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Thomson Women's Clinic

At Thomson Women’s Clinics, we are committed to providing modern and comprehensive care for women of all ages. Our experienced team of O&amp;G specialists is dedicated to creating a caring environment where your health and well-being are our top priorities. Our specialists provide specialised services on preventive measures, accurate diagnosis, and personalised treatment plans.Whether you need specialised care for women-related conditions or navigating the journey of childbirth, seeking support for family planning and fertility treatments, or requiring compassionate care through menopause, we are here for you.

Our Expertise

Specialists in Women’s Health

We understand that managing your health appointments around work and family commitments can be challenging. For your convenience, we provides women's health consultations beyond standard hours at multiple locations across Singapore.Extended Hours LocationsWhile all 12 of our women's health clinics operate during standard clinic hours, the following locations offer extended consultation times:Northeast<ul><li>Woodleigh: Thursday, 6pm - 9pm</li><li>Sengkang: Tuesday &amp; Friday, 4:30pm - 7:30pm</li><li>Punggol: Tuesday, Thursday &amp; Friday, 12pm - 8pm</li></ul>East<ul><li style="text-align: justify;">Tampines: Monday, 7pm - 9pm</li><li style="text-align: justify;">Katong: Wednesday, 10am - 8pm</li></ul>West<ul><li style="text-align: justify;">Jurong: Monday &amp; Thursday, 6pm - 9pm</li><li style="text-align: justify;">Bukit Batok: Monday, Thursday &amp; Friday, 6pm - 8:30pm</li><li style="text-align: justify;">Choa Chu Kang: Monday, 6pm - 8pm</li></ul>Thomson Medical is committed to providing accessible healthcare that fits your schedule.

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Gynae Evening Clinics

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Thomson Women’s Clinic

Thomson Paediatric Centre

At Thomson Paediatric Centres, our unwavering commitment is to treat your child with the same level of care and dedication as we would our own. We provide children's healthcare services to alleviate every parent's concerns and ensure the well-being of our next generation. Our experienced team of Paediatricians is devoted to cultivating a caring environment where your child's health is our top priority.Besides General Paediatrics services, we also offer specialised services in Neonatology and Paediatric Cardiology. Our specialist doctors are experienced in areas such as Nutrition, Respiratory, Growth &amp; Development assessment, and Paediatric Urgent Care for babies to young children and adolescents. Trust us to be your partner in safeguarding your child's health and ensuring a compassionate and comprehensive approach to their medical needs.

Specialists in Children’s Health

Our Paediatricians

Please click on the below links for our Paediatricians' availabilities.
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 <td>Paediatricians</td>
 <td>Clinic Location</td>
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 <td>Dr Ang Ai Tin</td>
 <td><a href="https://maps.app.goo.gl/XcyrrQBgEW35Rw3f6" target="_blank">Thomson Paediatric Centre (TPC 1)</a></td>
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 <td>Dr Eugene Han</td>
 <td><a href="https://maps.app.goo.gl/odint8UJmba6RBPbA" target="_blank">Thomson Paediatric Centre (TPC 4)</a></td>
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 <td>Dr Grace Lim</td>
 <td><a href="https://maps.app.goo.gl/obLpwmEFumMjMzRz8" target="_blank">Thomson Specialists (Woodleigh)</a> </td>
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 <td>Dr Kenneth Chua Yong Yeow</td>
 <td><a href="https://maps.app.goo.gl/Kp3TYWxzLXkfkkPYA" target="_blank">Thomson Paediatric Centre (Punggol)</a></td>
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 <td>Dr Leo Deng Jin</td>
 <td><a href="https://maps.app.goo.gl/NVzfb9zvkUMvvNxN8" target="_blank">Thomson Paediatric Centre (Bukit Panjang)</a></td>
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 <td>Dr Lim Yang Chern</td>
 <td><a href="https://maps.app.goo.gl/7Ex6ra4NmwHQUopS6" target="_blank">Thomson Paediatric Centre (Jurong)</a></td>
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 <td>Dr Ong Ian</td>
 <td><a href="https://maps.app.goo.gl/78WJoj482r35Af7T9" target="_blank">Thomson Paediatric Centre (Parkway Parade)</a></td>
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 <td>Dr Tan Kuanyang</td>
 <td><a href="https://maps.app.goo.gl/odint8UJmba6RBPbA" target="_blank">Thomson Paediatric Centre (TPC 4)</a></td>
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 <td>Dr Yang Linqi</td>
 <td><a href="https://maps.app.goo.gl/XcyrrQBgEW35Rw3f6" target="_blank">Thomson Paediatric Centre (TPC 1)</a></td>
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Refer to each paediatrician's <a href="https://www.thomsonmedical.com/centres/paediatric-centre/paediatricians-consultation-hours">consultation hours</a> for their availability.

Our Paediatricians' Leave Schedule

Thomson Specialists

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Latest share price, financial performance, and other materials relevant to investors.Read about our <a href="https://assets.contentstack.io/v3/assets/blt5f400315f9e4f0b3/blt5a13f1dd33c615fa/651e7a9aecf48b6d54c38b23/TMG-Investor-Relations-Policy-3Sep2020.pdf?branch=uat_release_3" target="_self">Investor Relations Policy</a>For Investor Relations matters, please email us at <a href="mailto:ir@thomsonmedical.com">ir@thomsonmedical.com</a> Thomson Medical Group Limited 101 Thomson Road #20-04/05, United Square Singapore 307591 Tel: +65 6331 0188 Fax: +65 6331 0180

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<table><tbody><tr><td>Stock symbol</td><td>A50.SI</td></tr><tr><td>Listing</td><td>Singapore Exchange </td></tr><tr><td>Financial Year End</td><td>June 30</td></tr><tr><td>Total issued shares as at 30 June 2023</td><td>26,441,066,807 ordinary shares</td></tr><tr><td>Market capitalisation as at 30 June 2023</td><td>S$1.6 billion</td></tr></tbody></table>

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See All Screenings

Our dedicated Obstetrics and Gynaecology (O&amp;G) team at Thomson's Women's Clinic provides various walk-in outpatient services. With a compassionate team of experienced gynaecologists, we are here to address any issues you may have regarding your gynaecological health.

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Supporting you through your cancer screening needs

Enquire Now

<table><thead><tr><th style="text-align: center;">Age</th><th style="text-align: center;">25 to 29</th><th style="text-align: center;">30 to 49</th><th style="text-align: center;">50 and above</th></tr></thead><tbody><tr><td>Cancer Screening Recommendations</td><td><a href="https://www.thomsonmedical.com/women-health/gynaecology/pap-smear" target="_self">Pap Test</a> for Cervical Cancer once every three years</td><td><a href="https://www.thomsonmedical.com/women-health/gynaecology/hpv-vaccine" target="_self">HPV Test</a> for Cervical Cancer once every five years</td><td><a href="https://www.thomsonmedical.com/blog/breast-screening-mammogram-ultrasound" target="_blank">Mammogram</a> for Breast Cancer once every two years</td></tr></tbody></table>

Screening Recommendation

Cancer Screening Recommendation by Age

Book Your Appointment

<table><colgroup data-width='919.1987344007073'><col style="width:35%"/><col style="width:35%"/><col style="width:15.000000000000002%"/><col style="width:15.000000000000002%"/></colgroup><thead><tr><th>Screens For:</th><th>Includes</th><th>Recommended Frequency</th><th>Pricing (Including GST)</th></tr></thead><tbody><tr><td><ul><li>Reproductive health<ul><li>Uterine abnormalities (fibroids, polyps, endometrial conditions)</li><li>Ovarian cysts or masses</li><li>Pelvic inflammatory disease and infections</li></ul></li><li>Common cancer detection<ul><li>Cervical cancer</li><li>Ovarian cancer</li><li>Breast cancer</li><li>Colorectal cancer</li></ul></li><li>Other conditions<ul><li>Bladder abnormalities and irregularities</li><li>Causes of abnormal bleeding or pelvic pain</li><li>Unexplained abdominal or pelvic swelling</li><li>Iron deficiency</li><li>Hypertension</li></ul></li></ul></td><td><ul><li>Medical consultation with physical assessment (height, weight, BMI, waist-hip ratio, body fat)</li><li>Blood pressure</li><li>Blood investigations (anaemia profile)</li><li>Urine &amp; stool analysis</li><li>ThinPrep Pap Test for cervical cancer screening</li><li>Choice of 2 radiology options:<ul><li>Ultrasound Pelvis</li><li>Ultrasound Breast</li><li>Mammogram</li></ul></li><li>Comprehensive medical report</li><li>Post-screening consultation with lifestyle counselling</li></ul></td><td>Every 1-2 years or more recommended by your doctor</td><td>$788</td></tr></tbody></table>Add-ons Available<ul><li>Lucence (Multi-cancer early detection tests)</li><li>Upon doctor's assessment<ul><li>Transvaginal Ultrasound</li><li>MRI Breast</li></ul></li></ul>

Package

The Pink of Health Package

Buy a health screening package online, and our staff will schedule your screening at a time that works for you.

1) Book your screening

Thoughtful consultations where you'll never feel rushed. Share your concerns, and ask questions — we're here to listen.

2) Meet our doctors

Evidence-based screening tailored to your life stage and health goals. We focus on what matters most.

3) Personalised assessment

After your screening, our doctors will walk you through a simple, actionable health report that makes sense. No medical jargon, just clear guidance for your well-being.

4) Get your screening report

What to expect?

What to Expect

How does the health screening work?

