From uncertainty to answers: Why coordinated breast assessment matters

From uncertainty to answers: Why coordinated breast assessment matters 23 Sep 2026 10:10AM When a breast screening raises questions, close coordination between specialists can help bring clarity and guide the next steps in care. When 45-year-old business analyst Abby Koh* went for her annual health screening in December 2025, she had no reason to suspect anything was wrong. She had not noticed a lump or any other unusual changes.However, her mammogram detected a cluster of tiny calcium deposits, known as calcifications, in the upper part of her right breast. Ms Koh made an appointment with Dr Esther Chuwa, a senior consultant and breast surgeon at Solis Breast Care and Surgery Centre, for further assessment. She did not expect her appointment to be brought forward to just two days later, after Solis requested and reviewed her screening images and report. “I was a little worried,” said the mother of two. “My appointment was originally set for two months out.”Three days after meeting Dr Chuwa, Ms Koh underwent a biopsy at Solis’ partner Luma Women’s Imaging Centre. The biopsy revealed atypical lobular hyperplasia (ALH), an abnormal growth of cells in the breast lobules that warranted further assessment to check for any associated or more significant abnormalities and determine whether further management was needed.What followed was a series of investigations and clinical decisions involving surgery, radiology and pathology – eventually uncovering an invasive cancer that had not been evident at the outset.“From my first appointment and biopsy to the surgery, the whole process went by in a flash,” said Ms Koh. “Dr Chuwa and her team were incredibly efficient and on top of everything.” “FOR ANY CANCER, TIMELY DIAGNOSIS AND TREATMENT ARE KEY TO LESS COMPLICATED TREATMENTS, BETTER QUALITY OF LIFE AND BETTER OUTCOMES.” FROM ASSESSMENT TO TREATMENT: HOW BREAST CARE COMES TOGETHERSolis​Specialist assessment of breast symptoms and abnormal findings Diagnosis and management of breast conditions Personalised treatment planning Breast surgery, including lumpectomy and mastectomy Breast reconstruction and oncoplastic surgery, where appropriate Weekly multidisciplinary tumour board (MDT) discussions to support coordinated care and treatment planning Post-care support​LumaDiagnostic breast imaging, including 3D mammography, ultrasound and MRI Image-guided breast biopsies Pathology services, including frozen-section assessment Day surgery GETTING A CLEARER PICTURE After the biopsy showed ALH, Dr Chuwa recommended that Ms Koh undergo magnetic resonance imaging (MRI) at Luma to assess the extent of the abnormality and look for other areas of concern.“MRI can provide a more comprehensive view of the breast and surrounding tissue, offering additional information that may help doctors assess the extent of an abnormality or clarify findings when needed,” said Dr Chuwa.According to Dr Eugene Ong, a consultant radiologist and imaging director at Luma, the MRI showed that the abnormality was confined to the area identified on the mammogram, with no signs of disease elsewhere in the breast. This information helped guide the team’s surgical planning.Ms Koh was scheduled for surgery to remove the affected tissue, with partial breast reconstruction performed at the same time. “BREAST SURGEONS HAVE THE OPPORTUNITY TO DISCUSS IMAGING FINDINGS DIRECTLY WITH OUR RADIOLOGISTS AND PLAN THE SURGERY TOGETHER.”– DR EUGENE ONG, CONSULTANT RADIOLOGIST AND IMAGING DIRECTOR, LUMA WOMEN’S IMAGING CENTRE WHEN DECISIONS ARE MADE IN REAL TIME Before Ms Koh underwent surgery, two guide wires were inserted into her breast under local anaesthesia and mammographic guidance to mark the area for removal.“The close proximity of the mammography suite to the operating room reduces the likelihood of the localising wires shifting position,” said Dr Ong.Once the abnormal tissue was removed, it was X-rayed to confirm that the targeted calcifications were present in the excised tissue.During breast-conserving surgery, the surgeon aims to remove the abnormal area along with a rim of surrounding tissue. The edges of the excised tissue, known as surgical margins, can be assessed while the patient is still in the operating theatre.At Luma, pathologist Professor Tan Puay Hoon examines these margins in the frozen-section laboratory across the corridor from the operating room. If cancer cells are found at or close to the edge of the specimen – known as a positive margin – the surgeon will remove additional tissue during the operation. If the margins are clear, the remainder of the operation can proceed as planned.Ms Koh had her surgery at Luma’s day surgery operating theatre, where she was able to recover and return home on the same day. “REAL-TIME COMMUNICATION BETWEEN THE PATHOLOGIST AND SURGEON HELPS ACHIEVE CLEAR SURGICAL MARGINS AND REDUCES THE LIKELIHOOD OF THE PATIENT REQUIRING A SECOND OPERATION TO REMOVE RESIDUAL DISEASE.”– PROF TAN PUAY HOON, PATHOLOGIST, LUMA WOMEN’S MEDICAL CENTRE The final histology of the excised breast tissue showed that Ms Koh had Stage 1 invasive lobular carcinoma. Reading the post-surgery report was difficult for her and her husband, she recalled. “Dr Chuwa’s constant positivity helped lift the mood, reminding us that Stage 1 is very early and manageable.”Dr Chuwa walked Ms Koh and her husband through the available treatment options and recommended radiotherapy and a consultation with an oncologist. Her team then coordinated Ms Koh’s treatment with the respective specialists and guided her through her recovery. Solis and Luma work across breast surgery, diagnostic imaging and pathology, allowing specialists to coordinate assessment and treatment at different stages of a patient’s care. Despite the diagnosis, maintaining a sense of normality for her family remained important to Ms Koh. Just three days after her day surgery, Ms Koh was back on the sidelines watching her two sons play back-to-back football matches.“My husband thought I should be resting at home, but I wanted to be there cheering for them like I always do,” she said. “Keeping up with our normal family routine is what keeps us all grounded and moving forward.”Ms Koh has since completed radiotherapy and continues to see Dr Chuwa for regular follow-up checks.Looking back, what she valued was not having to navigate every stage of her diagnosis and treatment across multiple locations. She said: “It was a challenging period, but having my care coordinated in one place took some of the stress out of the experience. I’m grateful to the team for their support throughout.”*The patient’s name has been changed to protect her privacy. Published: 23 Sept 2026 Photos: Mediacorp Studio 3, Solis​ WHEN YOU HAVE QUESTIONS, START WITH AN ASSESSMENT​​ Whether you have noticed a change in your breast or received an abnormal screening result, Solis and Luma can help clarify your next steps.​ FIND OUT MORE​