cancer 2022;175S1:S18

  17. Tan MP, Sitoh NY, Sim AS.  Evaluation of eligibility and utilisation of breast conservation treatment in an Asian context.  Asian Pac J Cancer Prev 2014;15:4683-4688

  18. Tan MP, Sitoh NY, Sitoh YY.  Optimising breast conservation treatment for multifocal and multicentric breast cancer: a worthwhile endeavour? World J Surg. 2016 Feb;40(2):315-22.

  19. Tan MP, Sitoh NY, Sitoh YY.  Does changing classification for multifocal and multicentirc breast cancers alter breast conservation rates?  The Breast 2017;32S1:S69.

  20. Tan MP.  Surmounting the challenges of sentinel lymph node biopsy for breast cancer in non-tertiary centres and community-based practices.  ANZ J. Surg 2006;76:306-309.

  21. Ung OA, Tan M et al.  Complete axillary dissection: a technique that still ahs relevance in contemporary management of breast cancer.  ANZ J Surg 2006;78:516-523

  22. Tan MP, Sitoh NY, Sim AS.  The Impact of Intraoperative Frozen Section Analysis for Margin Status in Breast Conservation Surgery in a Private Hospital Setting.  International Journal of Breast Cancer 2014;2014:715404.

Information correct as of 1 Aug 2023.

Breast Conservation Treatment Evidence

Cosmetic appearance after Breast Conservation Surgery

As performed by Dr Mona Tan using restorative techniques without symmetrisation, reconstruction or implants.

Dr Tan uses certain operative techniques to allow her to performed Breast Conservation Surgery (BCS) for patients without taking tissue from another part of the body to replace the empty space left after removing the cancer.  By meticulously planning preoperatively how to perform the cancer removal, she removes the cancer with a surrounding margin of normal tissue, then moves the patient's own remaining breast tissue only to fill the space and return the shape of the breast as much as possible to its original appearance.  This is referred to as de-escalation of surgery which results in shorter operating times and therefore lower surgical risk.  Please note that depending on the cancer size and patient characteristics, there may be some variation in the final cosmetic appearance.

Breast Cancer Surgeon working towards patient cure

Based on analysis of the available data, at least 30% more women with breast cancer undergo Breast Conservation Treatment (BCT) with Dr Tan than elsewhere in Singapore.  It is reported that 1300 women a year are treated at these other centres.  Therefore, it is estimated that at least 390 women, or more, a year would have mastectomy when they can actually undergo BCT.  It is this group of women among the 390 in number, every year, that Dr Tan hopes to help with Breast Conservation Treatment so that they can benefit from the higher survival rates associated with BCT.  In some situations, survival rates for women with BCT may be up to 70% higher than those who undergo mastectomy.

Please note that while breast conservation treatment was successful in these cases, there will be about 10-15% of women for whom BCT will not be suitable.  Please consult Dr Tan on eligibilty for BCT.

Or call +65 6694 1704

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