Breast cancer is the most common cancer among women in Singapore. <a href="https://www.singaporecancersociety.org.sg/learn-about-cancer/types-of-cancer/breast-cancer.html#overview" target="_blank">Data from the Singapore Cancer Registry</a> under the Ministry of Health (MOH) shows that over 2,000 women in Singapore are diagnosed with breast cancer each year.When detected early, breast cancer is highly curable, and patients can remain well for 5, 10, or even 20 years after. The earlier the detection through breast cancer screening, the higher the chance one can recover from breast cancer.The recommended method to detect early signs of breast cancer is to go for a mammogram. A supplementary breast ultrasound may also be ordered by your doctor as well. In this article, we will explain what you need to know about breast cancer screening.There are 2 common types of clinical breast examination that you can choose from, on top of monthly breast self-examinations:<ol><li>Mammogram</li><li>Breast Ultrasound</li></ol><h2>Mammogram</h2>A mammogram screening is an x-ray of the breasts and is the most reliable screening tool for early breast cancer and other breast diseases.Screening refers to a process to check for early disease when there are no signs or symptoms yet. A mammogram can detect tiny lumps or calcium spots in the breasts, which may be a sign of early breast cancer, or caused by non-cancerous reasons.During the x-ray, a female radiographer will place your breast between two flat plastic plates and compress it for a few seconds. This is performed on one breast at a time. Patients may experience some discomfort when the breast tissue is compressed for a clearer image. Additional angles and views may also be taken for closer examination.The patient will be exposed to a low dose of radiation during the procedure (equivalent to exposure to environmental background radiation for two months), so the overall radiation risk is low. As such, the potential benefits outweigh the risks.If there is an abnormal mammogram result, your doctor may recommend further tests in your medical report. It is important to note that age and breast density can affect the accuracy of the mammogram screening test, which are also possible reasons for additional tests. For example, younger women tend to have denser breast tissue, which could mean that abnormalities will not appear during the mammogram and is ineffective in detecting cancer.<h2>Breast Ultrasound</h2>An ultrasound of the breasts is safe, non-invasive, and painless, and is the same technology used to monitor a baby during pregnancy. The procedure helps to detect lumps and determines if a lump is solid or cystic.However, an ultrasound cannot detect calcium spots. Therefore, your doctor may order an ultrasound-guided biopsy to confirm what type of lump it is. An ultrasound may also supplement a mammogram for ladies with dense breasts.If you have breast implants or a family history of breast cancer, talk to your doctor to ask about MRI screening.For patients where breast cancer screening picks up an abnormality, consult your doctor, and they will advise if you need a biopsy.<h2>HPB Screen For Life Breast Cancer Screening</h2>The <a href="https://www.healthhub.sg/programmes/screen_for_life" target="_blank">Screen For Life</a> Breast Cancer Screening programme by the Singapore Health Promotion Board (HPB) offers subsidised mammogram screenings for women aged 50 and above, or women between the ages of 40 to 49, who decided to make a mammogram appointment after consulting their doctor.You may get a subsidised mammogram screening test at <a href="https://www.singaporecancersociety.org.sg/images/campaigns/BCAM-Collateral-Low-Res.pdf" target="_blank">participating Breast Screening Centres</a> verified by the Health Promotion Board and the Singapore Cancer Society. Thomson Medical Centre is a participating centre under the Screen For Life programme.To be eligible for the screening, you must not have the following breast symptoms: <ul><li>painless lump</li><li>persistent rash around nipple</li><li>bleeding or unusual discharge from nipple</li><li>swollen or thickened skin</li><li>dented inwards or folded outwards skin</li><li>retracted nipple</li></ul>For women over 50, you haven't gone for a mammogram within the past two years. For women aged 40 and 49, you haven't gone for a mammogram within the past year.<figure><div data-img-caption-container="true" style="display: inline-block; text-align: center;"><img alt="Screen for Life - Breast Screening Eligibility" src="https://images.contentstack.io/v3/assets/blt5f400315f9e4f0b3/bltda412a78821a3190/6594f37d3ea36118f35768e0/screencapture-healthhub-sg-programmes-screen-for-life-screening-journey-2024-01-03-13_39_32-edit.png?branch=production" height="auto" target="_blank" /><figcaption style="text-align: center;" >https://www.healthhub.sg/programmes/screen_for_life/screening-journey</figcaption></div></figure><h2>FAQ</h2><h3>At what age should you get a cancer screening?</h3>Women aged 40 to 49 are recommended to go for a mammogram every year due to the higher breast cancer risk. However, for women aged 50 and above, screenings can be reduced to once every two years.For younger women below the age of 40, a screening mammogram is not recommended. However, if you have a high risk of breast cancer due to family history or hereditary genetic mutations, you should speak to a breast specialist early, and they will recommend when you should start breast cancer screening.In addition to screening, all women aged 18 and above should do monthly breast self-examinations (BSE). This examination helps you be familiarised with the look and feel of your breasts. As a result, you can detect any changes and abnormalities in your breast tissues more efficiently and increase the chances of early detection.If you notice a change in your breasts that seems abnormal or if one breast is different from the other while doing a BSE, you should seek immediate medical advice from your doctor.<h3>Is a mammogram painful?</h3>The whole mammogram procedure is not necessarily painful but you may experience discomfort due to the compression of the breasts between two plates. If it gets too uncomfortable, please do not hesitate to inform your radiographer.<img asset_uid="bltfb693f0d8529545c" src="https://images.contentstack.io/v3/assets/blt5f400315f9e4f0b3/bltfb693f0d8529545c/6513b28e305f2c2050f4c395/mammogram-screening-breast-screening-singapore.png?branch=production" alt="woman doing mammogram screening at the hospital female wellness healthy screening Thomson Breast Centre breast care cancer" height="auto"/><h3>What are the major risk factors for developing breast cancer?</h3>Some women are at higher risk of developing breast cancer. Here are some of the risk factors:<ul><li>Having one or more close relatives with breast cancer</li><li>Personal history of breast cancer</li><li>Age: breast cancer risk increases as one gets older, especially after menopause</li><li>Being overweight</li><li>Being physically inactive</li><li>Drinking alcohol regularly</li><li>History of ovarian cancer</li><li>Early-onset of menstruation, or</li><li>Long-term use of combined hormone replacement therapy (of more than five years)</li></ul>Regular mammograms are essential, even more so for women with these risk factors. Note that not having any risk factors does not mean you will not develop breast cancer. It simply means your breast cancer risk is lower than others. Therefore, it is recommended that you go for a mammogram screening in Singapore even if you do not detect any abnormalities in your breast tissue.<h3>What happens after the diagnosis of breast cancer?</h3>Once your doctor confirms a breast cancer diagnosis, the first process involved is staging. This will help determine the extent of the disease and prognosis. It is also used to plan treatment options.Breast cancer is typically classified into Stage 0, I, II, III, or IV. These stages are based on the tumour size, the involvement of lymph nodes, and whether it has spread to other body parts.The presence of tumour markers like estrogen progesterone receptors and proliferation factors (HER2) are also analysed during the staging process, as they may affect the sequence of treatment for surgery versus systemic therapy.<h3>What are the most common treatments for breast cancer?</h3>Once staging is done, your doctor will advise on the ideal treatment options. The course of treatment will highly depend on your overall health, breast cancer type, stage, grade, size, sensitivity to hormones, and your personal preference.The most common treatment options are Surgery (Lumpectomy or Mastectomy), Chemotherapy, Radiation Therapy, and Hormonal Therapy.Here’s what you need to know about the treatments for breast cancer:<h4>Lumpectomy</h4>This procedure is a form of “breast preservation” or “breast-conserving” surgery. Only the tumour and a small portion of healthy tissues surrounding the tumour are removed in this surgery. After the surgery, you may expect a scar and/or dimple, and changes in breast shape and size. To further eliminate cancer cells that may remain after lumpectomy or “breast-conserving” surgery, most patients undergo radiation therapy for a week after the surgical wounds have healed.<h4>Mastectomy</h4>This procedure is the surgical removal of the whole breast. Generally, the surgeon will remove all the breast tissues from the breast. If patients opt for reconstruction surgery, this may be performed, and we will preserve the skin in the breast region, or maybe even the nipple if suitable. Reconstruction of the breast is done with tissue taken from another part of the body. Skin-saving and nipple-sparing mastectomy can only be performed when the breast under the skin or nipple is free from tumour cells.<h4>Radiation therapy</h4>With the use of high-powered protons and X-rays, this procedure is used to kill cancer cells by focusing on the part of your body where the malignant tumour is located and making it shrink. This type of treatment may last between one to three weeks.<h4>Chemotherapy</h4>This is the administration of cancer drugs intravenously (IV) to reduce the risk of cancer coming back. The risk of recurrence is linked to the stage of your cancer. The side effects of chemotherapy include nausea, rash, fever, and hair loss, but the frequency and severity vary from patient to patient.<h4>Hormone-blocking therapy</h4>There are breast cancers that are progesterone (PR positive) or estrogen receptor-positive (ER-positive). Such hormone-sensitive cancers are suitable for this treatment in the form of a daily tablet. It also helps decrease the chances of breast cancer recurring.<h4>Targeted therapy drugs</h4>Some cancers have overexpression of HER2 (Human Epidermal Growth Factor 2). This receptor (sensor) makes a cell grow very fast. Targeted therapy drugs can be taken orally or given intravenously (IV). In targeted therapy, only HER2 cells are attacked, and healthy cells are spared compared to chemotherapy, wherein both cancer cells and healthy cells are attacked.<h4>Immunotherapy</h4>Immunotherapy uses your body’s immune system to fight off cancer cells. It is not a first-line treatment for breast cancer. However, for rare cancers that do not respond to usual chemo/targeted treatment or in cases of cancer recurrences, the doctor may recommend immunotherapy. It is one of the most expensive treatment options for cancer.<h4>Sentinel lymph node biopsy</h4>During the operation, this procedure is done to check the first few “guarding” lymph nodes. Breast cancer usually spreads to the axilla lymph nodes (armpit) since it is closest to the breast. If the sentinel lymph node biopsy is normal, nothing further is done. If the sentinel lymph node biopsy shows a cancer spread, your doctor will proceed with axillary lymph node dissection.<h4>Axillary lymph node dissection</h4> This is a procedure done to remove all visible fat (which contains the lymph nodes) in the axilla.<h4>Palliative or supportive care</h4>For patients with stage 4 cancer, palliative care aims to improve the quality of life of the cancer patient. In combination with other treatment options, palliative care focuses on alleviating the symptoms experienced by the cancer patient.

Find out more about breast screening methods including mammograms and ultrasounds, and how they can detect early signs of breast cancer.

Breast Screening in Singapore: Mammogram & Ultrasound

According to the <a href="https://www.nrdo.gov.sg/publications/cancer" target="_blank">Singapore Cancer Registry 50th Anniversary Monograph</a>, breast cancer is the most common cancer diagnosed in women in Singapore, accounting for 29.4% of all cancers diagnosed in women from 2013 to 2017. Breast cancer occurs when some breast cells grow abnormally and may spread to the rest of the breast, lymph nodes, or other parts of the body. Early breast cancer typically does not present any symptoms, which is why <a href="https://www.thomsonmedical.com/blog/breast-screening-mammogram-ultrasound" target="_blank">regular screening </a>is crucial. Women aged 40 and above should perform regular <a href="https://www.thomsonmedical.com/blog/breast-self-examination" target="_blank">breast self-examinations</a> and <a href="https://www.thomsonmedical.com/appointment?location=Thomson+Breast+Centre" target="_blank">schedule mammograms</a> for early detection.<img asset_uid="bltd8f067b5e976cce7" src="https://images.contentstack.io/v3/assets/blt5f400315f9e4f0b3/bltd8f067b5e976cce7/6513b2a26ccdcb6d5f8e0ab3/Breast-Cancer-Detection-Breast-Lump-Causes.png?branch=production" alt="woman doing breast check for breast cancer detection" height="auto"/><h2>Signs &amp; symptoms of breast cancer</h2><ul><li><h4>Breast lump</h4><ul><li>The most common symptom is a lump or mass in the breast. Most breast lumps are benign, caused by hormonal changes or conditions like fibroadenomas or cysts. If you find a lump, your breast specialist will conduct a thorough interview and physical examination, followed by imaging tests such as <a href="https://www.thomsonmedical.com/blog/breast-screening-mammogram-ultrasound">breast ultrasound or mammogram</a>. Additional tests like a<a href="https://www.thomsonmedical.com/blog/breast-biopsy"> breast biopsy</a> may be recommended if needed.</li></ul></li><li><h4>Changes in shape or size of breast</h4><ul><li>Swelling in any area of the breast or one breast appearing bigger than the other can indicate breast cancer. A significant change in breast shape or size warrants a visit to a<a href="https://www.thomsonmedical.com/find-a-doctor/breast-doctor"> breast specialist</a>.</li></ul></li><li><h4>Unusual nipple discharge</h4><ul><li>Discharge that is stained with blood or pus, or appears greenish or yellowish, is uncommon and should be checked by a doctor immediately.</li></ul></li><li><h4>Dimpling or puckering of skin</h4><ul><li>Dimpling of the skin can suggest blocked lymph vessels, leading to inflammation and swelling. This could indicate inflammatory breast cancer and should be evaluated by a doctor.</li></ul></li><li><h4>Retracted nipple</h4><ul><li>A nipple that starts moving inwards can be a sign of breast cancer. If this occurs and you weren't born with a retracted nipple, see a doctor.</li></ul></li><li><h4>Rashes, itching, or redness</h4><ul><li>Although rare, these symptoms can be associated with Paget's disease, a condition linked to breast cancer. It presents as an eczema-like itchy red rash on the nipple or surrounding area.</li></ul></li></ul><h2>Living with breast cancer</h2>Being diagnosed with breast cancer can be overwhelming, but with proper medical help, you can manage the symptoms and live a fulfilling life. Early-stage breast cancer (stages 0 and 1) has survival rates of over 90% with prompt treatment. If cancer is confirmed after imaging tests and biopsy, your breast specialist will explain the stage, necessary treatments, and provide advice on managing your condition with the support of a <a href="https://www.thomsonmedical.com/breast" target="_blank">holistic breast care team</a>.<h2>Tips for managing your diagnosis</h2><ul><li><h4>Seek information</h4><ul><li>Ask your doctor questions about managing your condition. Research treatment options and lifestyle changes that can improve your situation. Your doctor can help you decide what works best for you.</li></ul></li><li><h4>Understand physical changes</h4><ul><li>Breast cancer treatment may bring physical changes. Discuss these with your doctor beforehand to understand what to expect and receive a personalised treatment plan.</li></ul></li><li><h4>Build a support network</h4><ul><li>Don’t keep your emotions bottled up. Talk to family, friends, or support groups. Connecting with others who understand your journey, such as other breast cancer patients or survivors, can be invaluable.</li></ul></li></ul><img asset_uid="blt35d452cd483a1289" src="https://images.contentstack.io/v3/assets/blt5f400315f9e4f0b3/blt35d452cd483a1289/6513b517305f2c8e4df4c4d3/thomsonmedical_corporate_family_small.jpg?branch=production" alt="thomsonmedical_corporate_family_small.jpg" height="auto"/><h2>Additional support</h2>It is crucial to seek medical help if you detect any of the signs listed above. Many women live fulfilling lives despite a breast cancer diagnosis. The best way to prevent cancer is to adopt a holistic approach to health and wellness—eat whole foods, exercise regularly, look after your mental and emotional health, and build strong bonds with family and friends.Book an appointment with our female breast specialists <a href="https://www.thomsonmedical.com/breast" target="_blank">Thomson Breast Centre </a>to address your breast concerns today.

