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Thomson Specialists

Thomson Medical offers convenient access to comprehensive specialist outpatient and surgical care for women, children, and families through Thomson Specialists. Our team is dedicated to addressing your unique needs and providing tailored treatment options. Take control of your health today by booking an appointment at any of our Thomson Specialists clinics and embark on a journey towards improved well-being.

Bringing Comprehensive Specialist Care Closer To You

Thomson Women's Clinic

At Thomson Women’s Clinics, we are committed to providing modern and comprehensive care for women of all ages. Our experienced team of O&amp;G specialists is dedicated to creating a caring environment where your health and well-being are our top priorities. Our specialists provide specialised services on preventive measures, accurate diagnosis, and personalised treatment plans.Whether you need specialised care for women-related conditions or navigating the journey of childbirth, seeking support for family planning and fertility treatments, or requiring compassionate care through menopause, we are here for you.

Our Expertise

Specialists in Women’s Health

We understand that managing your health appointments around work and family commitments can be challenging. For your convenience, we provides women's health consultations beyond standard hours at multiple locations across Singapore.Extended Hours LocationsWhile all 12 of our women's health clinics operate during standard clinic hours, the following locations offer extended consultation times:Northeast<ul><li>Woodleigh: Thursday, 6pm - 9pm</li><li>Sengkang: Tuesday &amp; Friday, 5:30pm - 7:00pm</li><li>Punggol: Tuesday, Thursday &amp; Friday, 12pm - 8pm</li></ul>East<ul><li style="text-align: justify;">Tampines: Monday, 7pm - 9pm</li><li style="text-align: justify;">Katong: Wednesday, 10am - 8pm</li></ul>West<ul><li style="text-align: justify;">Jurong: Monday &amp; Thursday, 6pm - 9pm</li><li style="text-align: justify;">Bukit Batok: Monday, Thursday &amp; Friday, 6pm - 8:30pm</li><li style="text-align: justify;">Choa Chu Kang: Monday, 6pm - 8pm</li></ul>Thomson Medical is committed to providing accessible healthcare that fits your schedule.

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Thomson Women’s Clinic

Thomson Paediatric Centre

At Thomson Paediatric Centres, our unwavering commitment is to treat your child with the same level of care and dedication as we would our own. We provide children's healthcare services to alleviate every parent's concerns and ensure the well-being of our next generation. Our experienced team of Paediatricians is devoted to cultivating a caring environment where your child's health is our top priority.Besides General Paediatrics services, we also offer specialised services in Neonatology and Paediatric Cardiology. Our specialist doctors are experienced in areas such as Nutrition, Respiratory, Growth &amp; Development assessment, and Paediatric Urgent Care for babies to young children and adolescents. Trust us to be your partner in safeguarding your child's health and ensuring a compassionate and comprehensive approach to their medical needs.

