We refer to the letter by Dr Sitoh Yih Yiow (Mastectomy not the only treatment option for breast cancer; June 19).
We agree that more awareness can be raised for breast cancer treatment options, and that both breast conservation therapy and mastectomy are treatment options which have shown equivalent survival outcomes for breast cancer patients.
At KK Women's and Children's Hospital, holistic care is provided in a multi-disciplinary team-based approach to partner and aid breast cancer patients through all phases - from diagnosis and treatment to remission and recovery. Patients can also find peer support from the KK Alpine Blossoms Breast Cancer Support Group.
The team works closely with patients to understand their conditions, suitable treatment options and associated risks and complications, before the best individualised treatment for each patient is determined.
While it may be ideal for all patients with breast cancer to conserve their breasts, not all will be suitable for breast conservation therapy. This is especially true for patients with a large cancer-to-breast-size ratio, which can lead to a disfiguring breast deformity and a higher incidence of incomplete resection if breast conserving surgery is performed.
Fortunately, since the advent of oncoplastic surgery, some patients with breast cancer who were previously deemed not suitable for breast conservation therapy are now able to potentially conserve their breasts with a good cosmetic outcome and avoid a mastectomy.
In some cases, chemotherapy may be offered before surgery in an attempt to downsize the cancer, so as to increase the chances of successful breast conservation.
Despite this, some patients may prefer or only be suitable for a mastectomy. Although mastectomy with reconstruction will give a better cosmetic outcome compared with a mastectomy alone, the decision to reconstruct or not remains a very deeply personal choice.
In cases where patients have planned for a mastectomy and opted for no reconstruction, the novel technique of minimal-scar mastectomy, as reported in The Straits Times, provides another good option to the armamentarium, enabling the conservation of the nipples and areolas with less scarring for suitable patients (New mastectomy technique at KKH leaves less scarring; June 14).
Lim Geok Hoon (Dr)
KK Breast Department
KK Women's and Children's Hospital