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Article ; Online: Encapsulated papillary carcinoma of the breast: An institutional case series and literature review.

Tan, Hiang Jin / Tan, Puay Hoon / Leong, Lester Chee Hao / Tan, Veronique Kiak Mien / Tan, Benita Kiat Tee / Lim, Sue Zann / Preetha, Madhukumar / Wong, Chow Yin / Yong, Wei Sean / Sim, Yirong

Cancer medicine

2023 Volume 12, Issue 10, Page(s) 11408–11416

Abstract: Background: Encapsulated papillary carcinoma of the breast is rare, making difficult diagnosis and resulting in patients undergoing excision biopsy before definitive surgery. Evidence-based guidelines are sparse. We would like to further elucidate the ... ...

Abstract	Background: Encapsulated papillary carcinoma of the breast is rare, making difficult diagnosis and resulting in patients undergoing excision biopsy before definitive surgery. Evidence-based guidelines are sparse. We would like to further elucidate the clinicopathological, treatment and survival outcomes. Materials and methods: 54 patients identified, with a median follow up duration of 48 months. Patients' demographics, radiological and clinicopathological characteristics, treatment, adjuvant therapies as well as survival data were analysed. Results: 18 (33.3%) cases were pure EPC, 12 (22.2%) were EPC associated with ductal carcinoma in situ (DCIS) and 24 (44.4%) cases had concurrent invasive ductal carcinoma. EPCs were more likely to present as a solid-cystic mass on sonography (63.8%), regular-shaped (oval or round) (97.9%), lack spiculations (95.7%) and lack suspicious microcalcifications (95.6%). Median tumour size was largest in the EPC with IDC group (18.5 mm). 2 patients developed loco-regional recurrence. Overall survival is good for EPCs of all subtypes. Conclusion: EPC is a rare tumour with excellent prognosis.
MeSH term(s)	Humans ; Female ; Carcinoma, Papillary/surgery ; Carcinoma, Papillary/pathology ; Breast/pathology ; Carcinoma in Situ ; Carcinoma, Intraductal, Noninfiltrating/pathology ; Prognosis ; Breast Neoplasms/diagnosis ; Breast Neoplasms/therapy ; Carcinoma, Ductal, Breast/pathology ; Retrospective Studies
Language	English
Publishing date	2023-03-31
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	2659751-2
ISSN	2045-7634 ; 2045-7634
ISSN (online)	2045-7634
ISSN	2045-7634
DOI	10.1002/cam4.5855
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Article ; Online: The effects of a video-based education in women with newly diagnosed breast cancer in Singapore.

Tan, May Leng / Lee, Kim Hua / Yong, Wei Sean / Rodgers, Cheryl

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer

2018 Volume 26, Issue 11, Page(s) 3891–3897

Abstract: Purpose: The purpose of this study was to evaluate the impact of an educational video among women who were newly diagnosed with breast cancer on knowledge, anxiety, and satisfaction with their surgical decision.: Methods: A pre-post-test design was ... ...

Abstract	Purpose: The purpose of this study was to evaluate the impact of an educational video among women who were newly diagnosed with breast cancer on knowledge, anxiety, and satisfaction with their surgical decision. Methods: A pre-post-test design was used to evaluate knowledge, anxiety, and satisfaction levels with decision-making regarding surgery among women with breast cancer. A purposive sampling strategy was implemented to compare outcomes of newly diagnosed breast cancer women who received standard of care that included breast care nurse counseling sessions and written materials to women who received standard of care plus a supplement educational video. Knowledge and anxiety scores were collected at baseline and 2 weeks post-operatively. Satisfaction with decision (SWD) on the nature of surgery was gathered 2 weeks after surgery. Results: Sixty-two subjects were recruited in a Singapore tertiary cancer center with a cohort of 32 women in the non-video group and 30 women in the video group. There was a statistically significant interaction effect of group and time (p = .008), wherein knowledge increased for both groups, although the increase was steeper for the video group. Both groups had significantly lower anxiety at post-implementation compared to pre-implementation (p < .001). There were no differences in SWD scores in both groups. Conclusions: Use of an additional video-based education significantly increased breast cancer knowledge levels among women in the educational video group. Nurses and healthcare professionals should focus on identifying individual informational needs based on surgical options to provide personalize care and transfer the necessary knowledge in empowering woman's decision-making process on her nature of breast surgery.
MeSH term(s)	Adult ; Anxiety/epidemiology ; Attitude to Health ; Breast Neoplasms/diagnosis ; Breast Neoplasms/epidemiology ; Breast Neoplasms/psychology ; Breast Neoplasms/surgery ; Counseling/methods ; Decision Making ; Female ; Humans ; Knowledge ; Mastectomy/education ; Mastectomy/psychology ; Mastectomy/statistics & numerical data ; Middle Aged ; Patient Education as Topic/methods ; Patient Satisfaction/statistics & numerical data ; Singapore/epidemiology ; Standard of Care ; Teaching Materials ; Video Recording
Language	English
Publishing date	2018-05-18
Publishing country	Germany
Document type	Controlled Clinical Trial ; Journal Article
ZDB-ID	1134446-5
ISSN	1433-7339 ; 0941-4355
ISSN (online)	1433-7339
ISSN	0941-4355
DOI	10.1007/s00520-018-4258-2
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Article ; Online: Breast-related extranodal Rosai-Dorfman disease presenting as subcutaneous masses with thick hyperechoic rim, with review of the literature.