Specialists in Children’s Health

Our Paediatricians

Please click on the below links for our Paediatricians' availabilities.
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 <td>Paediatricians</td>
 <td>Clinic Location</td>
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 <td>Dr Ang Ai Tin</td>
 <td><a href="https://maps.app.goo.gl/XcyrrQBgEW35Rw3f6" target="_blank">Thomson Paediatric Centre (TPC 1)</a></td>
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 <td>Dr Eugene Han</td>
 <td><a href="https://maps.app.goo.gl/odint8UJmba6RBPbA" target="_blank">Thomson Paediatric Centre (TPC 4)</a></td>
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 <td>Dr Grace Lim</td>
 <td><a href="https://maps.app.goo.gl/obLpwmEFumMjMzRz8" target="_blank">Thomson Specialists (Woodleigh)</a> </td>
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 <td>Dr Kenneth Chua Yong Yeow</td>
 <td><a href="https://maps.app.goo.gl/Kp3TYWxzLXkfkkPYA" target="_blank">Thomson Paediatric Centre (Punggol)</a></td>
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 <td>Dr Leo Deng Jin</td>
 <td><a href="https://maps.app.goo.gl/NVzfb9zvkUMvvNxN8" target="_blank">Thomson Paediatric Centre (Bukit Panjang)</a></td>
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 <td>Dr Lim Yang Chern</td>
 <td><a href="https://maps.app.goo.gl/7Ex6ra4NmwHQUopS6" target="_blank">Thomson Paediatric Centre (Jurong)</a></td>
 </tr>
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 <td>Dr Ong Ian</td>
 <td><a href="https://maps.app.goo.gl/78WJoj482r35Af7T9" target="_blank">Thomson Paediatric Centre (Parkway Parade)</a></td>
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 <td>Dr Tan Kuanyang</td>
 <td><a href="https://maps.app.goo.gl/odint8UJmba6RBPbA" target="_blank">Thomson Paediatric Centre (TPC 4)</a></td>
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 <td>Dr Yang Linqi</td>
 <td><a href="https://maps.app.goo.gl/XcyrrQBgEW35Rw3f6" target="_blank">Thomson Paediatric Centre (TPC 1)</a></td>
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Refer to each paediatrician's <a href="https://www.thomsonmedical.com/centres/paediatric-centre/paediatricians-consultation-hours">consultation hours</a> for their availability.

Our Paediatricians' Leave Schedule

General Information

Your Guide to Thomson Medical

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Latest share price, financial performance, and other materials relevant to investors.Read about our <a href="https://assets.contentstack.io/v3/assets/blt5f400315f9e4f0b3/blt5a13f1dd33c615fa/651e7a9aecf48b6d54c38b23/TMG-Investor-Relations-Policy-3Sep2020.pdf?branch=uat_release_3" target="_self">Investor Relations Policy</a>For Investor Relations matters, please email us at <a href="mailto:ir@thomsonmedical.com">ir@thomsonmedical.com</a> Thomson Medical Group Limited 101 Thomson Road #20-04/05, United Square Singapore 307591 Tel: +65 6331 0188 Fax: +65 6331 0180

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<table><tbody><tr><td>Stock symbol</td><td>A50.SI</td></tr><tr><td>Listing</td><td>Singapore Exchange </td></tr><tr><td>Financial Year End</td><td>June 30</td></tr><tr><td>Total issued shares as at 30 June 2025</td><td>26,441,066,807 ordinary shares</td></tr><tr><td>Market capitalisation as at 30 June 2025</td><td>S$1.1 billion</td></tr></tbody></table>

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Prevalence: Most common abnormal finding in cervical cancer screeningSignificance: High-risk HPV types (especially 16, 18) present in ~13% of women globallyAction: Triggers co-testing with Pap smear and follow-up protocolsPrimary Associated Cancers:<ul><li>Cervical Cancer (99% HPV-associated)<ul><li>HPV 16/18: ~70% of all cervical cancers</li><li>HPV 31/33/45/52/58: Additional high-risk types</li><li>Progression timeline: 10-20 years from infection to invasive cancer</li></ul></li><li>Secondary Associated Cancers:<ul><li>Vaginal Cancer (70% HPV-associated)</li><li>Vulvar Cancer (40% HPV-associated)</li><li>Anal Cancer (90% HPV-associated)</li><li>Oropharyngeal Cancer (Increasing incidence, especially HPV-16)</li></ul></li><li>Precancerous Conditions:<ul><li>CIN 1/2/3 (Cervical Intraepithelial Neoplasia)</li><li>VIN (Vulvar Intraepithelial Neoplasia)</li><li>VAIN (Vaginal Intraepithelial Neoplasia)</li></ul></li></ul>

