Find answers and information on mammograms, ultrasounds, biopsies, and follow-up care from Dr Evan Woo of Evan Woo Breast & Plastic Surgery, and Dr Cheryl Lim & Dr Niketa Chotai from RadLink Diagnostic Imaging. Read these frequently asked questions to better understand your breast imaging options and feel empowered on your healthcare journey.
Dr Evan Woo, Surgical Oncologist, Evan Woo Breast & Plastic Surgery
Dr Evan Woo: Don’t panic. Many causes of abnormal mammograms and ultrasound breast results are benign and harmless. That said, it is important for you to follow up with a Breast Surgeon to assess your condition. This may include additional view(s) on your mammogram, ultrasound, MRI or biopsy.
Dr Evan Woo: Medisave and insurance will cover breast biopsies. The amount that you would need to pay in cash upfront would depend on your policy and coverage.
Our clinic is a member of many insurance panels, feel free to check with us.
Dr Evan Woo: In general, I’m not in favour of vacuum assisted biopsy for removing breast lump because it has been shown that it may not be a complete removal. If I get request for breast lump removals, it would be an open removal where care is taken to site the scar in a hidden location and the wound closure is meticulous as you would expect from a plastic surgeon. Many times scars are barely perceptible.
Dr Cheryl Lim, Senior Consultant Radiologist, RadLink Diagnostic Imaging
Dr Cheryl Lim: A biopsy is a medical procedure where we take a sample of tissue and send it to the laboratory for testing. The pathologist will then look under the microscope and examine to see if the cells are abnormal or not.
Usually biopsies are recommended for lumps that look borderline or worrisome on imaging. This will tell us if it contains abnormal cells (cancerous, pre cancerous) or not (non cancerous). The information will help your doctor come up with an appropriate management or treatment plan for you.
Most of the time no special preparation is required prior to a biopsy. Certain types of blood thinning medications may need to be stopped a few days in advance (and your doctor will advise on that accordingly). As these procedures are done under local anesthesia, no fasting or sedation is required. I usually tell my patients to have their meal before coming for the appointment. They may wish to wash their hair in advance as it will be difficult to do so for the next 24 hours due to the dressing. After the biopsy, strenuous activity of the arm on the same side, swimming and aerobic exercise should be avoided for 2 to 3 days. Routine light housework and office work should not be a problem.
Dr Niketa Choitai, Senior Consultant Radiologist, RadLink Diagnostic Imaging
Dr Niketa Chotai: The choice of biopsy modality depends on the imaging method that best visualises the lesion. If the lesion is clearly visible on multiple modalities (e.g., mammogram, ultrasound, or MRI), ultrasound is generally preferred because it offers better patient comfort and is more cost-effective.
Microcalcifications are typically best visualised on mammograms, making mammogram-guided biopsy the preferred method for such cases. Breast masses that are well seen on ultrasound should be biopsied under ultrasound guidance. However, lesions that are only visible on MRI, without a clear correlate on mammogram or ultrasound, would require MRI-guided biopsy.
MRI-guided biopsy involves specialized equipment, advanced skills, and is more expensive, making it less commonly performed. It is usually reserved for lesions that can only be identified on MRI. Together with your physician, we will determine the best approach tailored to your diagnosis.
This article was developed with contributions from Dr Evan Woo (Evan Woo Breast & Plastic Surgery) and the radiologists at RadLink.
The Breast Cancer & Lymphoema Centre
Website: breastcancerclinic.com.sg
www.evanwooplasticsurgery.com
Tel: +65 6734 1213
WhatsApp: +65 8808 1213
Address: 101 Irrawaddy Road, #14-05/06,
Royal Square Medical Centre
Singapore S329565