Learn about signs of breast cancer, early detection, and management tips. Expert advice for living well with a breast cancer diagnosis.

A Guide to Breast Cancer: Symptoms, Diagnosis, and Management

A breast ultrasound is a safe, non-invasive imaging test used to detect and evaluate breast abnormalities such as cysts, fibroadenomas, or breast cancer.

Breast Ultrasound: What It Is and When You Might Need It

“It all started with a persistent pain in the left breast, and I was referred by my General Practitioner for a mammogram and ultrasound. Both the mammogram and ultrasound results showed an abnormal lump, and I was further scheduled for a breast biopsy to determine if the lump was benign or malignant. Questions started to fill my mind. What is breast biopsy and how is it performed? And is it painful?”For many patients, pain is a very common symptom and is the most common complaint that brings them to see a doctor. For a small group, there happens to be an abnormal lump found that needs a biopsy. Most times, pain is not a sign of cancer, and any lumps found may not be the cause of the breast pain you experienced.Some of us may face a similar situation when a lump is detected. It is normal to have many questions. This article aims to address some of your preliminary questions while you arrange for a consult with a professional specialist. It is important to seek timely professional diagnosis and treatment.Here’s what you need to know about a breast biopsy and what to expect.<h2>What is a breast biopsy?</h2>A breast biopsy is a process where a small sample of breast tissue is removed through a special biopsy needle. The tissue samples removed from the breast lump will be further examined under a microscope. Typically, the breast biopsy is performed if there is an abnormality detected from your previous mammograms or breast ultrasounds. The goal of the biopsy is to determine what the abnormality is and the best treatment to move forward with.Although ultrasounds and mammograms are useful ways to identify breast lumps, a breast biopsy is the <a href="https://www.mayoclinic.org/tests-procedures/breast-biopsy/about/pac-20384812" target="_self">only way to confirm</a> what the lump is. Breast screening is to be done, even if you are well and have no symptoms at all, and annual mammograms should start from age 40.If you experience any symptoms, please see a doctor for early diagnostic imaging tests:<ul><li>Breast lump</li><li>Changes in the colour or contour of the breast or nipple or dimpling of skin</li><li>Discharge from the nipple</li></ul>Most breast biopsies are quick and painless. Many of the breast lumps may turn out to be benign as there are a variety of conditions that can cause lumps in the breast. However, your doctor will usually want to take precautions and order breast screening tests to rule out early breast cancer.<h2>How to prepare for a breast biopsy?</h2>Before your breast biopsy, you can prepare by informing your breast surgeon if you:<ul><li>Have any allergies</li><li>Are taking any <a href="https://www.ucsfhealth.org/education/biopsy-for-breast-cancer-diagnosis-surgical-breast-biopsy" target="_self">blood-thinning medications</a></li><li>Have consumed <a href="https://www.ucsfhealth.org/education/biopsy-for-breast-cancer-diagnosis-surgical-breast-biopsy" target="_self">aspirin</a> in the last seven days</li><li>Not able to lie face down for more than an hour</li></ul>You will likely meet with your specialist prior to the procedure. Your doctor would be able to advise you on the procedure and give you advice such as:<ul><li>What type of breast biopsy procedure will be done?</li><li>What is the location of my biopsy?</li><li>Will a part or all of the lump be extracted?</li><li>Will it leave a scar?</li><li>How soon will I receive my results?</li><li>How soon can I resume normal activities?</li><li>What type of anaesthesia will be used?</li></ul>Make sure to wear a <a href="https://www.ucsfhealth.org/education/biopsy-for-breast-cancer-diagnosis-surgical-breast-biopsy" target="_self">sports bra and loose clothing</a> to have ease in dressing after the procedure. You may also want to have a designated driver or someone to accompany you home safely.<h2>What are the different types of breast biopsies and how are they performed?</h2>Once your breast surgeon decides that a biopsy is needed, they will determine the best type of biopsy for your situation. There are a few breast biopsy procedures to obtain samples of a patient’s breast lumps. Your breast surgeon will recommend based on the location, size, and other characteristics of the breast abnormality.Your breast surgeon will take a tissue sample either through a minimally invasive biopsy procedure or surgery. Minimally invasive procedures are ideal because they offer:<ul><li>Less pain</li><li>Less scarring</li><li>Faster recovery time</li><li>Lower risk of infection</li><li>Lower hospital costs</li><li>Able to return to usual activities quickly</li></ul><h3>Ultrasound-guided breast biopsy</h3>This procedure is performed through ultrasound guidance. An ultrasound is a method that utilises high-frequency sound waves to generate precise images.The breast surgeon will locate the lump within the patient’s breasts using the breast ultrasound device before a small incision is made for the biopsy needle to retrieve tissue samples. With an ultrasound-guided breast biopsy, the breast surgeon can identify <a href="https://www.radiologyinfo.org/en/info/breastbius" target="_self">lumps near the chest wall or under the arms</a>.It can be used in conjunction with <a href="https://www.radiologyinfo.org/en/info/breastbius" target="_self">vacuum-assisted core biopsy, core needle biopsy, or fine needle aspiration biopsy</a>. This ultrasound-guided breast biopsy procedure is also more cost-effective than other methods like open surgical biopsy.<h3>Stereotactic biopsy</h3><img src="https://images.contentstack.io/v3/assets/blt5f400315f9e4f0b3/bltdc27a561fa0c5072/6545217008cc0104077ce311/Stereotactic_Biopsy.jpeg?branch=uat_release_3" height="auto"/>With a stereotactic biopsy, a 3D image of the breast is created from the mammogram results. The doctor uses the image to pinpoint the exact location of the suspected breast lump and guides the needle there.The patient will lay <a href="https://www.healthline.com/health/breast-biopsy-stereotactic#procedure" target="_self">facing down on a padded biopsy table</a> with one of the breasts positioned in the hole in the table. The patient’s breast will be compressed with two plates while the biopsy site is located using a targeted mammogram. The breast surgeon or radiologist will then create a small incision into the biopsy site and insert a large core needle to remove tissue samples.<h3>RI-guided core needle biopsy</h3>Instead of using an ultrasound device, a biopsy can be performed under the guidance of an MRI. This imaging device captures cross-sectional images of the breast so that the hollow needle can be guided to the site of the breast lump. This procedure can be <a href="https://www.radiologyinfo.org/en/info/breastbimr" target="_self">used with core needle biopsy, vacuum-assisted core biopsy, or wire localisation</a>.he different types of breast biopsy vary in terms of how invasive the procedure it can be. Your breast surgeon will advise on the procedure that is the best for you.<h3>Open (surgical) biopsy</h3><img src="https://images.contentstack.io/v3/assets/blt5f400315f9e4f0b3/blt4155c1fcecc004d3/654521990970dd001bd16e10/Open_(Surgical)_Biopsy.png?branch=uat_release_3" height="auto"/>The breast surgeon will remove part or the entire lump. If the lump is small and deep, a very thin needle and a thin wire will be <a href="https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/breast-biopsy/surgical-breast-biopsy.html" target="_self">placed inside the breast</a> before the operation to help guide the breast surgeon.Generally, a surgical biopsy is performed in an operating room usually under general anaesthesia.<h3>Fine needle aspiration (FNA) cytology</h3>In this procedure, a thin needle attached to a syringe is inserted into the breast lumps. The syringe will collect the sample of fluid or cells from the lump and small tissue samples are removed. Your doctor will advise if this is suitable for you.<h3>Sentinel node biopsy</h3>This procedure removes the <a href="https://www.cancer.gov/about-cancer/diagnosis-staging/staging/sentinel-node-biopsy-fact-sheet" target="_self">sentinel lymph node</a> or the first node to which cancer cells are most likely to spread. The surgeon uses blue dye or a radioactive tracer to identify the node. Then, the node is removed and tested for cancer. Cancer could have spread to other lymph nodes if the sentinel node tests positive. However, if it is negative, the likelihood of cancer spreading to other lymph nodes is lower.<h3>Vacuum-assisted core biopsy</h3>This procedure is performed with an ultrasound or mammogram unit and can be seen as an upgraded form of the core needle biopsy. Like the core biopsy, a larger needle is used and allows for several tissue samples to be taken at one time.<a href="https://www.insideradiology.com.au/vacuum-assisted-core-biopsy" target="_self">A probe or hollow tube is inserted into a cut made on the skin</a>. Then, a vacuum-assisted device is used to pull the tissue into the needle while a rotating cutting device takes the sample. Using a suction device is beneficial because it can get more cells and fluid through the needle, which cuts down on the number of times the needle will need to be inserted to retrieve multiple samples.<h2>Benefits and risks of breast biopsy</h2>Before proceeding with breast biopsy procedures, you may want to discuss with the breast surgeon and weigh the benefits and risks to determine the suitable procedure that is right for you. Fortunately, most procedures are less invasive compared to surgical biopsy and some will leave minimal to no scarring. The biopsy results will indicate whether the breast lump is malignant or benign which would either allow you to rest easy or quickly get the treatment that you need.Although these procedures are generally safe, there are some risks involved. Possible complications that can incur from a breast biopsy include:<ul><li>Mild pain and bruising</li><li>Infection</li><li>Prolonged bleeding</li><li>Soreness at the biopsy site</li></ul>Many of these side effects are simply temporary. However, if they persist, contact your breast surgeon for treatment. Generally, following the aftercare instructions will greatly reduce these risks and limit the odds of infection.<h2>FAQ</h2><h3>Why is a breast biopsy done?</h3>A breast biopsy can be done for several reasons:<ul><li>To identify any lumps in your breast</li><li>To check for the potential causes of any nipple problems such as bloody discharge</li><li>To evaluate whether the breast lump or breast mass is cancerous or non-cancerous.</li><li>To check the severity of a problem seen from the breast imaging results, such as a fluid-filled cyst or calcium deposits in breast tissue (microcalcifications)</li></ul><h3>How often are breast biopsies positive for cancer?</h3>&gt; 80% of the patients who undergo the biopsy procedure do not have cancer, while only &lt; 20% of breast biopsies are malignant. When the results are negative, the breast lump is benign.<h3>Does a breast biopsy hurt?</h3>The breast surgeon may use local anaesthesia to help numb the biopsy area during the procedure. It may be slightly uncomfortable, but most patients describe it as tolerable. Once the site is numb from the local anaesthetic, one should only feel pressure but no pain from the biopsy.Typically, only local anaesthesia is required. However, general anaesthesia may be used in severe cases, meaning the entire body is numbed.<h3>How long does it take to recover from breast biopsy?</h3>Biopsy procedures do not cause significant pain to your body. However, you may experience some bruising, tenderness, or soreness for a few days after the biopsy procedure. Patients can take non-aspirin pain relievers that contain acetaminophen and apply cold packs to help ease the pain and discomfort. However, it can take longer to recover from surgical removal procedures when compared to nonsurgical procedures.With all breast biopsy procedures, except for the surgical biopsy, you will be able to go home without a patient caregiver. You will likely have bandages and a cold pack over the biopsy site. Most patients can resume usual activities within a day after the procedure.Tell your breast surgeon if you notice the following problems after the biopsy:<ul><li>Pain that gets worse</li><li>Chills or fever</li><li>Swelling, redness, drainage, or bleeding</li></ul><h3>How soon should you expect to receive your breast biopsy results?</h3><img src="https://images.contentstack.io/v3/assets/blt5f400315f9e4f0b3/blt3ce74f2f0f705f43/654521d254447604077cfdc6/Breast_Biopsy.jpeg?branch=uat_release_3" height="auto"/>Once the procedure is done, the breast tissue samples are sent to the lab. A pathologist will evaluate the samples using specialised tools and then create a report to send to the breast surgeon, who will share the results with you.Generally, it takes a few days before the results are ready. However, it can take as long as two weeks before the test results are available if the lab needs more time to process your specimen.Sometimes a clear diagnosis is not possible based on the sample given. In this scenario, you may need another biopsy performed so that the breast surgeon can obtain more breast tissue for further evaluation.The results will share details about the consistency and size of the breast tissue samples, the location of the biopsy site, and whether there are cancer cells present. If it is malignant, the report will detail the type of breast cancer you have. Based on the findings, your breast surgeon will advise on the next steps for treatment.<h2>Book Your Appointment at Thomson Breast Centre</h2>Prevention is always better than cure! Our clinical team at <a href="https://www.thomsonmedical.com/breast" target="_blank">Thomson Breast Centre</a> offers different services for all <a href="https://www.thomsonmedical.com/blog/breast-screening-mammogram-ultrasound" target="_blank">breast screening</a> needs with the assurance that you will be well taken care of. It is important to detect signs of breast cancer early. The sooner it is detected, the faster the treatment can start. At Thomson Medical, our doctors will evaluate the lump and provide the appropriate tests for diagnosis.Most patients start with a specialist consultation for a personalised clinical breast assessment. We offer a wide range of biopsy procedures, from minimally invasive removal to more advanced surgical options if a biopsy is needed. Book a specialist consultation with Thomson Breast Centre and start your breast health journey today.