HPV (16/18/32/33/45/52/58) Positive Results

Prevalence: ASCUS found in ~5% of Pap tests; LSIL in ~2-3%Significance: Indicates cellular changes requiring monitoring or interventionAction: Reflex HPV testing for ASCUS; colposcopy consideration for persistent abnormalities<ul><li>ASCUS (Atypical Squamous Cells of Undetermined Significance):<ul><li>5-17% risk of high-grade lesions (CIN 2+)</li><li>0.1-0.2% risk of invasive cervical cancer</li><li>Often associated with HPV infection, inflammation, or hormonal changes</li></ul></li><li>LSIL (Low-grade Squamous Intraepithelial Lesion):<ul><li>12-16% risk of progression to high-grade lesions</li><li>Correlates with CIN 1</li><li>60-90% associated with high-risk HPV</li></ul></li><li>HSIL (High-grade Squamous Intraepithelial Lesion):<ul><li>84-97% associated with CIN 2/3</li><li>1-2% risk of concurrent invasive cervical cancer</li><li>30% risk of progression to invasive cancer if untreated</li></ul></li></ul>

Abnormal Pap Smear Results (ASCUS/LSIL)

Prevalence: Affects ~10% of postmenopausal womenSignificance: Most common presenting symptom of endometrial cancer (90% of cases)Action: Urgent endometrial assessment via biopsy or imaging<ul><li>Primary Associated Cancer:<ul><li>Endometrial Cancer (Type I &amp; II)&nbsp;<ul><li>90% of endometrial cancers present with abnormal bleeding</li><li>5-10% of postmenopausal bleeding cases are due to endometrial cancer</li><li>Risk increases with age, obesity, diabetes</li></ul></li><li>Secondary Associations:<ul><li>Cervical Cancer (Advanced stages)</li><li>Vaginal Cancer</li><li>Ovarian Cancer (Estrogen-producing tumors)</li></ul></li></ul></li><li>Benign Associated Conditions:<ul><li>Endometrial hyperplasia (25% of cases)</li><li>Endometrial polyps (15-25%)</li><li>Cervical polyps</li><li>Atrophic vaginitis (Most common cause)</li><li>Hormone replacement therapy effects</li></ul></li></ul>

Postmenopausal Bleeding

Prevalence: Found in ~1-3% of routine screening in postmenopausal womenSignificance: Primary tumor marker for ovarian cancer, though not cancer-specificAction: Combined with imaging and clinical assessment for further evaluationRange: The normal range of CA125 is 0-35 units/ml. While a CA125 level over 35 units/ml may indicate cancer, this is not a sure-fire way to diagnose cancer as high levels of CA125 can be caused by other conditions too, it is just a potential indicator for doctors to conduct further tests to make a diagnosis.Primary Conditions Associated:<ul><li>Primary Associated Cancer:<ul><li>Epithelial Ovarian Cancer<ul><li>Elevated in 85% of advanced ovarian cancers</li><li>Only 50% of early-stage ovarian cancers</li><li>Higher levels correlate with advanced disease</li></ul></li></ul></li><li>Secondary Associated Cancers:<ul><li>Fallopian Tube Cancer</li><li>Primary Peritoneal Cancer</li><li>Endometrial Cancer (Advanced stages)</li><li>Breast Cancer (Metastatic)</li></ul></li><li>Benign Associated Conditions:<ul><li>Endometriosis (Can significantly elevate CA-125)</li><li>Ovarian cysts (Functional or benign)</li><li>Pelvic inflammatory disease</li><li>Liver disease</li><li>Heart failure</li><li>Menstruation (Mild elevation)</li></ul></li></ul>