Choo, Peter Zhi Qing / Loh, Alwin Hwai Liang / Selvarajan, Sathiyamoorthy / Tan, Puay Hoon / Tan, Veronique Kiak Mien / Yong, Wei Sean / Leong, Lester Chee Hao

The breast journal

2021 Volume 27, Issue 12, Page(s) 883–886

Abstract: Rosai-Dorfman disease (RDD) is a rare, idiopathic histiocytic proliferative disorder. We report two cases of RDD related to the breast which showed common distinctive imaging characteristics which can help facilitate accurate diagnosis and appropriate ... ...

Abstract	Rosai-Dorfman disease (RDD) is a rare, idiopathic histiocytic proliferative disorder. We report two cases of RDD related to the breast which showed common distinctive imaging characteristics which can help facilitate accurate diagnosis and appropriate management.
MeSH term(s)	Breast/diagnostic imaging ; Breast Diseases/diagnostic imaging ; Breast Neoplasms/diagnostic imaging ; Female ; Histiocytosis, Sinus/diagnostic imaging ; Humans
Language	English
Publishing date	2021-08-31
Publishing country	United States
Document type	Case Reports ; Review
ZDB-ID	1289960-4
ISSN	1524-4741 ; 1075-122X
ISSN (online)	1524-4741
ISSN	1075-122X
DOI	10.1111/tbj.14286
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Article: Tuesdays with Mrs Fox

Tan Yong Wei, Sean

Balint Journal

2015 Volume 16, Issue 04, Page(s) 109–114

Language	English
Publishing date	2015-12-01
Publisher	© Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2072320-9
ISSN	1439-9008 ; 1439-5142
ISSN (online)	1439-9008
ISSN	1439-5142
DOI	10.1055/s-0035-1565197
Database	Thieme publisher's database

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Article ; Online: Impact of Subsidy on the Use of Personalized Medicine in Breast Cancer.

Lim, Jue Tao / Koh, Jemima Jia En / Ho, Peh Joo / Liu, Jenny / Lim, Swee Ho / Tan, Ern Yu / Tan, Benita Kiat Tee / Tan, Veronique Kiak Mien / Tan, Su Ming / Yong, Wei Sean / Hartman, Mikael / Chen, Cynthia

Value in health regional issues

2022 Volume 29, Page(s) 108–115

Abstract: Objectives: Advances in adjuvant therapy have led to increased survival rates after cancer prognosis. Herceptin, a targeted therapy, had first been introduced to Singapore in 2006. We aimed to assess whether subsidies for Herceptin from 2012 will lead ... ...