Worried about a breast lump? Don't panic. A breast biopsy is a simple procedure that can help determine if the lump is benign or malignant. Learn more about the process and what to expect from this article.

Everything You Need to Know About Breast Biopsy

Breast cancer is the <a href="https://www.nccs.com.sg/patient-care/cancer-types/cancer-statistics" target="_blank">most common cancer</a> in women in Singapore. Doing a breast self-examination (BSE) at home is good for you to pick up on any changes in your breast tissue. Regular BSE are like a little personal checkup routine. They help keep tabs on your breast health and catch any signs of breast cancer early on, which makes treatment way more effective. It's important to remember that most lumps or abnormalities aren't cancerous, so don't jump to conclusions. But, and this is important, even if it seems minor, it's best to share any changes with your doctor or a <a href="https://www.thomsonmedical.com/find-an-expert?sub_specialization=Surgery+-+Breast" target="_blank">breast specialist</a>. Early detection is always the goal. <h2 src="https://old.thomsonmedical.com/wp-content/uploads/2020/03/2-What-is-Breast-Self-Examination.jpg" alt="What is Breast Self-Examination" width="528">What is breast self-examination?</h2>As the term itself implies, breast self-examination (BSE) is a physical and visual examination of the breasts done by an individual. BSE should be done monthly; in addition, <a href="https://www.thomsonmedical.com/blog/breast-screening-mammogram-ultrasound" target="_blank">breast screenings</a> should be done by your doctor every three years if you are in your 20s or 30s, or every year if you are 40 or older. Mammogram screening should be included once a lady turns 40 years old.<h2>Why is it important to do a breast self-examination?</h2>Regular BSE will help you be familiarised with the feeling and look of your breasts. You can detect any changes and abnormalities more easily. Regular BSE can help detect and treat breast cancer as early as possible. If you notice a change in your breasts that seems abnormal or if one breast is different from the other while doing BSE, you should let your doctor know immediately. BSE is not always reliable in detecting breast cancer. However many women who have breast cancer reported that they discovered a new breast lump through BSE. This is the reason why doctors still recommend BSE so that you can be familiar with the normal consistency of your breasts.<h2>How to do a self-breast examination?</h2>It is best to check with your doctor on how to conduct BSE. Your doctor can explain what you are feeling in the breast tissue, so when you perform it on your own, you will be able to notice if there are changes that have occurred as you examine yourself each month. Alternatively, you can follow the detailed guide below before seeking professional advice. Begin with a visual examination of your breasts. <h3>Step 1: Stand in front of a mirror </h3>Stand straight with your hands on your sides so that you will be able to see your breasts clearly. Check for the following symptoms by using your hands to examine your breasts. Make sure to use the fat pads of the fingertips of the 3 middle fingers.Make an appointment with your doctor if you notice any of the following symptoms: <ul><li>change in the size or shape of your breast</li><li>development of a lump</li><li>bloody discharge from the nipple</li><li>breast swelling</li><li>redness, thickening, or dimpling of the skin</li><li>swollen lymph nodes under the arms</li><li>pain and redness in the nipple</li><li>pulling in of the nipple or other parts of the breast</li><li>pain that is localized in one area and that does not vary with your monthly cycle</li></ul><h3>Step 2: Arms over your head</h3>Stand straight with your arms raised above your head or interlocked behind your head. Observe your breasts the same way as mentioned in Step 1 to check for any symptoms. <img asset_uid="bltdb8275d0ac8af5ac" src="https://images.contentstack.io/v3/assets/blt5f400315f9e4f0b3/bltdb8275d0ac8af5ac/6596d97eb05b9e9c9ed73747/Breast_Self-examination_1080x720.png?branch=production" alt="Breast_Self-examination_1080x720.png" height="auto"/><h3>Step 3: Hands on your hips while bending forward</h3>Press your hands firmly on your hips and bend slightly toward the mirror as you feel your chest muscle tighten. Observe and check for any symptoms. <h3>Step 4: Lie down flat on your back</h3>It is best to examine the breasts lying down as your breast tissues spread evenly over the chest. Put one shoulder on a pillow or a folded towel and place one arm over your head. Your breast will be flattened in this position so that it is easier to check. Lotion or powder is used by some women so that their fingers can easily glide on the skin while feeling for lumps. Press your fingers in small areas the size of a dime. Make sure to cover the entire breast area. <h3>Step 5: In the shower</h3>Your soapy skin can easily make your fingers glide so that it becomes easier to feel for changes underneath. Using patterns will help you make a more thorough breast self-examination. The whole breast must be inspected, especially the area between the breast and the underarm. The area above the breast up to the collarbone all the way over to your shoulder should also be examined. Below are some of the patterns you can use for your BSE.<ul><li>Line patterns: Your fingers need to move up and down starting in the underarm area and covering the whole breast area. Do the movement slowly.</li><li>Circle pattern: Move your fingers slowly from the outer edge of the breast and around the whole breast in a circle. Work toward the nipple making smaller and smaller circles. Make sure to also check the areas under the arm and the upper chest.</li><li>You can also begin from the nipple, moving in larger and larger circles until you reach the outer edge of the breast.</li><li>Wedge pattern: Divide the breast area into wedge sections and start at the outer edge of the breast and move towards the nipple, then back to the edge.</li></ul><h3>Step 6: Examine your nipples</h3>Bleeding discharges from the nipple should also be checked. To do so, squeeze the nipple gently to find out if there is bleeding or any discharge. Make sure not to skip any areas of the breast, whichever method you use.<h2>FAQ</h2><h3>When should you do a breast self-examination?</h3>You can start doing breast self-examination by the time you reach 20 years old. Menstruating women should conduct their breast self-examination a few days after the period has ended. This will ensure that your breasts are not tender or swollen. Women taking hormones should consult with their doctor about when to do BSE. If you see any breast changes such as swelling, redness, skin changes, presence of a lump, or discharge from your nipple, let your doctor know immediately. Make BSE a routine. The more you examine your breasts, the more you will learn about them and the easier it will be for you to tell if something has changed. <h3>How often should you do a breast self-examination?</h3>It should be conducted once every month so that you can become familiar with the looks and feel of your breasts. This way, it will be easier for you to detect any changes or abnormalities. Women in the stage of menopause should conduct breast self-examination on any day of the month. In order not to forget, choose a day that you can easily remember as the first or last day of the month. <h3>How hard should you press when checking breasts?</h3>You also need to apply 3 different levels of pressure to examine your breasts.<ul><li>You need to exert light pressure when examining the tissue closest to the skin.</li><li>Apply medium pressure so that you can feel a little deeper.</li><li>Apply firm pressure to feel deeper tissues near the chest wall.</li></ul><h3>What should you do if you detect a lump?</h3>It can be frightening to feel a lump or find some breast abnormalities. This is the reason why it's helpful to conduct regular BSE. You should not panic if you find a lump in your breasts during one of your BSEs as lumpiness can be caused by other reasons aside from having breast cancer. Women often experience abnormalities such as lumps and breast changes during their period. Most of these symptoms will disappear after your period ends. However, if the lumps or changes last even after your menstrual period is over, or if the lump seems to get bigger or more prominent, then you should consult your doctor immediately. On the other hand, not all lumps are cancerous; some breast lumps are benign. There are a lot of possible causes for non-cancerous breast lumps. This includes normal hormonal changes, injuries, or a benign breast condition. However, if it is accompanied by bloody discharges or changes in your skin such as puckering or dimpling, then you should seek professional advice immediately. We recommend that you undergo a thorough examination at <a href="https://www.thomsonmedical.com/breast" target="_blank" rel="noopener noreferrer">Thomson Breast Centre</a> — a one-stop centre for all breast-related problems, we can help to diagnose and provide the necessary treatment for your condition. <a href="https://www.thomsonmedical.com/appointment?location=Thomson+Breast+Centre" target="_blank" rel="noopener noreferrer">Book an appointment</a> with us today.

Discover the importance of regular breast self-examinations and how to perform them correctly.

How to Do a Breast Self-examination?

Breast cancer is the most prevalent cancer among women in Singapore, with nearly 200 new cases diagnosed each month. Early detection through <a href="https://www.thomsonmedical.com/blog/breast-screening-mammogram-ultrasound" target="_blank">regular breast cancer screening</a> can significantly enhance the prognosis, allowing many patients to lead healthy lives for decades. Despite the proven effectiveness of mammograms, which utilise low-dose X-rays to identify early signs of breast cancer, various misconceptions persist. These myths can deter women from seeking this vital screening. In this article, we tackle and dispel common myths about mammograms and breast cancer screening, providing clear, evidence-based information to empower women to make informed health decisions about breast health.<img asset_uid="blt1645f777c492cf99" src="https://images.contentstack.io/v3/assets/blt5f400315f9e4f0b3/blt1645f777c492cf99/65156c6d6ccdcbe86f8e113c/woman_health_boxing_breast_cancer.jpg?branch=production" alt="asian female wearing pink boxing gloves with breast cancer pink ribbon" height="auto" width="770" max-width="770" style="max-width: 770px;width: 770px;height: auto;"/><h2>Myth 1: Radiation from regular mammograms can cause cancer</h2>The radiation from a mammogram is equivalent to two months of exposure to environmental background radiation, which is completely safe.<h2>Myth 2: Mammograms are very painful</h2>Mammograms require breast compression between two plates to get a clear picture. Most women report it as discomfort, while others may feel some pain.<img asset_uid="bltfad619e01bc2147b" src="https://images.contentstack.io/v3/assets/blt5f400315f9e4f0b3/bltfad619e01bc2147b/65156b402d2a057f273fa181/mammogram_patient.jpg?branch=production" alt="female patient doing mammogram scan under watch of radiographer" height="auto" width="778" max-width="778" style="max-width: 778px;width: 778px;height: auto;"/><h2>Myth 3: Only those with a family history of breast cancer should get screened regularly</h2>This is false. Only 5-10% of <a href="https://www.thomsonmedical.com/blog/breast-cancer" target="_blank">breast cancers</a> are genetic. In fact, 70% of women with breast cancer do not have a family history. All women should get a screening mammogram once they turn 40.<h2>Myth 4: Doing a mammogram every few years, instead of yearly, is fine</h2>Yearly mammograms are recommended based on extensive research to ensure the best chance of early cancer detection. Some cancers can grow quickly, so yearly screenings are crucial once you turn 40.<h2>Myth 5: Young women do not get breast cancer</h2>The Singapore Cancer Registry reported that 18% of women diagnosed with invasive breast cancer between 2010 and 2014 were under 45. While cancer is more common with age, young women under 40 can also develop breast cancer. Monthly <a href="https://www.thomsonmedical.com/blog/breast-self-examination" target="_blank">breast self-examinations</a> from age 20 can help with early detection. Look for lumps, nipple discharge, retraction, or skin changes. Not all changes indicate cancer, so <a href="https://www.thomsonmedical.com/find-a-doctor/breast-doctor" target="_blank">consult a breast specialist</a> for a review if you notice any abnormalities.<h2>Need additional support?</h2>Visit us at Thomson Breast Centre, located in Thomson Medical Centre. <a href="https://www.thomsonmedical.com/appointment?location=Thomson+Breast+Centre" target="_blank">Book an appointment today</a>.