Elevated CA-125

Prevalence: Found in approximately 1-2% of routine screening in postmenopausal women; less commonly elevated in premenopausal womenSignificance: Complementary biomarker to CA125 for ovarian cancer detection; more specific than CA125 for malignancy (less frequently elevated in benign conditions)Action: Used in combination with CA125 in risk algorithms (such as ROMA - Risk of Ovarian Malignancy Algorithm) for stratifying patients with pelvic masses; also valuable for monitoring treatment response and disease recurrenceRange: The normal range of HE4 varies by menopausal status and assay manufacturer, but generally:<ul><li>Premenopausal women: &lt;70 pmol/L</li><li>Postmenopausal women: &lt;140 pmol/L</li></ul>While elevated HE4 levels may indicate ovarian cancer, this is not definitive for diagnosis as elevated levels can occur in other conditions. It serves as an indicator for physicians to conduct comprehensive evaluation including imaging and clinical assessment.Primary Conditions Associated:Primary Associated Cancers:<ul><li>Epithelial Ovarian Cancer<ul><li>Elevated in approximately 75-80% of ovarian cancers</li><li>Particularly sensitive for serous and endometrioid subtypes</li><li>Less elevated in mucinous ovarian tumors</li><li>Higher specificity than CA125 (fewer false positives from benign conditions)</li></ul></li><li>Endometrial Cancer<ul><li>&nbsp;(Advanced stages) Elevated in 30-50% of cases, especially high-grade tumors</li></ul></li></ul>Secondary Associated Cancers:<ul><ul><li>Lung Cancer (Adenocarcinoma)</li><li>Breast Cancer (Advanced/metastatic)</li><li>Pancreatic Cancer</li><li>Gastric Cancer</li></ul></ul>&nbsp;Benign Associated Conditions:<ul><li>Renal Impairment/Chronic Kidney Disease (Most common benign cause - HE4 is cleared by kidneys)</li><li>Liver Cirrhosis/Fibrosis</li><li>Pulmonary Disease (COPD, pulmonary fibrosis)</li><li>Heart Failure</li><li>Age-related physiologic elevation (increases with age in healthy individuals)</li><li>Ovarian cysts (much less frequently than CA125)</li><li>Endometriosis (rarely elevated - major advantage over CA125)</li></ul>

HE4 (Human Epididymis Protein 4)

Prevalence: Found in approximately 0.5-1% of routine screening in general population; higher prevalence in patients with gastrointestinal symptoms or pancreatobiliary diseaseSignificance: Primary tumor marker for pancreatic cancer and biliary tract malignancies; useful for monitoring treatment response and detecting recurrence; not recommended for general population screening due to limited sensitivity and specificityAction: Used in conjunction with imaging and clinical assessment for evaluating suspected pancreatic/biliary malignancies; valuable for monitoring known cancer patients during and after treatmentRange: The normal range of CA19-9 is typically 0-37 U/mL (units per milliliter).While CA19-9 levels above 37 U/mL may indicate cancer, this is not diagnostic on its own as elevated levels can result from various benign conditions. Additionally, approximately 5-10% of the population (particularly those negative for Lewis antigen) cannot produce CA19-9, resulting in false-negative results even in the presence of cancer.&nbsp;Primary Conditions Associated:<ul><li>Primary Associated Cancers:<ul><li>Pancreatic Adenocarcinoma<ul><li>Elevated in 70-85% of pancreatic cancers</li><li>Only 50-60% sensitivity in early-stage disease</li><li>Higher levels (&gt;1000 U/mL) often correlate with advanced/metastatic disease</li><li>Undetectable in Lewis antigen-negative patients (5-10% of population)</li></ul></li><li>Cholangiocarcinoma (Bile Duct Cancer)<ul><li>Elevated in 50-85% of cases</li><li>Particularly useful for intrahepatic cholangiocarcinoma</li></ul></li></ul></li><li>Secondary Associated Cancers:<ul><li>Gastric (Stomach) Cancer</li><li>Colorectal Cancer (Advanced stages)</li><li>Hepatocellular Carcinoma (Liver Cancer)</li><li>Ovarian Cancer (Mucinous type)</li><li>Esophageal Cancer</li><li>Lung Cancer (Adenocarcinoma)</li></ul></li></ul>&nbsp;Benign Associated Conditions:<ul><li>Cholestasis/Biliary Obstruction (Can cause very high elevations &gt;1000 U/mL)<ul><li>Gallstones</li><li>Bile duct strictures</li><li>Primary sclerosing cholangitis</li></ul></li><li>Pancreatitis (Acute or chronic)</li><li>Liver Disease<ul><li>Cirrhosis</li><li>Hepatitis</li><li>Liver fibrosis</li></ul></li><li>Inflammatory Bowel Disease<ul><li>Crohn's disease</li><li>Ulcerative colitis</li></ul></li><li>Cystic Fibrosis</li><li>Hypothyroidism</li><li>Renal Failure</li></ul>