Abstract	Objectives: Advances in adjuvant therapy have led to increased survival rates after cancer prognosis. Herceptin, a targeted therapy, had first been introduced to Singapore in 2006. We aimed to assess whether subsidies for Herceptin from 2012 will lead to changes in uptake among HER2-positive patients by socioeconomic groups. Methods: Random-intercept logistic regression was used to model diagnostic test and Herceptin uptake using the Singapore Breast Cancer Cohort from 2006 to 2018, adjusting for covariates such as education, housing type, and marital status before and after subsidies. Interrupted time series analysis was used to evaluate the impact of Herceptin subsidy on treatment uptake. Concentration index was also computed by ethnicity and education to measure inequality in uptake. Results: We found that the odds of diagnostic testing were not associated with socioeconomic factors. Nevertheless, before subsidies, highest education attained (odds ratio 4.57; 95% confidence interval 1.90-11.02; P<.01) significantly increased the odds of Herceptin uptake. These odds were leveled after the introduction of subsidies to Herceptin treatment from 2012. After subsidy, we also found that Herceptin uptake increased significantly by 11.4% (95% confidence interval 3.47-19.4; P=.016). In addition, inequality of Herceptin use decreased especially among the Indians, where at least 40% were used in the higher educated group before subsidy. Conclusions: Subsidies have lowered the barriers to Herceptin uptake for marginalized individuals. Having targeted subsidies for socioeconomically disadvantaged groups may work more efficiently in providing ease of access than a blanket subsidy in Herceptin.
MeSH term(s)	Breast Neoplasms/drug therapy ; Cohort Studies ; Female ; Humans ; Precision Medicine ; Singapore ; Trastuzumab/therapeutic use
Chemical Substances	Trastuzumab (P188ANX8CK)
Language	English
Publishing date	2022-01-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	2679127-4
ISSN	2212-1102 ; 2212-1099
ISSN (online)	2212-1102
ISSN	2212-1099
DOI	10.1016/j.vhri.2021.10.002
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Article ; Online: Changing self-concept in the time of COVID-19: a close look at physician reflections on social media.

Chiam, Min / Ho, Chong Yao / Quah, Elaine / Chua, Keith Zi Yuan / Ng, Caleb Wei Hao / Lim, Elijah Gin / Tan, Javier Rui Ming / Wong, Ruth Si Man / Ong, Yun Ting / Soong, Yoke Lim / Kwek, Jin Wei / Yong, Wei Sean / Loh, Kiley Wei Jen / Lim, Crystal / Mason, Stephen / Krishna, Lalit Kumar Radha

Philosophy, ethics, and humanities in medicine : PEHM

2022 Volume 17, Issue 1, Page(s) 1

Abstract: Background: The COVID-19 pandemic has changed the healthcare landscape drastically. Stricken by sharp surges in morbidity and mortality with resource and manpower shortages confounding their efforts, the medical community has witnessed high rates of ... ...

Abstract	Background: The COVID-19 pandemic has changed the healthcare landscape drastically. Stricken by sharp surges in morbidity and mortality with resource and manpower shortages confounding their efforts, the medical community has witnessed high rates of burnout and post-traumatic stress amongst themselves. Whilst the prevailing literature has offered glimpses into their professional war, no review thus far has collated the deeply personal reflections of physicians and ascertained how their self-concept, self-esteem and perceived self-worth has altered during this crisis. Without adequate intervention, this may have profound effects on their mental and physical health, personal relationships and professional efficacy. Methods: With mentions of the coronavirus pervading social media by the millions, this paper set out to collate and thematically analyse social media posts containing first-person physician reflections on how COVID-19 affected their lives and their coping mechanisms. A consistent search strategy was employed and a PRISMA flowchart was used to map out the inclusion/exclusion criteria. Results: A total of 590 social media posts were screened, 511 evaluated, and 108 included for analysis. Salient themes identified include Disruptions to Personal Psycho-Emotional State, Disruptions to Professional Care Delivery, Concern for Family, Response from Institution, Response from Society and Coping Mechanisms. Conclusion: It is evident that the distress experienced by physicians during this time has been manifold, multi-faceted and dominantly negative. Self-concepts were distorted with weakened self-esteem and perceived self-worth observed. The Ring Theory of Personhood (RToP) was adopted to explain COVID-19's impact on physician personhood as it considers existential, individual, relational and social concepts of the self. These entwined self-concepts serve as 'compensatory' to one another, with coping mechanisms buffering and fortifying the physician's overall personhood. With healthcare institutions playing a vital role in providing timely and targeted support, it was further proposed that a comprehensive assessment tool based on the RToP could be developed to detect at-risk physicians and evaluate the presence and effectiveness of established support structures.
MeSH term(s)	COVID-19 ; Humans ; Pandemics ; Physicians ; SARS-CoV-2 ; Self Concept ; Social Media
Language	English
Publishing date	2022-01-26
Publishing country	England
Document type	Journal Article
ZDB-ID	2229777-7
ISSN	1747-5341 ; 1747-5341
ISSN (online)	1747-5341
ISSN	1747-5341
DOI	10.1186/s13010-021-00113-x
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Article: The Impact of Statin Use and Breast Cancer Recurrence - A Retrospective Study in Singapore.