Discover the truth about mammograms and breast cancer screening. Debunk common myths and learn essential tips for early detection and better health outcomes.

Top 5 Mammogram Myths Debunked

Breast Cancer

Thomson Breast Centre

<h2>What is Pap smear?</h2>The Pap smear, also known as Pap test or cytology, is a screening procedure used to detect abnormal cellular changes in the cervix, which could indicate the presence of cervical cancer or precancerous conditions.&nbsp;<h2>Pap smear purpose: Why is Pap smear being done?</h2>The primary goal of a Pap smear is to detect cellular abnormalities in the cervix, particularly those caused by persistent high-risk human papillomavirus (HPV) infection.&nbsp;This screening is important as they can detect pre-cancerous changes, allowing for timely intervention and preventing the progression to cervical cancer. This preventive measure has contributed significantly to the reduction of cervical cancer incidence and mortality rates.<h2>Pap smear age: When should you get your first Pap smear?</h2>According to the <a href="https://www.moh.gov.sg/docs/librariesprovider4/guidelines/cpg_cancer-screening.pdf">Ministry of Health (MOH)</a>, all women who have ever engaged in sexual intercourse should undergo cervical cancer screening starting at the age of 25.<h2>How often do you need a Pap smear?</h2>According to <a href="https://www.moh.gov.sg/news-highlights/details/awareness-of-need-for-cervical-cancer-checks/">MOH guidelines</a>, women aged 25 to 29 are advised to have a Pap smear every three years. This recommendation does not apply to women with a history of previous abnormal Pap smears who are following up with a gynaecologist.For women aged 30 and older, they are recommended to get an Human Papillomavirus (HPV) test every five years.<h2>Pap smear procedure: How is pap smear done?</h2><img src="https://images.contentstack.io/v3/assets/blt5f400315f9e4f0b3/blt10d0b9a989ddf5ce/65f02a4f5caa4b6a4c60999b/Pap_Smear.jpg?branch=production" alt="Pap_Smear.jpg" height="auto"/>Pap smear involves the following steps:<ol><li>Positioning: A speculum is gently inserted into your vagina to widen it.</li><li>Cell collection: Cells are collected from the cervix using a brush or spatula. They will be sent to a lab to identify any abnormalities.</li><li>Speculum removal: The speculum is carefully removed from your vagina.</li></ol>The test is quick, relatively simple, and generally causes minimal discomfort. You may have some light spotting or discharge afterward, but you can resume your normal activities afterward.<h2>How to prepare for your Pap smear?</h2>Preparing for a Pap smear is a straightforward process. Here are detailed steps on how to prepare for it:<ol><li>Choose the right timing:<ul><li>Schedule the appointment when you are not menstruating. The best time is usually 10 to 20 days after the first day of your last menstrual period to ensure optimal sample collection.</li></ul></li><li>Avoid certain products:<ul><li>For 48 hours before the test, avoid using vaginal creams, foams, or douches, as they may interfere with the test results.</li></ul></li><li>Skip sexual activity:<ul><li>Refrain from sexual intercourse for at least 48 hours before the test. Semen, lubricants, and certain products can affect the Pap smear results.</li></ul></li><li>Inform your healthcare provider:<ul><li>Inform your healthcare provider about any concerns, symptoms, or changes in your reproductive health. They can address your specific needs and provide appropriate care.&nbsp;</li></ul></li><li>Reschedule if sick:<ul><li>If you have an active infection or are feeling unwell, consider rescheduling your Pap smear. Infections can affect the accuracy of the test.&nbsp;</li></ul></li><li>Comfortable clothing:<ul><li>Wear comfortable clothing to your appointment, as you may need to undress from the waist down.</li></ul></li><li>Relaxation techniques:<ul><li>Practice relaxation techniques if you feel anxious. Deep breathing or meditation can help ease tension.</li></ul></li><li>Ask questions:<ul><li>Feel free to ask your healthcare provider any questions you may have about the procedure. Understanding the process can help alleviate concerns.</li></ul></li></ol><h2>Who does not need a Pap smear?</h2>Guidelines for Pap smears may vary depending healthcare organisations. However, some general considerations for not needing a Pap smear may include:<ol><li>Women who have never had sexual intercourse</li><li>Women who have had a total hysterectomy (removal of the uterus and cervix) for non-cancerous reasons may not need Pap smears. However, this depends on the type of hysterectomy and the presence of other risk factors.</li></ol><h2>Can HPV test be done with Pap smear?</h2>In recent years, there has been a growing trend towards combining Pap smears with HPV testing for a more comprehensive approach to cervical cancer screening. This combination of tests facilitates more precise risk assessment and enables early detection of high-risk HPV strains.<h2>FAQ</h2><h3>Can you get a Pap smear earlier than 25?</h3>Generally, routine Pap smears are not recommended for women below 25 years old in Singapore. However, if you have specific concerns or risk factors, discuss them with your doctor or gynaecologist to determine the most appropriate course of action.<h3>Where can you get HPV vaccine in Singapore?</h3>To get the HPV vaccine in Singapore, you can consult with doctor/gynaecologist or visit clinics and hospitals where vaccination services are offered.There are two types of HPV vaccine available:<ol><li>HPV2 (Cervarix) – guards against HPV types 16 and 18, which account for 70% of cervical cancers.</li><li>HPV9 (Gardasil 9) – protect against HPT types 6, 11, 16, 18, 31, 33, 45, 52, and 58, which account for an additional 20% of cancer-causing HPV types.</li></ol><h3>Do I still need Pap smears if I have had the HPV vaccine?</h3>Yes, the HPV vaccine doesn't cover all cancer-causing HPV types, so regular screenings are still essential.<h3>Are Pap smears covered by health insurance in Singapore?</h3>Certain health insurance plans covers regular health screenings. For instance, AIA Vitality, Income's Lady 360 and Prudential insurances cover Pap smear.<h3>Can I do a Pap smear during pregnancy?</h3>Yes, Pap smears can be safely conducted during pregnancy.<h3>What if my Pap smear results are abnormal?</h3>Abnormal results may indicate cellular changes in the cervix. It does not necessarily mean cancer. Further tests, such as colposcopy or biopsy, may be recommended for a more detailed examination.&nbsp;<h3>Is a Pap smear painful?</h3>Pap smears are generally not painful but may cause mild discomfort. Inform your healthcare provider if you're experiencing pain.<h3>Can cervical cancer be prevented with Pap smear?</h3>Regular Pap smears can detect precancerous changes, allowing for early intervention and prevention of cervical cancer.<h3>Do you still need a Pap smear after menopause?</h3><a href="https://www.moh.gov.sg/docs/librariesprovider4/guidelines/cpg_cancer-screening.pdf">According to MOH</a>, a woman may discontinue screening at 69 years if her Pap smear at that age is negative and she has had two prior consecutive negative smears within the last 10 years. However, women aged over 69 years who have a history of sexual intercourse but have never undergone a Pap smear should still undergo screening.<h3>Do you need a pap smear if not sexually active?</h3>Pap smears are generally recommended for sexually active individuals, but guidelines may vary. Consult with a healthcare provider to determine individual screening needs.<h3>Do virgins need Pap smears?</h3>The need for Pap smears for women who have never had sexual intercourse may depend on individual factors and guidelines. Consult with a doctor for personalised recommendations.<h3>HPV test vs Pap smear: What is the difference?</h3>A Pap smear detects abnormal cervical cells, while an HPV test identifies the presence of the human papillomavirus, a common cause of cervical cancer. Both tests may be done together or independently.<h3>How much bleeding is normal after a Pap smear?</h3>Some spotting or light bleeding is normal after a Pap smear. If bleeding is excessive or persists, contact a healthcare provider for guidance.

Everything you need to know about Pap smear, including its purpose, procedure, frequency required, and FAQ.

Pap Smear for Cervical Cancer Screening: What to Expect & FAQs

Learn more about the early stages of cervical cancer, including risk factors, early detection methods, and treatment options. 

