Breast cancer screening through mammography is the recommended way to identify cancer, especially when it is in the early stages and the tumour may not be detectable through a routine breast self-exam.

With breast cancer continuing to be the top cancer affecting Singaporean women today – according to the Singapore Cancer Society – early detection is key. This is especially important as breast cancer has the highest survival rate for each year, post-diagnosis –  95.1 per cent at one year and 82.1 per cent at five years, according to the Singapore Cancer Registry Annual Report 2019.

“Screening usually involves checking your breasts for cancer, even before there are any signs and symptoms. While screening cannot prevent breast cancer, it can help detect the cancer early so that it can be treated earlier,” says Dr Wong Chiung Ing, a senior medical oncologist at Parkway Cancer Centre (PCC).

In Singapore, most mammograms are taken in a two-dimensional (2D) format, where each breast is captured in two X-ray pictures taken from two angles, forming a total of four flat images, similar to the pages in a book.

However, sometimes the images may not be clear enough for doctors to spot tumours, especially if they are smaller or hidden. In fact, studies have shown that up to 20 per cent of cancers are not detected by 2D mammograms.

With the advent of 3D mammogram technology, scans are now able to capture up to 80 X-ray images of the breast from different angles, which are then digitally reconstructed into a 3D view of the breast. This will help doctors pinpoint the exact location, size and shape of any lesions with much greater accuracy.

Better clarity can lead to better outcomes with 3D scans

Dense breasts – a higher concentration of glandular tissue and lesser amount of fatty breast tissue – pose a challenge when it comes to detecting tumours using 2D mammograms. This is where 3D mammograms come in.

“The multiple images taken during a 3D mammogram allow clearer views at varying depths of the breast, and small cancers can be easily detected, even in very dense breasts,” explains Dr Lim Siew Kuan, a senior consultant and breast surgeon at Solis Breast Care and Surgery Centre.

Greater clarity will also help to reduce the number of false positives which, in turn, will help ensure that patients have to undergo a biopsy only when necessary. Fewer false positives also mean fewer patients get recalled for further evaluation and this will lessen their anxiety from being called up for further screening.

Furthermore, 3D machines use a flexible compression paddle that allows the machine to gently fit the natural curve of the breast, allowing the pressure to be dispersed evenly. This results in less pain and discomfort.

According to Dr Lim, 3D scans are ideal for all age groups. “Women in their 40s have denser breasts and will benefit from it. Older women also tend to prefer a 3D mammogram after they have tried it, as the scan requires less compression and is more comfortable,” she adds.

Dr Lim says 3D mammograms can be paired with an ultrasound scan to increase the pickup rate of small cancers, especially for women who are at high risk of contracting breast cancer.

A holistic approach towards tackling breast cancer

At Solis Breast Care and Surgery Centre, the focus is on offering a seamless and empathic approach to breast health.

Here, patients undergo a 3D mammogram, which is quickly followed by a same-day consultation with a specialist. Dr Lim says this lessens their anxiety, especially if they have an abnormal result.

“There is often a lot of anxiety and fear from receiving bad results when women come for a screening. Regardless of the results, most women appreciate receiving them as soon as possible, instead of having to worry about the unknown over the next few days. And knowing the next steps allows them to plan their schedule better, so that the required treatment can start promptly,” she adds.

Should you need further treatment, Solis works closely with PCC to offer you a holistic approach to your breast cancer journey.

“This includes a team of breast cancer specialists who will assess each patient and tailor the most appropriate treatment to achieve the best outcome. We also have experienced nurses, counsellors and dietitians to help deliver holistic cancer care in a safe and comforting environment,” says Dr Wong.

An example of how this collaboration works: if a patient receives an abnormal 3D mammogram report, Solis will coordinate the next steps, including scheduling a biopsy to confirm the diagnosis as well as planning surgical procedures in-house to remove smaller tumours.

If the treatment plan requires more specialised attention and includes procedures such as chemotherapy, radiotherapy, targeted therapy, hormonal therapy or immunotherapy, the partnership with PCC comes into play.

This collaboration ensures you have access to a broader spectrum of treatment options and a team of medical professionals to guide you at each step, enhancing the support system and resources available to you during your treatment journey.

“The PCC medical oncologist and Solis surgeon maintain communication at every stage of a patient's breast cancer journey as it’s very important to do so,” says Dr Wong.

“We jointly decide on the most appropriate treatment sequence and update each other on the patient’s progress, so that we can time the chemotherapy and surgery properly. Post-surgery, we will follow up with the patient regularly to ensure joint continuity of care.”

Visit Solis Breast Care and Surgery Centre to schedule your next mammogram and get more information at Parkway Cancer Centre.