Elevated CA19-9 (Carbohydrate Antigen 19-9)

Abnormal Gynecological Test Results: Key Indicators of Risk

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Receiving an abnormal Pap smear or a positive results can be overwhelming and anxiety-provoking for many patients. However, understanding what these results mean is crucial for making informed decisions about your health.&nbsp;An abnormal result doesn't necessarily mean you have cancer; rather, it indicates that further investigation is needed to assess your risk and determine the best course of action.Following an abnormal result, your healthcare provider may recommend additional procedures such as colposcopy, targeted biopsies to obtain tissue samples for analysis, specialized imaging like MRI of the cervix to better evaluate the extent of any abnormal changes.

Uterine_Cancer_Screening.png

Abnormal Women's Test and Scans Results Guide

Dr Wang Junjie (JJ) is a Senior Consultant Obstetrician and Gynaecologist at <a href="https://www.thomsonmedical.com/centres/women-clinic/novena" target="_blank">Thomson Women's Clinic &amp; Cancer Surgery</a> in Thomson Medical Centre, Novena.&nbsp;From 2022 to 2025, he served as Head of the Department of Gynaecological Oncology at KKH, where he oversaw the founding team that established Singapore's first OncoFertility Clinic, which offers fertility preservation options for women undergoing cancer treatment.With over 17 years&nbsp; of experience in clinical services, he specialises in general&nbsp;<a href="https://www.thomsonmedical.com/speciality/obstetrics-gynaecology">obstetrics and gynaecology</a>&nbsp;(O&amp;G) and provides services including&nbsp;<a href="https://www.thomsonmedical.com/blog/pregnancy/antenatal">antenatal</a>&nbsp;and&nbsp;<a href="https://www.thomsonmedical.com/blog/postnatal">postnatal care</a>, early pregnancy care and management of various women’s conditions like menstruation issues, fibroids, and ovarian cysts.He also subspecialises in<a href="https://www.thomsonmedical.com/speciality/gynaecology/oncology">&nbsp;Gynaecological Oncology</a>&nbsp;with a clinical interest in<a href="https://www.thomsonmedical.com/speciality/minimally-invasive-surgery">&nbsp;minimally invasive surgery</a>&nbsp;(keyhole surgery) to treat gynaecological cancers, pre-invasive conditions, and general O&amp;G conditions. He is accredited to perform a range of procedures, including laparoscopic and deep pelvic surgery, vaginal natural orifice transluminal endoscopic surgery (VNOTES), hysteroscopic surgery, myomectomy, ovarian cystectomy,&nbsp;<a href="https://www.thomsonmedical.com/blog/colposcopy">colposcopy</a>, and other gynaecological surgeries.Dr Wang obtained his Bachelor of Medicine and Bachelor of Surgery (MBBS) from the National University of Singapore (NUS) in 2007. He completed his housemanship at Changi General Hospital and KK Women’s and Children’s Hospital (KKH), followed by service as a medical officer in the Singapore Armed Forces.He began specialist training in obstetrics and gynaecology at KKH, where he was named Best Registrar during his residency. He subsequently attained Membership of the Royal College of Obstetricians and Gynaecologists (MRCOG) and became a board-certified obstetrician and gynaecologist in Singapore upon passing the national exit examinations.In 2018, Dr Wang was awarded the SingHealth Health Manpower Development Plan (HMDP) Fellowship. This supported his subspecialty training in laparoscopic oncological surgery at Inselspital in Bern, Switzerland, and the Oscar Lambret Cancer Centre in Lille, France.Prior to joining private practice, he was the Head of the Gynaecological Cancer Centre at KKH, the first centre outside the United Kingdom to be recognised by the Royal College of Obstetricians and Gynaecologists (RCOG) as an accredited training centre. In recognition of his contributions, he was admitted as a Fellow of the RCOG (FRCOG).In addition to clinical work, Dr Wang is actively involved in research and medical education. His research interests include sentinel lymph node biopsy and surgical innovation in gynaecological oncology. He has presented at local and international conferences, and his work has been published in peer-reviewed medical journals.Dr Wang holds academic appointments at all three medical schools in Singapore, he is a Clinical Assistant Professor at Duke-NUS Medical School, an Adjunct Assistant Professor at the Lee Kong Chian School of Medicine (NTU), and a Clinical Lecturer at the Yong Loo Lin School of Medicine (NUS). He is also a Physician Faculty Member of the SingHealth Obstetrics and Gynaecology Residency Programme.Additionally, he’s also a Fellow of the Academy of Medicine, Singapore, and sits on the Councils of the College of Obstetricians and Gynaecologists, Singapore, and the Obstetrical and Gynaecological Society of Singapore (OGSS), where he contributes to the professional development of the speciality and its educational events.Dr Wang is accredited to perform surgical procedures at Thomson Medical Centre.

