Q My sister had lump (one) in her breast. Initial test indicated it was only a normal lump by a doctor at Kubang Krian Hospital (KKH) in Kota Bharu. The lump was removed few weeks ago but was confirmed by the doctor later to be cancerous and at stage one. She tried to seek a second opinion from specialists in KL yesterday but was told not possible since the doctor at KKH had not given her a report. KKH’s doctor had recommended that she remove her breast and be given chemotherapy. What is the best solution? Please advise.

LKH 8 May 2004

A Normally for university and government hospitals, an official letter to your sister’s doctor in Kubang Kerian Hospital to request for a report with the histopathology results would help. In fact, patients are also known to request for the histopathology slides to seek second opinions or even to seek treatment in other states or overseas. With this report, your sister can then, seek a second opinion elsewhere.

Perhaps, someone (such as yourself) could accompany your sister (as she may still be in shock from the news from her doctor) to discuss the situation with her doctor. It is recommended that someone always accompanies her so that the information and communication from the doctor/s  involved is clear. This is because all of a sudden your sister and the family are faced with something unexpected – as especially for the patient, she is unlikely to be able to absorb everything the doctor tells her.

Please do get in touch with the local breast cancer support network in Kota Bharu. The Breast Cancer Welfare Association based in Petaling Jaya is also on the website at:http://www.radiologymalaysia.org/breasthealth/bcwaindex.htm

As for the exact treatment that your sister needs, it will depend on the cell type of the cancer, grading and other factors. In addition, it is common for the surgeon to subsequently operate on the axillary (armpit) lymph nodes to remove them for testing (Histopathology) for spread to these nodes. This will give the final staging of the breast cancer in your sister. Therefore it is not possible to advise on the particular treatment (surgical/chemo/radiotherapy) as it is individualized to the person concerned.

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