Pre-cervical cancer: Causes, Detection and Treatment

<h2>What is cervical cancer?</h2>Cervical cancer develops in the cells of the cervix, the lower part of the uterus connecting to the vagina. It starts with abnormal changes in cervical cells, known as precancerous changes or dysplasia, which can develop into cancerous tumours over time. This type of cancer progresses slowly, providing opportunities for early detection and intervention.<img asset_uid="bltf07c9bef147d9648" src="https://images.contentstack.io/v3/assets/blt5f400315f9e4f0b3/bltf07c9bef147d9648/66c2c6ba6cbe3cecb54444b5/Cervical_Polyps_1440x810.png?branch=production" alt="Cervical Polyps_1440x810.png" height="auto"/><h2>Prevalence of cervical cancer in Singapore</h2>Despite an advanced healthcare system, cervical cancer remains a significant health issue in Singapore. According to the Singapore Cancer Registry, it is one of the top ten cancers affecting women in the country.<h2>Who is at risk of cervical cancer?</h2>Several factors increase the risk of developing cervical cancer, including:<ol><li><h4>HPV infection</h4><ul><li>Persistent infection with high-risk strains of HPV is the leading cause of cervical cancer.</li></ul></li><li><h4>Smoking</h4><ul><li>Tobacco use increases the risk of cervical cancer and can worsen the effects of HPV infection.</li></ul></li><li><h4>Weak immune system</h4><ul><li>Conditions or medications that weaken the immune system can increase susceptibility to HPV infection and cervical cancer.</li></ul></li><li><h4>Multiple sexual partners</h4><ul><li>Engaging in sexual activity with multiple partners or having a partner who has multiple sexual partners increases the risk of HPV infection.</li></ul></li><li><h4>Early sexual activity</h4><ul><li>Initiating sexual activity at an early age is associated with a higher risk of HPV infection and cervical cancer.</li></ul></li></ol><h2>What are the symptoms of cervical cancer?</h2>Cervical cancer may not cause noticeable symptoms in its early stages, making regular screening crucial. As the cancer progresses, symptoms may include:<ul><li>Irregular bleeding between periods</li><li>Bleeding after sexual intercourse</li><li>Bleeding after menopause</li><li>Heavier or longer menstrual periods&nbsp;</li></ul><ol><li><h4>Pelvic pain or discomfort</h4><ul><li>Persistent pelvic pain unrelated to menstruation or other known causes.<img asset_uid="bltdc06d29d0ef8c79e" src="https://images.contentstack.io/v3/assets/blt5f400315f9e4f0b3/bltdc06d29d0ef8c79e/65156b77ca785331d5bd0207/ovarian-cysts-symptoms-and-diagnosis.jpg?branch=production" alt="woman holding stomach in pain ovarian cyst symptoms and diagnosis" height="auto"/></li><li>Pain during sexual intercourse (dyspareunia)</li></ul></li><li><h4>Unusual vaginal discharge</h4><ul><li>Increased vaginal discharge that may be watery foul-smelling</li><li>Discharge may contain blood or occur outside of menstrual periods</li></ul></li><li><h4>Pain or bleeding during urination</h4><ul><li>Painful urination (dysuria)</li><li>Blood in the urine (hematuria)</li></ul></li><li><h4>Other symptoms</h4><ul><li>Pain or discomfort in the lower back or abdomen</li><li>Fatigue or weakness</li><li>Unexplained weight loss</li><li>Swelling of one or both legs (edema)</li></ul></li></ol><h2>Treatment of cervical cancer</h2>Treatment depends on the stage of the cancer, overall health, and patient preferences. Options include:<ol><li><h4>Surgery</h4><ul><li>Surgical procedures such as hysterectomy (removal of the uterus) or trachelectomy (removal of the cervix) may be recommended for early-stage cervical cancer.</li></ul></li><li><h4>Radiation therapy</h4><ul><li>High-energy beams are used to destroy cancer cells, often combined with surgery for locally advanced cancer.</li></ul></li><li><h4>Chemotherapy</h4><ul><li>Drugs are used to kill cancer cells, either with radiation (chemoradiation) or as palliative treatment for advanced cancer.</li></ul></li><li><h4>Targeted therapy and immunotherapy</h4><ul><li>These treatments target specific molecular pathways and harness the immune system to fight cancer cells.</li></ul></li></ol>In addition to these treatment modalities, supportive care such as pain management, nutritional support, and psychological support plays a crucial role in improving the quality of life for women with cervical cancer.<h2>FAQs</h2><h3>What are the screening tests for cervical cancer?</h3>Screening aims to detect precancerous changes or early-stage cancer for timely intervention. The main screening tests include:<ol><li><h4>Pap smear (Pap test)</h4><ul><li>This test collects cells from the cervix and sends them to a laboratory for analysis. The <a href="https://www.thomsonmedical.com/women-health/gynaecology/pap-smear" target="_blank">Pap smear</a> can detect changes in cervical cells that may indicate precancerous or cancerous conditions.</li></ul></li><li><h4>HPV DNA test</h4><ul><li>This test detects high-risk HPV strains in cervical cells, identifying women at higher risk of developing cervical cancer due to persistent HPV infection. It is often used in conjunction with the Pap smear.&nbsp;</li></ul></li></ol><h3>How is cervical cancer diagnosed?</h3><ol><li><h4>Colposcopy</h4><ul><li>If abnormalities are detected during screening, a colposcopy examines the cervix in greater detail, and areas of abnormality can be biopsied.</li></ul></li><li><h4>Biopsy</h4><ul><li>A small tissue sample is removed from the cervix for examination under a microscope to confirm the diagnosis and provide information about the type and stage of the cancer.</li><li>There are different types of biopsies which may be performed depending on the location and extent of the abnormality. A biopsy allows for the definitive diagnosis of cervical cancer.&nbsp;</li></ul></li><li><h4>Imaging tests</h4><ul><li>Ultrasound, CT scan, or MRI may be used to assess the extent of the cancer and guide treatment decisions.</li></ul></li></ol><h3>Can cervical cancer be prevented?</h3>Yes, cervical cancer can be prevented through several key strategies:<ol><li><h4>HPV vaccination</h4><ul><li><a href="https://www.thomsonmedical.com/women-health/gynaecology/hpv-vaccine" target="_blank">Vaccination against HPV</a> is highly effective in preventing cervical cancer. It is recommended for adolescents before sexual activity but can also benefit those who have been sexually active.</li></ul></li><li><h4>Regular cervical cancer screening</h4><ul><li><a href="https://www.thomsonmedical.com/women-health/gynaecology/pap-smear" target="_blank">Pap smears</a> and HPV DNA tests detect abnormal cells or HPV infection early, allowing for timely intervention.</li></ul></li><li><h4>Safe sex practices</h4><ul><li>Consistent condom use and limiting the number of sexual partners reduce the risk of HPV infection.</li></ul></li><li><h4>Smoking cessation</h4><ul><li>Quitting smoking reduces the risk of developing cervical cancer.</li></ul></li><li><h4>Healthy lifestyle choices</h4><ul><li>A balanced diet, regular physical activity, and avoiding excessive alcohol consumption support a strong immune system.<img asset_uid="bltf60ffbc79b526333" src="https://images.contentstack.io/v3/assets/blt5f400315f9e4f0b3/bltf60ffbc79b526333/65156b276ccdcb81b08e0ff8/healthy_women_exercise.jpg?branch=production" alt="three young asian women in active wear athleisure talking an laughing after yoga or activity class" height="auto"/></li></ul></li><li><h4>Screening and treatment of precancerous lesions</h4><ul><li>Prompt treatment of precancerous changes can prevent progression to invasive cancer.</li><li>Procedures such as cryotherapy, loop electrosurgical excision procedure (LEEP), or cone biopsy may be used to remove abnormal cervical tissue.</li></ul></li></ol><h2>Additional support</h2>Early detection and intervention are essential in the fight against cervical cancer. If you have any concerns about cervical cancer, feel free to reach out to Thomson Medical. Our team is here to assist you with any questions and provide the support you need.

Cervical cancer starts in the cervix cells. Early detection through regular Pap tests is key. Learn about symptoms, causes, and treatment.

Cervical Cancer: Symptoms, Causes, and Treatment

Both affect the female reproductive tract. Cervical cancer develops slowly with noticeable symptoms. Ovarian cancer is a 'silent killer' that's less noticeable.

Cervical Cancer vs Ovarian Cancer: Symptoms & Key Differences

Being a virgin does not mean you are immune to cervical cancer. Learn more about the risks and causes and why regular screenings are important.

Cervical Cancer and Virginity: Are You at Risk?

Addressing the common misconceptions about cervical cancer causes, prevention, and treatment.

8 Common Myths About Cervical Cancer Debunked

Learn about cervical cancer discharge, its signs, symptoms, and when to seek medical advice for early detection and proper treatment.

Cervical Cancer Discharge: What It Looks & Smells Like & What It Means

Everything you need to know about cervical cancer treatments, including surgery, chemotherapy, and advanced therapies in Singapore.

Cervical Cancer Treatments: Surgery, Chemotherapy, and More

A loop electrosurgical excision procedure (LEEP), is a minimally invasive surgical technique used to diagnose and treat cervical cells. Learn more here.

LEEP: Purpose, Procedure, Side Effects, Recovery & Pregnancy

Radiotherapy (radiation therapy), utilises high-energy X-rays to target and destroy cancer cells. This effective treatment option aims to shrink tumours.

Radiotherapy for Cervical Cancer

Cervical Cancer

Gynaecological Oncology

CA125 is a biomarker that detects certain conditions or diseases. High levels of CA125 may indicate ovarian cancer, endometriosis, pelvic inflammatory disease.

CA125 Tumour Marker Blood Test: Normal & Dangerous Range

<h2>What is ovarian cancer?</h2>Ovarian cancer is a type of cancer that originates in the ovaries, the female reproductive organs responsible for producing eggs (ova) and hormones such as estrogen and progesterone. The ovaries are almond-sized organs located on either side of the uterus in the pelvis.<h2>What are the types of ovarian cancer?</h2><ol><li>Epithelial ovarian cancer:&nbsp;<ul><li>This is the most common type, accounting for about 90% of ovarian cancers. It develops in the epithelial cells covering the outer surface of the ovary.</li></ul></li><li>Stromal ovarian cancer:&nbsp;<ul><li>This type forms in the ovarian tissue that produces hormones. Stromal tumors are often diagnosed at an earlier stage than epithelial tumors.</li></ul></li><li>Germ cell ovarian cancer:&nbsp;<ul><li>Germ cell tumors originate in the cells that produce eggs. These tumors are rare and tend to occur in younger women.</li></ul></li><li>Borderline ovarian tumors:&nbsp;<ul><li>These tumors have abnormal cells that may become cancerous but often have a better prognosis than invasive ovarian cancer.</li></ul></li></ol><h2>What are the signs and symptoms of ovarian cancer?</h2>Ovarian cancer is often called the "silent killer" because it may not cause noticeable symptoms in its early stages. As the disease progresses, symptoms may include:<ul><li>Abdominal bloating or swelling</li><li>Pelvic pain or discomfort</li><li>Feeling full quickly during meals</li><li>Changes in bowel habits, such as constipation</li><li>Frequent urination</li><li>Unexplained weight loss</li><li>Fatigue</li><li>Back pain</li></ul><h2>How do you test for ovarian cancer?</h2><ol><li>CA-125 blood test:&nbsp;<ul><li>The CA-125 blood test measures the levels of a protein called CA-125 in the blood. Elevated levels of CA-125 can be associated with ovarian cancer. However, CA-125 is not specific to ovarian cancer and can be elevated for other reasons, such as endometriosis, adenomyosis, fibroids, pelvic inflammatory disease, and gastrointestinal causes.</li></ul></li><li>Pelvic ultrasound:<ul><li>Pelvic ultrasound involves detailed images of the ovaries to visualise any ovarian masses with suspicious features of cancer such as solid areas, ascites, bilateral cysts.</li></ul></li></ol><h2>FAQs</h2><h3>Who is at risk of ovarian cancer?</h3><ol><li>Women with a positive family history: A family history of ovarian cancer may increase the risk. Ministry of Health stated that women with the following risk factors are at a higher risk:<ul><li>Confirmed BRCA1/2 mutation carriers or untested first-degree relatives of known BRCA1/2 mutation carriers</li><li>Two or more first degree relatives with ovarian cancer</li><li>Family history of breast and/or ovarian cancer suspicious of BRCA mutation</li></ul></li><li>Age:&nbsp;<ul><li>The risk of ovarian cancer increases with age, with the highest risk occurring in women over 60.</li></ul></li><li>Reproductive history:&nbsp;<ul><li>Women who have never been pregnant or had their first child after the age of 35 may have a slightly higher risk.</li></ul></li><li>Personal history of breast cancer:&nbsp;<ul><li>Women with a personal history of breast cancer may face an increased risk.</li></ul></li><li>Inherited syndromes:&nbsp;<ul><li>Certain genetic syndromes, such as Lynch syndrome (hereditary nonpolyposis colorectal cancer) and Peutz-Jeghers syndrome, are associated with an increased risk of ovarian cancer.</li></ul></li><li>Women on hormone replacement therapy (HRT):&nbsp;<ul><li>Long-term use of hormone replacement therapy after menopause may slightly increase the risk of ovarian cancer. The risk appears to be higher with the use of estrogen-alone HRT, as opposed to combined estrogen and progesterone therapy.</li></ul></li><li>Women with endometriosis:&nbsp;<ul><li>Endometriosis, a condition where tissue similar to the lining of the uterus grows outside the uterus, is associated with an increased risk of ovarian cancer.</li></ul></li></ol><h3>What are the challenges in ovarian cancer screening?</h3><ol><li>Absence of early symptoms:&nbsp;<ul><li>Ovarian cancer is often referred to as the "silent killer" because it may not cause noticeable symptoms in its early stages. When symptoms do appear, they are often non-specific and may be attributed to other common conditions. This makes it challenging to identify the disease at an early and more treatable stage.</li></ul></li><li>Lack of a definitive biomarker:<ul><li>Unlike some other cancers, ovarian cancer lacks a definitive biomarker that can reliably indicate the presence of the disease. While the CA-125 blood test is often used, it is not specific to ovarian cancer and can yield false positives.</li></ul></li><li>False positives and overdiagnosis:&nbsp;<ul><li>Current screening methods, such as the CA-125 blood test and transvaginal ultrasound (TVUS), can produce false-positive results. Elevated CA-125 levels can be associated with conditions other than ovarian cancer, leading to unnecessary anxiety and further testing. False positives can also result in overdiagnosis, leading to unnecessary surgeries.</li></ul></li><li>Low prevalence in the general population:&nbsp;<ul><li>Ovarian cancer is relatively rare compared to other cancers. In the general population, the prevalence of ovarian cancer is low, making widespread screening less cost-effective and potentially leading to an increased number of false positives.</li></ul></li><li>Complexity of ovarian tumors:&nbsp;<ul><li>Ovarian tumors can be complex, with various subtypes that behave differently. Some tumors may be slow-growing, while others are more aggressive. The lack of a one-size-fits-all screening approach adds complexity to the development of effective screening strategies.</li></ul></li><li>Limited sensitivity and specificity of screening tests:&nbsp;<ul><li>The sensitivity and specificity of current screening tests, such as CA-125 and transvaginal ultrasound, are not ideal. These tests may not reliably detect early-stage ovarian cancer, and false negatives can occur, providing a false sense of security.</li></ul></li><li>Risk factors are not well-defined:&nbsp;<ul><li>While certain risk factors, such as a family history of ovarian cancer or mutations in specific genes (BRCA1 and BRCA2), are associated with an increased risk, many cases occur in women without these known risk factors. This lack of clear risk factors hampers the development of targeted screening strategies.</li></ul></li></ol><h3>How to confirm the diagnosis of ovarian cancer?</h3>A tissue biopsy is the only thing that can definitively confirm an ovarian cancer diagnosis.<h3>How to manage ovarian cancer?</h3>Managing ovarian cancer involves a multidisciplinary approach that combines surgery, chemotherapy, targeted therapies, and supportive care. The specific treatment plan will depend on the stage of the cancer, the type of ovarian cancer, the patient's overall health, and individual considerations. Here are the key components of managing ovarian cancer:<ol><li>Surgery: Surgery is a crucial component of ovarian cancer treatment. The extent of surgery depends on the stage of the cancer. Common procedures include:<ul><li>Oophorectomy: Removal of one or both ovaries.</li><li>Salpingectomy: Removal of one or both fallopian tubes.</li><li>Hysterectomy: Removal of the uterus.</li><li>Lymph node dissection: Removal of nearby lymph nodes to check for cancer spread.</li></ul></li><li>Chemotherapy:&nbsp;<ul><li>Chemotherapy is often used after surgery to eliminate remaining cancer cells and prevent recurrence. It may be administered intravenously or directly into the abdominal cavity (intraperitoneal chemotherapy). The choice of chemotherapy drugs depends on the specific characteristics of the cancer.</li></ul></li><li>Targeted therapies:&nbsp;<ul><li>Targeted therapies focus on specific molecules involved in cancer growth. For example, drugs like bevacizumab may be used to inhibit the growth of blood vessels that supply tumors. Poly (ADP-ribose) polymerase (PARP) inhibitors, such as olaparib and niraparib, may be used for certain types of ovarian cancer with specific genetic mutations.</li></ul></li><li>Hormone therapy:&nbsp;<ul><li>Hormone therapy may be considered for certain types of ovarian cancer that are hormone-sensitive. This approach aims to block or interfere with hormones that contribute to cancer growth.</li></ul></li><li>Immunotherapy:&nbsp;<ul><li>Immunotherapy drugs, such as immune checkpoint inhibitors, are being investigated in clinical trials for ovarian cancer. These drugs aim to boost the body's immune system to recognize and destroy cancer cells.</li></ul></li><li>Follow-up care:&nbsp;<ul><li>After completing initial treatment, regular follow-up appointments are essential to monitor for any signs of recurrence or complications. Follow-up care may include imaging tests, blood tests (CA-125), and discussions about potential side effects of treatment.</li></ul></li><li>Symptom management and supportive care:&nbsp;<ul><li>Managing symptoms and addressing the side effects of treatment are critical aspects of ovarian cancer care. This may involve medications to alleviate pain, nausea, or other symptoms. Supportive care, including counseling, nutritional support, and palliative care, can enhance the overall well-being of the patient.</li></ul></li><li>Palliative care:&nbsp;<ul><li>Palliative care focuses on improving the quality of life for patients facing serious illnesses. It can be integrated into ovarian cancer management to address symptoms, provide emotional support, and assist with decision-making.</li></ul></li></ol>