Dr Wang Junjie

Our Gynaecological Oncologist

<a href="https://shop.thomsonmedical.com/4-in-1-women-cancer-screening-dr-wang-jj/?utm_campaign=norra" target="_self">The 4-in-1 Women's Cancer Screening</a> package is designed to support women in taking proactive steps towards their reproductive health. It combines consultation, screening tests, and imaging to help detect early changes in the cervix, uterus, and ovaries.Suitable for: Women aged 21 and above (especially those with menstrual changes, family history of cancer, or who would like a routine gynaecological review)Price: $520 SGD (including GST)Available at: <a href="https://www.thomsonmedical.com/centres/women-clinic/novena?utm_campaign=storepackage">Thomson Women Clinic's Novena</a>Fasting Required?: NoConsists of:<ol><li>Consultation &amp; Examination A one-on-one session with a gynaecologist to review your health history and assess current concerns.</li><li>ThinPrep Pap Test (Pap Smear) A screening test that examines cells from the cervix to check for precancerous or abnormal changes.</li><li>HPV Test Detects the presence of high-risk Human Papillomavirus (HPV) strains that are linked to cervical cancer.</li><li>Pelvic Ultrasound Scan An imaging test that provides a view of the uterus, ovaries, and surrounding structures.</li></ol>Optional Add-On: HPV Vaccination – available at SGD $280This package helps screen for:<ul><li>Cervical cancer and precancerous changes</li><li>Uterine (endometrial) abnormalities</li><li>Ovarian cysts, fibroids, or cancer</li></ul>

Gynaecological Cancers Screen - Offered by Dr Wang Junjie

HPV (Human Papillomavirus) Testing:<ul><li>HPV Positive: Indicates presence of high-risk HPV types (16, 18, 31, 33, 42, etc.)</li><li>HPV 16/18: Highest-risk types responsible for ~70% of cervical cancers</li><li>Other high-risk types (like HPV 42): Associated with increased cancer risk</li></ul>Pap Smear Abnormalities:<ul><li>ASCUS: Atypical Squamous Cells of Undetermined Significance</li><li>LSIL: Low-grade Squamous Intraepithelial Lesion</li><li>HSIL: High-grade Squamous Intraepithelial Lesion</li></ul>Cervical Intraepithelial Neoplasia (CIN):<ul><li>CIN 1: Mild dysplasia</li><li>CIN 2: Moderate dysplasia</li><li>CIN 3: Severe dysplasia/carcinoma in situ</li></ul>

What are the indicators for Cervical Cancers?

