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HEALTH&FITNESS
304
November14
QUESTION #3
After cancer surgery, what will my
breast look like?
Though the aesthetic outcome may not be
the first thing on the mind of a woman who
has been diagnosed with breast cancer,
says DR GEORGETTTE CHAN, it can be an
important part of the road to full physical and
psychological recovery. Where a mastectomy
is required, she will if possible recommend a
skin- and nipple-sparing mastectomy.
“In
my opinion,” she says, “it’s the nicest form of
reconstruction that we can do for a patient with
breast cancer.”
Who is it for?
It’s a viable option in cases where the breast
tumour is located well away from the nipple, and
where the nipple itself is healthy and normal.
What’s more, during the surgery itself, I shave
off tissue just behind the nipple and have it
tested on the spot. If the pathologist confirms
that it’s free of tumour cells, I will then save
the nipple.
QUESTION #4
Am I at risk for diabetes?
Diabetes can be a devastating condition if
not treated correctly, says endocrinologist
DR BEN NG. Singapore has amongst the
highest incidence in the developed world
– a whopping 11.8 percent! Fortunately, the
condition responds well to lifestyle, diet and
medical therapy.
What is diabetes?
The classic sign is the presence of high blood
sugars. However, it is a little more complicated
that that. Diabetes develops over years as a
result of a combination of insulin deficiency
and insulin resistance, and can result in chronic
inflammation, liver dysfunction, muscle insulin
resistance and pancreatic failure.
Very often, people with diabetes have
detectable liver fat, high body fat, high blood
pressure and high cholesterol – all associated
with this metabolic disorder. In other words, the
development of high sugars in diabetes must be
seen as a metabolic failure in the body system,
rather than merely as a rise in blood sugars.
What does it entail?
We remove all the breast tissue – so it’s as oncologically clean as possible,
but we save the skin and also the nipple. Usually, patients who have
undergone a mastectomy do not require further radiation therapy.
What’s the advantage to saving the nipple and the breast skin?
Reconstruction of the nipple-areolar complex is an extremely challenging
area for a plastic surgeon, so for the aesthetic appearance of the operated
breast it’s ideal if we can save the nipple.
Keeping the breast skin intact allows it to serve as an envelope to receive
the reconstructive material immediately. Whether an implant is going in, or
transplanted muscle, the plastic surgeon can more easily balance it with
the patient’s other breast. Psychologically, a nice surgical outcome does
wonders for the patient’s outlook and self-esteem.
Georgette Chan
Breast and General Surgeon
#11-09 Mount Elizabeth Medical Centre
3 Mount Elizabeth
6836 5167 | georgettechan.com.sg
How is it diagnosed?
The basic screening involves checking a fasting blood sugar. For better
prediction and assessment of risk, I would also measure weight, cholesterol
ratios and body composition. Risk factors include a family history of diabetes,
a sedentary lifestyle and being overweight.
When should one seek medical help?
As soon as possible – ideally through the early identification of individuals
who are at risk. Lifestyle and dietary changes – even before the early signs
of diabetes can be seen – has been shown to reduce the risk of diabetes by
more than half. Furthermore, in several studies, the early use of medications
has been shown to reduce the incidence of this condition.
What are the treatment options? Can diabetes be cured?
Early-stage diabetes can be managed with lifestyle and dietary changes, but
some kind of medication is generally required. Medication is usually oral, but
about a third of people with Type 2 diabetes may require insulin treatment.
Diabetes can indeed be cured in some cases, for example through weight-
loss surgery coupled with significant lifestyle changes.
Arden Endocrinology Specialist Clinic
38 Irrawaddy Road
Mount Elizabeth Novena Specialist Centre
6334 2301 | arden.com.sg