Sim, Yirong / Lim, Cindy / Phyu, Nitar / Tan, Kiat Tee Benita / Chew, Lita Sui Tjien / Wong, Chow Yin / Madhukumar, Preetha / Yong, Wei Sean / Lim, Sue Zann / Hamzah, Julie Liana Bte / Tan, Si Ying / Chay, Wen Yee / Wong, Fuh Yong / Tan, Puay Hoon / Tan, Veronique Kiak-Mien

Frontiers in oncology

2022 Volume 12, Page(s) 835320

Abstract: Introduction: Statins, HMG-CoA reductase inhibitors, are commonly used cholesterol-lowering medications which are also increasingly recognized to have anti-cancer properties for various cancers, including breast cancer. Most clinical evidence supports a ...

Abstract	Introduction: Statins, HMG-CoA reductase inhibitors, are commonly used cholesterol-lowering medications which are also increasingly recognized to have anti-cancer properties for various cancers, including breast cancer. Most clinical evidence supports a protective effect of statin on reducing breast cancer recurrence, particularly in hormone-receptor positive breast cancers.This study seeks to study the impact of statin use on breast cancer recurrence in an Asian population. Methods: This is a retrospective study of patients diagnosed with breast cancer at the National Cancer Centre and Singapore General Hospital from 2005-2015. Statin use was defined as use after surgery. Associations between statin use, breast cancer recurrence and overall survival were estimated using Cox proportional hazards regression with adjustment for age, TNM stage, grade, ER/HER2 status, and co-morbidities. Associations between statin-use and disease-specific survival were estimated using competing risks regression. Results: A total of 7858 females with breast cancer were studied, 1353(17.2%) were statin users, 6505(82.8%) were non-statin users, with a median follow-up of 8.67 years. Distribution of cancer stage, histology, molecular subtypes and grades were similar in both groups. Estrogen receptor(ER) positive (HR 0.57,95%CI 0.43-0.76,p<0.001) and HER2 negative (HR 0.74,95%CI 0.57-0.96,p=0.026) invasive cancers had a lower risk of recurrence in statin users. Statin users trended towards a long term recurrence-risk reduction (all subtypes,HR 0.48,p=0.002; ER-, HR 0.34,p=0.036; HER2+,HR 0.10,p=0.002). The risk-reduction benefit is not appreciated in statin users with DCIS, possibly due to small recurrence event numbers. Disease-specific survival benefit was seen in statin users with ER+ cancers (adjusted SHR 0.71,95%CI 0.53-0.96,p=0.027), especially ER+ invasive cancers (adjusted SHR 0.72, 95%CI 0.53-0.97,p=0.028), but with no statistically significant benefit in overall survival for statin users (all subtypes). Conclusion: This is the first known retrospective study on the effect of statin use and breast cancer recurrence in an Asian population. Similar to previous international studies, statin use is associated with a risk reduction in breast cancer recurrence. This is especially beneficial in patients who have ER+ and HER2- invasive breast cancer. Statin use is also associated with a reduced risk of breast cancer recurrence in all subtypes of breast cancer in the long term (>6 years post diagnosis).
Language	English
Publishing date	2022-03-31
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2022.835320
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Article: Atypical Ductal Hyperplasia of the Breast on Core Needle Biopsy: Risk of Malignant Upgrade on Surgical Excision.

Bong, Tiffany Sin Hui / Tan, Jun Kiat Thaddaeus / Ho, Juliana Teng Swan / Tan, Puay Hoon / Lau, Wing Sze / Tan, Tuan Meng / Wong, Jill Su Lin / Tan, Veronique Kiak Mien / Tan, Benita Kiat Tee / Madhukumar, Preetha / Yong, Wei Sean / Lim, Sue Zann / Wong, Chow Yin / Ong, Kong Wee / Sim, Yirong

Journal of breast cancer

2022 Volume 25, Issue 1, Page(s) 37–48

Abstract: Purpose: This study identified factors predicting malignant upgrade for atypical ductal hyperplasia (ADH) diagnosed on core-needle biopsy (CNB) and developed a nomogram to facilitate evidence-based decision making.: Methods: This retrospective ... ...