Tumor Markers:<ul><li>CA-125 Elevated: &gt;35 U/mL may indicate ovarian cancer (though not specific)</li><li>HE4 (Human Epididymis Protein 4): More specific than CA-125 for ovarian malignancy</li><li>ROMA Index: Risk of Ovarian Malignancy Algorithm combining CA-125 and HE4</li></ul>Imaging Findings:<ul><li>Complex ovarian cysts: Multilocular, solid components, thick septations</li><li>Bilateral ovarian masses: Higher suspicion for malignancy</li><li>Ascites: Fluid accumulation in abdomen</li><li>Omental thickening: Spreading pattern typical of ovarian cancer</li></ul>Genetic Markers:<ul><li>BRCA1/BRCA2 mutations: 35-70% (BRCA1) and 10-30% (BRCA2) lifetime ovarian cancer risk</li><li>Lynch syndrome: Hereditary nonpolyposis colorectal cancer syndrome</li><li>PALB2, RAD51C, RAD51D mutations: Moderate ovarian cancer risk</li></ul>

What are the indicators for Ovarian Cancers?

Histological Results:<ul><li>Endometrial hyperplasia with atypia: Precancerous condition</li><li>Complex atypical hyperplasia: 25-30% risk of concurrent or future endometrial cancer</li><li>Abnormal endometrial cells on Pap: May indicate endometrial pathology</li></ul>Molecular Testing:<ul><li>Microsatellite instability (MSI-high): Associated with Lynch syndrome</li><li>MLH1, MSH2, MSH6, PMS2 mutations: Mismatch repair gene defects</li><li>PTEN loss: Tumor suppressor gene associated with endometrial cancer</li><li>PIK3CA mutations: Oncogene frequently mutated in endometrial cancer</li></ul>Clinical Indicators:<ul><li>Postmenopausal bleeding: Most common presenting symptom</li><li>Abnormal uterine bleeding: In premenopausal women</li><li>Thickened endometrium: &gt;4-5mm post-menopause on ultrasound</li></ul>Risk Assessment Tools:<ul><li>Endometrial biopsy: Gold standard for diagnosis</li><li>Transvaginal ultrasound: Endometrial thickness assessment</li><li>Sonohysterography: Enhanced visualization of endometrial cavity</li></ul>

What are the indicators for Endometrial Cancer?

Immediate <a href="https://www.thomsonmedical.com/blog/colposcopy" target="_blank">Colposcopy</a> Indications:<ul><li>HSIL (High-grade Squamous Intraepithelial Lesion) on Pap smear</li><li>ASC-H (Atypical Squamous Cells - cannot exclude HSIL)</li><li>AGC (Atypical Glandular Cells) - any type</li><li>AIS (Adenocarcinoma in situ)</li><li>Any cytological abnormality suggestive of invasive cancer</li></ul>HPV-Related Indications:<ul><li>ASCUS with positive high-risk HPV (co-testing approach)</li><li>HPV 16/18 positive regardless of cytology result</li><li>Persistent high-risk HPV positive for 2+ years</li><li>LSIL in women ≥25 years (acceptable management option)</li></ul>Follow-up Scenarios:<ul><li>Inadequate/unsatisfactory Pap smears after repeat attempts</li><li>Persistent ASCUS or LSIL after 12 months of surveillance</li></ul>

When do you need a Colposcopy?

During Colposcopy:<ul><li>Any visible abnormal areas identified during colposcopic examination</li><li>Acetowhite lesions with suspicious vascular patterns</li><li>Areas of abnormal transformation zone</li><li>Suspected invasive lesions</li></ul>Endocervical Curettage (ECC):<ul><li>AGC on cytology</li><li>Transformation zone not fully visible during colposcopy</li><li>Discrepancy between cytology and colposcopic findings</li><li>Suspected endocervical involvement</li></ul>Endometrial Biopsy:<ul><li>Postmenopausal bleeding</li><li>AGC cytology (to rule out endometrial pathology)</li><li>Abnormal uterine bleeding in women &gt;45 years</li><li>Failed medical management of abnormal bleeding</li></ul>

When do you need a Biopsy?