Everything you need to know about ovarian cancer and screening, including types of cancer, signs and symptoms, screening procedures, and FAQ. 

Ovarian Cancer Screening

The female reproductive system is comprised of several key structures, including the ovaries, fallopian tubes, uterus, cervix, vagina, and vulva (refer to the illustration below). Gynaecological cancers, which are cancerous tumors originating in any of these components, represent a significant health concern.According to <a href="https://www.singaporecancersociety.org.sg/learn-about-cancer/cancer-basics/common-types-of-cancer-in-singapore.html">data from the Singapore Cancer Registry</a>, during the period from 2017 to 2021, cancers of the uterus, ovary, and cervix were identified as the fourth, sixth, and tenth most prevalent cancers, respectively, among women in Singapore.Gynaecological cancer screening plays a crucial role in the early detection and prevention of cancers affecting the female reproductive system.In this article, we will look at the screenings for:<ol><li>Cervical cancer</li><li>Ovarian cancer</li><li>Endometrial cancer</li></ol><h2>Cervical cancer screening</h2><h3>Pap smear test</h3><ul><li>According to the <a href="https://www.moh.gov.sg/docs/librariesprovider4/guidelines/cpg_cancer-screening.pdf">Ministry of Health (MOH)</a>, all women who have ever engaged in sexual intercourse should undergo cervical cancer screening starting at the age of 25.</li><li>In Singapore, the <a href="https://www.thomsonmedical.com/blog/pap-smear">Pap smear</a> is a routine screening test available in polyclinics and private clinics.</li></ul><h3>HPV testing</h3><ul><li>Human Papillomavirus (HPV) testing is often used in conjunction with Pap smears.</li><li>HPV vaccination is a preventive measure, typically administered to girls between the ages of 9 and 14.</li></ul><h2>Ovarian cancer screening</h2><h3>CA-125 blood test</h3><ul><li>CA-125 is a protein that may be elevated in the presence of <a href="https://www.thomsonmedical.com/blog/ovarian-cancer-screening" target="_blank">ovarian cancer</a>.</li><li>However, CA-125 levels can be influenced by various factors, leading to limited reliability.</li></ul><h3>Pelvic ultrasound</h3><ul><li>Pelvic ultrasound involves detailed images of the ovaries to visualise any ovarian masses with suspicious features of cancer such as solid areas, ascites, or bilateral cysts.</li></ul><h2>Endometrial cancer screening</h2>Endometrial cancer is a type of cancer that begins in the lining of the uterus, known as the endometrium.&nbsp;<h3>Endometrial biopsy</h3><ul><li>Recommended for women experiencing abnormal vaginal bleeding or those at higher risk of endometrial cancer such as obesity, diabetes, or polycystic ovarian syndrome.</li><li>Helps diagnose endometrial cancer by examining a small tissue sample from the uterine lining.</li><li><a href="https://www.thomsonmedical.com/blog/hysteroscopy" target="_blank">Hysteroscopy</a>, dilation, and curettage can be performed as an alternative to endometrial biopsy as an investigation of abnormal vaginal bleeding.</li></ul><h3>Transvaginal Ultrasound</h3><ul><li>Imaging technique that allows visualisation of the ovaries for abnormalities.</li><li>Not recommended as a standalone screening tool due to its limited sensitivity and specificity.</li></ul><h2>FAQs</h2><h3>Why is early detection important in gynaecological cancers?</h3>Early detection of gynaecological cancers significantly increases the chances of successful treatment and cure. Regular screenings help identify abnormalities or cancerous cells at an early stage when intervention is most effective.<h3>Which cancers are screened for in routine gynaecological exams?</h3>Routine gynaecological exams typically screen for cervical, ovarian, and uterine (endometrial) cancers. Vaginal and vulvar cancers are often assessed during pelvic exams.<h3>When should I start cervical cancer screening?&nbsp;</h3>According to the <a href="https://www.moh.gov.sg/docs/librariesprovider4/guidelines/cpg_cancer-screening.pdf">Ministry of Health (MOH)</a>, all women who have ever engaged in sexual intercourse should undergo cervical cancer screening starting at the age of 25.<h3>How often should I undergo cervical cancer screening?&nbsp;</h3>According to <a href="https://www.moh.gov.sg/news-highlights/details/awareness-of-need-for-cervical-cancer-checks/">MOH guidelines</a>, women aged 25 to 29 are advised to have a Pap smear every three years. This recommendation does not apply to women with a history of previous abnormal Pap smears who are following up with a gynaecologist.For women aged 30 and older, they are recommended to get a Human Papillomavirus (HPV) test every five years.<h3>Can ovarian cancer be detected early?&nbsp;</h3><a href="https://www.thomsonmedical.com/blog/ovarian-cancer-screening" target="_blank">Early detection of ovarian cancer</a> is challenging, and there is no routine screening test with high accuracy. Awareness of symptoms, such as bloating, pelvic pain, and changes in bowel habits, is crucial for early diagnosis.<h3>What are the symptoms of gynaecological cancers?</h3>Symptoms vary depending on the type of cancer but may include abnormal vaginal bleeding, pelvic pain or pressure, changes in bowel or bladder habits, and unexplained weight loss. However, many women with early-stage cancers may not experience any symptoms.<h3>When should women start and stop gynaecological cancer screenings?</h3>Screening guidelines may vary based on factors like age, risk factors, and personal medical history. It is crucial to discuss individualised screening plans with healthcare providers. Generally, screenings may start in the early 20s and continue until the mid-60s.<h3>Can gynaecological cancers be prevented?</h3>Some risk factors, like HPV infection, can be addressed through vaccination. Additionally, lifestyle factors such as maintaining a healthy weight, not smoking, and using protection during sexual activity can potentially contribute to reducing the risk of gynaecological cancers.

Everything you need to know about gynaecological cancer screening, including how it works, types (cervical, ovarian, and endometrial), effectiveness, cost, and pros and cons. 