Abstract	Purpose: This study identified factors predicting malignant upgrade for atypical ductal hyperplasia (ADH) diagnosed on core-needle biopsy (CNB) and developed a nomogram to facilitate evidence-based decision making. Methods: This retrospective analysis included women diagnosed with ADH at the National Cancer Centre Singapore (NCCS) in 2010-2015. Cox proportional hazards regression was used to identify clinical, radiological, and histological factors associated with malignant upgrade. A nomogram was constructed using variables with the strongest associations in multivariate analysis. Multivariable logistic regression coefficients were used to estimate the predicted probability of upgrade for each factor combination. Results: Between 2010 and 2015, 238,122 women underwent mammographic screening under the National Breast Cancer Screening Program. Among 29,564 women recalled, 5,971 CNBs were performed. Of these, 2,876 underwent CNBs at NCCS, with 88 patients (90 lesions) diagnosed with ADH and 26 lesions upgraded to breast malignancy on excision biopsy. In univariate analysis, factors associated with malignant upgrade were the presence of a mass on ultrasound ( Conclusion: Our model provided good discrimination of breast cancer risk prediction (C-statistic of 0.81; 95% CI, 0.74-0.88) and selected for a subset of women at low risk (2.1%) of malignant upgrade, who may avoid surgical excision following a CNB diagnosis of ADH.
Language	English
Publishing date	2022-02-24
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	2559753-X
ISSN	2092-9900 ; 1738-6756
ISSN (online)	2092-9900
ISSN	1738-6756
DOI	10.4048/jbc.2022.25.e7
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Article ; Online: Recurrent Corynebacterium kroppenstedtii Breast Abscess in a Young Asian Female.

Goh, Zhaojing / Tan, Ai Ling / Madhukhumar, Preetha / Yong, Wei Sean

The breast journal

2015 Volume 21, Issue 4, Page(s) 431–432

MeSH term(s)	Abscess/microbiology ; Anti-Bacterial Agents/therapeutic use ; Asian Continental Ancestry Group ; Breast Diseases/drug therapy ; Breast Diseases/microbiology ; Corynebacterium/isolation & purification ; Corynebacterium Infections/microbiology ; Female ; Humans ; Young Adult
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2015-07
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1289960-4
ISSN	1524-4741 ; 1075-122X
ISSN (online)	1524-4741
ISSN	1075-122X
DOI	10.1111/tbj.12428
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Article ; Online: Male breast cancer: a Singapore perspective.

Lim, Joshua S H / Sim, Yirong / Ngeow, Joanne / Yuen, Jeanette / Tan, Veronique K M / Tan, Benita Kiat Tee / Yong, Wei-Sean / Wong, Chow Yin / Lim, Sue Zann / Hamzah, Julie Liana B / Tan, Si Ying / Wong, Fuh Yong / Madhukumar, Preetha

ANZ journal of surgery

2022 Volume 92, Issue 6, Page(s) 1440–1446

Abstract: Introduction: Male breast cancer (MBC) is rare, representing <1% of all breast cancers. Treatment recommendations have been extrapolated from trial data of female breast cancer patients. This study aims to report our institutional experience of MBC ... ...

Abstract	Introduction: Male breast cancer (MBC) is rare, representing <1% of all breast cancers. Treatment recommendations have been extrapolated from trial data of female breast cancer patients. This study aims to report our institutional experience of MBC across a 20 year period, analyse the survival outcome and prognosis of this group against female breast cancer patients treated at the same centre. Methods: Clinical, histopathological, treatment and survival data of male and female breast cancer patients treated between Jan 1999 and July 2019 at Singapore General Hospital and National Cancer Centre Singapore were identified and analysed. Results: Fifty-seven male patients were identified. The median age at diagnosis was 63 years. Majority had invasive ductal carcinoma (86%) and presented at an early disease stage: 70.2% presented as Tis/T1/T2 and 49.1% had no axillary nodal involvement. 84.2% had a simple mastectomy with either a sentinel lymph node biopsy or axillary clearance. The median follow up was 5.69 years for males and 5.83 years for females. The median survival was 11.86 years for males and 16.3 years for females. At 5 years, overall survival (OS) was 69.9% (52.3-82.1%) and disease free survival (DFS) was 62.9% (44.9-76.5%) for males compared with OS 83.8% (83.21-84.39%) and DFS 74.5% (73.91-75.09%) for females. Conclusion: MBC remains understudied. Our institutional data indicates that good long term survival in South-East Asian patients can be achieved with treatment protocols that are similar to female breast cancer. More prospective studies are required.
MeSH term(s)	Axilla/pathology ; Breast Neoplasms/pathology ; Breast Neoplasms, Male/epidemiology ; Breast Neoplasms, Male/surgery ; Disease-Free Survival ; Female ; Humans ; Lymph Node Excision/methods ; Lymphatic Metastasis ; Male ; Mastectomy ; Sentinel Lymph Node Biopsy ; Singapore/epidemiology
Language	English
Publishing date	2022-04-25
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2050749-5
ISSN	1445-2197 ; 1445-1433 ; 0004-8682
ISSN (online)	1445-2197
ISSN	1445-1433 ; 0004-8682
DOI	10.1111/ans.17737
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