S'pore surgeon on how she came to be a breast expert

SINGAPORE - As a child, Dr Felicia Tan, 35, loved animals and wanted to be a vet to nurse sick animals back to health.

This changed after a traumatic car accident killed her mother when she was only 11 years old.

At the accident and emergency department of Alexandra Hospital, she witnessed doctors and nurses trying in vain to resuscitate her mother, then a 35-year-old secretary.

Dr Tan recalled: "I could not recognise her as she was so badly smashed up and there was blood everywhere. Things were very chaotic.

"I knew, at that very moment, that I wanted to be a doctor. I wanted to be involved in saving lives."

While studying medicine at National University of Singapore, she found that she enjoyed surgery because it was simply "you see a lump, you take it out, and the patient gets well".

She received her post-graduate training as a general surgeon at the National Cancer Centre Singapore and the Singapore General Hospital. She then chose to sub-specialise in breast surgery, as she could relate to breast issues as a woman.

She worked at KK Women's and Children's Hospital (KKH) for two years before joining Raffles Hospital for another two years.

In 2012, she started her own surgical group practice, FeM Surgery, with clinics in Mount Elizabeth Hospital and Mount Elizabeth Novena Hospital.

The general and breast surgeon is a visiting consultant at Fortis Surgical Hospital, Thomson Medical Centre and KKH.

In 2011, she pioneered a procedure to help surgeons locate breast lumps that cannot be seen and felt through the flesh, as well as plan the ideal way to remove them while conserving as much healthy breast tissue as possible.

Her husband, Dr Tan Yu-Meng, is a hepatobiliary and cancer surgeon at FeM Surgery. They often operate and travel together for work.

They have a seven-year-old daughter and a four-year-old son.

I sub-specialise in breast surgery because...

As a woman, I fully empathise with my patients from the perspectives of a mother, a wife and a daughter.

I can relate to painful breasts, lactation woes and the notion of having surgery done to the breast.

Women are able to open up to me about their breast problems and I, in turn, feel comfortable treating them and discussing issues relating to this aspect of their sexuality.

The breasts are fascinating because...

They function as important glands that produce milk to feed babies but even more importantly, to most women and men, they are symbols of sexual attractiveness and femininity.

My job involves removing diseased parts of the breasts and addressing the cosmetic outcome at the same time.

One little known fact about breast surgery is...

Most types of surgery will not cause deformity to the breasts, especially for keyhole surgery that is done through small incisions.

If I were to give an analogy for what I do, I would be...

An ethical professional hacker.

A hacker has the highest level of understanding of computer systems. Similarly, I understand every detail and aspect of the breasts and am trained to assess any intrusions in the form of diseases.

My job is to detect and remove these intrusions swiftly.

A typical day for me...

Starts at 7am. I usually skip breakfast and head to one - or up to four - private hospitals to do ward rounds to check on my patients.

Then, I run outpatient clinics from 9am till 6pm, usually with short operations and procedures interspersed throughout the day.

My major operations begin in the evenings and continue until late at night. Dinner is usually eaten outside at about 10pm, so I get home at about midnight.

I sleep at about 1am or 2am after catching up on some reading and answering e-mail.

I try to spend weekends with my family, doing activities such as swimming, cycling, taking walks in the parks and chilling out at new cafes.

I have come across all types of cases...

From girls as young as six years old to women who are more than 100. Their problems range from benign and cancerous breast diseases, early asymptomatic breast cancers to fungating huge tumours. I also see men with similar issues.

One case stood out for me in the past few weeks. A 35-year-old woman who had been diagnosed with breast cancer before giving birth to twins was told to delay cancer treatment as the disease was still in its early stages.

But in the short span of six weeks, the tumour had grown to the size of an orange and the cancer had spread to her liver, lungs and bone.

Doctors need to recognise the importance of studying the molecular characteristics of individual tumours when treating patients.

I love patients who are...

Positive and who trust me. They tend to be the ones who do very well after treatment, with fewer complications and faster recovery.

Patients who get my goat are...

None, really. I understand that everyone has different needs and expectations. It is my job to empathise with them and treat them to the best of my ability.

Patients get to choose the doctor they want to treat them, not the other way around.

Things that put a smile on my face are...

Grateful patients who thank me after a successful operation and who appreciate the many sacrifices that surgeons make for their patients.

It breaks my heart when...

I see patients who are dying from cancer because of a lack of knowledge about the disease and a lack of medical care.

My best tip...

Early detection is your best protection against breast cancer.

You should examine your breasts once every month with water and soap when you are taking a shower, about seven to 10 days after your last menstrual period.

The method I favour involves moving the pads of your fingers around each breast in a circular pattern, from the outside to the centre, covering the entire breast and armpit area.

Check both breasts for any lumps, thickening or hardened knots.

In addition, visually inspect your breasts with your arms at your sides and with your arms raised overhead.

joanchew@sph.com.sg

This article was first published on June 19, 2014.
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