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Breast Cancer

DSO’s Breast Surgeons engage in clinical, translational and lab-based research on topics related to breast surgery and breast cancer. They collaborate closely with the multi-disciplinary breast cancer research team within NCCS and beyond.

One such collaboration is with the Saw Swee Hock School of Public Health titled The Singapore Breast Cancer Cohort Project. It aims to identify all patients diagnoses/treated at public hospitals in Singapore, evaluate important genetic and environmental risk factors in breast cancer and identify new genetic prognostic markers in the disease.

On the surgical front, precise characterization of axillary sentinel node locations and their relative predictive values is described and being explored by our surgeons. Potentially, a novel predictive model may reduce the need for axillary nodal dissection for patients needing a mastectomy for breast cancer. Prospective trials for new tracer techniques in sentinel node biopsies are also underway.

As the only institution in Singapore with an intraoperative radiation therapy device (Intrabeam), we provide intraoperative radiation therapy (IORT) as a clinical service. We also add to the current knowledge by having 2 ongoing clinical trials that explore the safety of IORT in extended indications, including its role in treating DCIS.

We work closely on various projects with the scientists in our NCCS labs, exploring the tumour microenvironment of breast cancer and developing cell lines that may shed light on predictive markers in neoadjuvant therapies for the breast. Recent successful work on fibroepithelial lesions identified a recurrent mutation within fibroadenomata, associated with dysregulated estrogen signaling, also found in uterine fibroids suggests a common genetic basis of these 2 benign tumours common in women. Sequencing of fibroadenomas and a range of phyllodes tumours demonstrated common mutations, providing insights into the molecular pathogenesis of breast fibroepithelial tumors, with potential clinical implications.