Thuy discovered a hard lump and changes in her right breast, along with discomfort. A diagnosis in Singapore confirmed early-stage, localized breast cancer. Due to surgical costs being three times higher in Singapore than in Vietnam, and her diagnosis occurring close to Tet, she chose to return to Vietnam for treatment.

Ultrasound and mammography at Tam Anh General Hospital, TP HCM, revealed microcalcifications along the milk ducts in Thuy's right breast, indicating early-stage breast cancer. Her left breast also showed suspicious lesions, though at a low grade.

Thuy had breast implants 10 years prior. Doctor Do Anh Tuan, from the Department of Oncology Surgery at the Oncology Center, noted a 1,5 cm lymph node in her right armpit. A fine needle aspiration cytology (FNAC) guided by ultrasound was performed to check for cancer metastasis. The results showed the lymph nodes were benign.

The medical team decided on a skin-sparing right mastectomy, combined with a sentinel lymph node biopsy to assess cancer invasion. Concurrently, Thuy underwent a prophylactic left mastectomy, with her breast implants preserved post-surgery to maintain breast symmetry.

Thuy for a follow-up visit with Doctor Tuan at Tam Anh General Hospital. *Photo: Trung Vu*

Doctor Tuan explained that the surgery presented challenges because breast implants altered the anatomical structure of the breast, impacting the ability to accurately assess the extent of the lesion. Nevertheless, he successfully dissected and completely removed the cancerous breast tissue while preserving the implants. Thuy recovered well after the operation and was discharged two days later.

One week after surgery, results confirmed multifocal ductal carcinoma in situ, with the largest lesion measuring 6 cm and showing no invasion. Thuy was prescribed adjuvant radiation therapy to eradicate the cancer, avoiding chemotherapy.

Doctor Tuan (right) performing surgery on Thuy. *Photo: Tam Anh General Hospital*

Ductal carcinoma in situ often presents without clear symptoms and is primarily detected through microcalcifications visible on mammograms. Early diagnosis significantly increases the chances of a cure and minimizes the impact on a patient's quality of life.

Doctor Tuan advises women aged 40 and older, particularly those with a family history of breast cancer, to undergo regular breast examinations. This practice facilitates the early detection of lesions and allows for timely intervention. Individuals with breast implants should proactively inform their doctors to ensure appropriate screening methods are chosen, as implants can obscure glandular tissue and reduce the ability to detect abnormalities on mammograms.

Minh Tam

*Patient's name has been changed*