Gynaecological Cancer Screening

Gynaecological cancers represent a significant area of concern in women's health globally, including in Singapore where they contribute prominently to the overall cancer burden.&nbsp;According to <a href="https://www.singaporecancersociety.org.sg/learn-about-cancer/cancer-basics/common-types-of-cancer-in-singapore.html">data from the Singapore Cancer Registry</a>, during the period from 2017 to 2021, cancers of the uterus, ovary, and cervix were identified as the fourth, sixth, and tenth most prevalent cancers, respectively, among women in Singapore.Advances in treatment options for gynaecological cancers in Singapore have been significant, ranging from surgery and radiation therapy to targeted therapies and immunotherapy. These treatments are tailored to the individual's specific type of cancer, its stage, and other personal health factors, aiming to maximise survival rates and improve the quality of life. The focus on early detection and regular screenings, such as HPV/<a href="https://www.thomsonmedical.com/blog/pap-smear" target="_blank">Pap smear</a> for cervical cancer, has also been a critical aspect of improving outcomes, as early-stage cancers are generally more treatable and have better prognosis.<h2>Cervical cancer</h2><h3>Early-stage (I and II)</h3><ol><li>Surgery:&nbsp;<ul><li>Removal of the cervix (radical hysterectomy) or a more conservative procedure called a trachelectomy for fertility preservation.</li></ul></li><li>Radiation therapy:&nbsp;<ul><li>External beam radiation or brachytherapy (internal radiation).</li></ul></li><li>Chemotherapy:&nbsp;<ul><li>May be recommended in combination with radiation therapy.</li></ul></li></ol><h3>Advanced-stage (III and IV)</h3><ol><li>Chemoradiotherapy:&nbsp;<ul><li>A combination of chemotherapy and radiation therapy.</li></ul></li><li>Surgery:<ul><li>In some cases, surgery may be considered after chemoradiotherapy.</li></ul></li><li>Systemic therapy:<ul><li>Chemotherapy or targeted therapies for advanced cases.</li></ul></li></ol><h2>Ovarian cancer</h2><h3>Early-stage</h3><ol><li>Surgery:&nbsp;<ul><li>Removal of the affected ovary or ovaries (oophorectomy) and, in some cases, a hysterectomy and removal of nearby tissues.</li></ul></li><li>Chemotherapy:&nbsp;<ul><li>Adjuvant chemotherapy after surgery.</li></ul></li></ol><h3>Advanced-stage</h3><ol><li>Surgery:<ul><li>Debulking surgery to remove as much of the tumor as possible, followed by chemotherapy.</li></ul></li><li>Chemotherapy:&nbsp;<ul><li>Standard treatment, often a combination of platinum-based drugs and taxanes.</li></ul></li><li>Targeted therapies:&nbsp;<ul><li>PARP inhibitors for certain genetic mutations.</li></ul></li></ol><h2>Uterine (endometrial) cancer</h2><h3>Early-stage</h3><ol><li>Surgery:&nbsp;<ul><li>Total hysterectomy with bilateral salpingo-oophorectomy. Lymph node dissection may also be performed.</li></ul></li><li>Radiation therapy:&nbsp;<ul><li>External beam radiation or brachytherapy in some cases.</li></ul></li><li>Hormone therapy:&nbsp;<ul><li>For hormone receptor-positive tumors.</li></ul></li></ol><h3>Advanced-stage</h3><ol><li>Surgery:&nbsp;<ul><li>Debulking surgery for advanced cases, followed by chemotherapy.</li></ul></li><li>Chemotherapy:&nbsp;<ul><li>Often a combination of drugs.</li></ul></li><li>Hormone therapy or targeted therapies:&nbsp;<ul><li>Depending on the molecular characteristics of the tumor.</li></ul></li></ol><h2>Vulvar cancer</h2><h3>Early-stage</h3><ol><li>Surgery:&nbsp;<ul><li>Wide local excision or vulvectomy.</li></ul></li><li>Lymph node dissection:<ul><li>Removal of nearby lymph nodes.</li></ul></li><li>Radiation therapy:&nbsp;<ul><li>Adjuvant radiation in some cases.</li></ul></li></ol><h3>Advanced-stage</h3><ol><li>Surgery:&nbsp;<ul><li>Extensive surgery for larger tumors, sometimes followed by reconstruction.</li></ul></li><li>Chemotherapy or radiation therapy:&nbsp;<ul><li>Depending on the extent of the disease.</li></ul></li></ol><h2>Vaginal cancer</h2><h3>Early-stage</h3><ol><li>Surgery:<ul><li>Removal of the tumor with wide margins.</li></ul></li><li>Radiation therapy:&nbsp;<ul><li>Adjuvant radiation in some cases.</li></ul></li></ol><h3>Advanced-stage</h3><ol><li>Surgery:&nbsp;<ul><li>More extensive surgery or pelvic exenteration in advanced cases.</li></ul></li><li>Chemotherapy or radiation therapy:&nbsp;<ul><li>Depending on the extent of the disease.</li></ul></li></ol><h2>Conclusion</h2>Key aspects of gynaecological cancer management guidelines include:<ol><li>Screening and early detection:<ul><li>Regular screenings for cervical, ovarian, uterine, and other gynaecological cancers.</li><li>Education and awareness programs to promote early detection and prevention.</li></ul></li><li>Diagnostic evaluation:<ul><li>Accurate staging through imaging studies and pathological assessments.</li><li>Consideration of genetic testing for hereditary factors influencing cancer risk.</li></ul></li><li>Treatment modalities:<ul><li>Surgery: Often the primary treatment for gynaecological cancers, aiming for complete tumor removal.</li><li>Chemotherapy: Administered to destroy cancer cells or shrink tumors.</li><li>Radiation therapy: Targeted radiation to eliminate cancer cells or alleviate symptoms.</li></ul></li><li>Multidisciplinary approach:<ul><li>Collaboration between gynaecologic oncologists, medical oncologists, radiation oncologists, and other specialists.</li><li>Individualised treatment plans based on the type and stage of cancer.</li></ul></li><li>Supportive care:<ul><li>Addressing physical and emotional aspects of cancer through palliative care and supportive services.</li><li>Management of treatment side effects to enhance the overall quality of life.</li></ul></li><li>Follow-up and surveillance:<ul><li>Regular follow-up appointments for monitoring and early detection of recurrence.</li><li>Survivorship programs to address long-term physical and psychological effects.</li></ul></li></ol><h2>FAQ</h2><h3>What are the common types of gynaecological cancers?</h3>Gynaecological cancers include cervical, ovarian, uterine (endometrial), vaginal, and vulvar cancers.<h3>How can I reduce my risk of gynaecological cancers?</h3>Regular screenings, maintaining a healthy lifestyle, HPV vaccination, and understanding family history can help reduce risks.<h3>What screening tests are available for gynaecological cancers?</h3>Pap smears for cervical cancer, pelvic exams, transvaginal ultrasounds, and blood tests for certain markers are common screening methods.<h3>What does a cancer diagnosis involve?</h3>Diagnosis includes imaging tests, biopsies, and pathological examinations to determine the type, stage, and characteristics of the cancer.<h3>What are the main treatment options for gynaecological cancers?</h3>Treatment may involve surgery, chemotherapy, radiation therapy, or a combination, depending on the type and stage of cancer.<h3>How is surgery used in gynaecological cancer management?</h3>Surgery aims to remove tumors and affected tissues. Procedures may include hysterectomy, oophorectomy, and lymph node dissection.<h3>What is the role of chemotherapy in gynaecological cancer treatment?</h3>Chemotherapy uses drugs to kill or slow the growth of cancer cells. It may be used before or after surgery, or as the primary treatment for advanced stages.<h3>When is radiation therapy recommended for gynaecological cancers?</h3>Radiation therapy is often used after surgery to eliminate remaining cancer cells or as a primary treatment for specific cancers.<h3>How important is a multidisciplinary approach in gynaecological cancer care?</h3>Collaboration between gynaecologic oncologists, medical oncologists, radiation oncologists, and other specialists ensures comprehensive and tailored treatment plans.<h3>What are the potential side effects of gynaecological cancer treatments?</h3>Side effects may include fatigue, nausea, hair loss, and changes in fertility. The impact varies based on the type of treatment.<h3>How frequently should follow-up appointments occur after treatment?</h3>Follow-up schedules depend on the type and stage of cancer but generally involve regular check-ups and screenings to monitor for recurrence.<h3>Are there support services available for gynaecological cancer patients?</h3>Yes, support services include counseling, support groups, and survivorship programs to address emotional and physical well-being.&nbsp;

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Breast lumps during pregnancy are very common. The expectant mother will experience many normal physiological changes ― an increase in breast size, more obvious sweat glands around the nipples, a darkening of the areola ― all of which will prepare her body for breastfeeding.Common non-cancerous variations to breasts include hormonal changes (fibrocystic changes), fibroadenomas, cysts, lipomas, accessory (extra) breast tissue. Pregnancy-related breast cancers make up about 3 per cent of all breast cancers.Whenever a pregnant woman feels a lump, she should see a doctor to get their opinion, keeping in mind that most times it will turn out to be nothing serious!<h2>What the doctor will do</h2>When you see the doctor, she will ask details as to how you detected the lump, how long it has been present and if you have detected any changes, so as to get an idea what the lump is likely to be.Next, the doctor will conduct a breast examination to confirm the presence of the lump, and check for any other symptoms such as skin changes or nipple discharge.Most patients will then be recommended to get an ultrasound scan ― this will give additional information as to whether this lump is benign or cancerous. If there is any concern that the lump may be cancerous, your doctor will advise you as to the pros and cons of having a biopsy, which can be done safely even during pregnancy.“If a pregnant women detects a lump, I would advise them to have a thorough consultation and a physical examination, followed by an ultrasound. If necessary, I would then perform a biopsy.”<h2>Breast cancer screening during pregnancy</h2>A screening checks for cancer even when a patient is feeling well and has absolutely no cancer signs or symptoms. For breast cancer screening, most countries, including Singapore, recommend mammogram screening from age 50 onwards. For women who are at higher risk, this may start at 40. Some specialists will recommend a supplementary ultrasound as well.If a pregnant women detects a lump, I would advise them to have a thorough consultation and a physical examination, followed by an ultrasound. If necessary, I would then perform a biopsy.<h2>Screening methods (Mammograms/Ultrasound)</h2>Ultrasound, the same technology used to monitor the baby during pregnancy, is safe and useful in detecting lumps, and to check if it’s solid or cystic. Most specialists do not use ultrasound as a screening method as the majority of such lumps it detects are not cancerous.A diagnostic ultrasound can still be performed safely on pregnant women to assess their breast lump. If a subsequent biopsy confirms a cancer, she may then need a baseline mammogram, after discussing the pros and cons with her doctor. This is because early stage breast cancer may not form a lump yet, but may attract calcium spots, which can be detected using a mammogram. An abdominal lead apron may be used to reduce the baby’s exposure to radiation.<h2>Breast cancer treatment</h2>If the biopsy shows that the lump is non-cancerous (benign), then it may be left alone.However, if the biopsy shows that it is cancerous, the breast cancer treatment protocols will be modified for the expectant woman. Staging* has to be conducted to find out if the cancer has spread to other parts of the body, but only with liver ultrasound and chest X-ray. Depending on which trimester of the pregnancy she is in, the breast surgeon, oncologist and the ob-gyn will discuss what is best for the patient and her baby.Chemotherapy may be administered from the second trimester onwards, followed by surgery after she deliver the baby. As such management of the patient’s treatment is complex, it will involve good multidisciplinary care by experienced doctors.*Staging is a way to describe where the cancer is located, how much the cancer has grown, and if or where it has spread.

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Although common breast changes are normal in pregnancy, finding a lump can be worrying. Learn what are the recommended next steps, and when you should worry.

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Breast Lumps During Pregnancy: What to Expect and Do

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Just as there are skin issues that arise during pregnancy, skin conditions can also develop after you give birth. Fortunately, they are largely treatable, so there is no need to fret – your postpartum skin and hair will bounce back in no time. We take a look at some of the most common conditions.<h2>Melasma</h2>Also known as “the mask of pregnancy”, this pigmentation condition is due to increased melanin production and is caused by a combination of genetic and hormonal factors, as well as sun exposure. It tends to affect Asian skin more, appearing as brownish patches over the cheeks, forehead, temples, nasal bridge, upper lips and jawline.It is best controlled by avoiding the sun and with regular use of sunscreen, lightening creams and topical agents, although it can persist in some cases. Other treatments include chemical peeling, intense pulsed light therapy and certain forms of laser therapy. Inform your doctor if you are breastfeeding – certain ingredients such as tretinoin and hydroquinone that can be found in some skincare products should be avoided by breastfeeding mums.<h2>Dermatitis/eczema</h2>Eczema or dermatitis is a relatively common yet noninfectious condition, so it will not spread to your baby. Often it is an aggravation of an underlying sensitive skin condition that has been present for some time. For new mothers, it can also develop as a result of excessive water contact due to frequent handwashing.Use moisturiser regularly to soothe inflamed and itchy skin. Topical steroid creams are prescribed to calm inflamed skin and are safe to use even when breastfeeding. Use a gentle soap substitute and continue to moisturise even after the skin rash has settled.<h2>Stretchmarks</h2>Affecting at least 90 percent of pregnant women, stretchmarks are a form of scarring that appear red when fresh, but most will fade to white after delivery. During pregnancy, intensive use of moisturisers may help the condition, and there are specially formulated stretchmark creams on the market that you can continue using after delivery. For more severe cases, dermatologists may prescribe tretinoin cream to use postpartum when you are not breastfeeding. Some skin-tightening laser treatments are safe options to remove stretchmarks even if you are breastfeeding, but these usually require multiple sessions.<h2>Telogen effluvium</h2>This condition results in hair fall that usually occurs about three months after delivery. Though increased hair fall can be distressing to new mothers, it is almost always a self-limiting condition, and you will usually recover within six months. If you notice increased hair fall, consult a doctor to exclude other causes of hair loss (such as low iron levels). Topical medications can be used if you are not breastfeeding.<h2>Acne</h2>Caused by an inflammation in the facial oil glands, acne may be aggravated by hormonal changes. Most of the time, acne clears within a few weeks or months, but medical treatment should be sought to prevent the risk of scarring. There are many topical agents that can be safely used even when breastfeeding. In more severe cases, oral medications such as antibiotics may be required.

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Postpartum skin problems like melasma, acne, and stretch marks are common but temporary. Learn how to relieve and prevent the 5 most frequent postpartum skin woes.

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The 5 Most Common Postpartum Skin Issues and How to Treat Them