Primary Indications:<ul><li>Confirmed invasive cervical cancer - for staging purposes</li><li>Clinical stage IB1 or higher cervical cancer</li><li>Assessment of parametrial invasion</li><li>Evaluation of lymph node involvement</li></ul>Specific Clinical Scenarios:<ul><li>Large cervical lesions (&gt;4cm) visible on examination</li><li>Suspected bladder or rectal involvement</li><li>Planning for fertility-sparing surgery (trachelectomy)</li><li>Radiation therapy planning</li><li>Monitoring treatment response in advanced cases</li></ul>Pre-surgical Assessment:<ul><li>Determining tumor size and extent before radical hysterectomy</li><li>Evaluating for distant metastases in advanced stages</li></ul>

When do you need a Cervix MRI?

<a href="https://www.thomsonmedical.com/women-health/gynaecology/pelvis-ultrasound?utm_campaign=norraleads" target="_blank">Transvaginal Ultrasound</a>:<ul><li>First-line imaging for pelvic masses</li><li>Endometrial thickness assessment in postmenopausal bleeding</li><li>Ovarian cyst characterization</li><li>Guidance for procedures (biopsy, aspiration)</li></ul>CT Scan:<ul><li>Advanced cervical cancer staging (chest, abdomen, pelvis)</li><li>Suspected metastatic disease</li><li>Evaluation of retroperitoneal lymph nodes</li><li>Assessment of distant organ involvement</li></ul>PET-CT Scan:<ul><li>Advanced cervical cancer (stage IIB and above)</li><li>Recurrent cervical cancer surveillance</li><li>Evaluation of treatment response</li><li>Detection of occult metastases</li></ul>

Do I need other scans?

Immediate High Risk (Requires urgent evaluation):<ul><li>HSIL/CIN 3</li><li>Postmenopausal bleeding</li><li>CA-125 &gt;200 U/mL with complex cysts</li></ul>Moderate Risk (Requires monitoring/intervention):<ul><li>Persistent HPV positive</li><li>ASCUS with high-risk HPV</li><li>CA-125 35-200 U/mL</li></ul>Low Risk (Routine follow-up):<ul><li>Transient HPV positive</li><li>ASCUS, HPV negative</li><li>Simple ovarian cysts</li></ul>

What indicatiors might need urgent evaluation?

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Abnormal Results: CA125, Pap, HPV & More

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Breast lumps during pregnancy are very common. The expectant mother will experience many normal physiological changes ― an increase in breast size, more obvious sweat glands around the nipples, a darkening of the areola ― all of which will prepare her body for breastfeeding.Common non-cancerous variations to breasts include hormonal changes (fibrocystic changes), fibroadenomas, cysts, lipomas, accessory (extra) breast tissue. Pregnancy-related breast cancers make up about 3 per cent of all breast cancers.Whenever a pregnant woman feels a lump, she should see a doctor to get their opinion, keeping in mind that most times it will turn out to be nothing serious!<h2>What the doctor will do</h2>When you see the doctor, she will ask details as to how you detected the lump, how long it has been present and if you have detected any changes, so as to get an idea what the lump is likely to be.Next, the doctor will conduct a breast examination to confirm the presence of the lump, and check for any other symptoms such as skin changes or nipple discharge.Most patients will then be recommended to get an ultrasound scan ― this will give additional information as to whether this lump is benign or cancerous. If there is any concern that the lump may be cancerous, your doctor will advise you as to the pros and cons of having a biopsy, which can be done safely even during pregnancy.“If a pregnant women detects a lump, I would advise them to have a thorough consultation and a physical examination, followed by an ultrasound. If necessary, I would then perform a biopsy.”<h2>Breast cancer screening during pregnancy</h2>A screening checks for cancer even when a patient is feeling well and has absolutely no cancer signs or symptoms. For breast cancer screening, most countries, including Singapore, recommend mammogram screening from age 50 onwards. For women who are at higher risk, this may start at 40. Some specialists will recommend a supplementary ultrasound as well.If a pregnant women detects a lump, I would advise them to have a thorough consultation and a physical examination, followed by an ultrasound. If necessary, I would then perform a biopsy.<h2>Screening methods (Mammograms/Ultrasound)</h2>Ultrasound, the same technology used to monitor the baby during pregnancy, is safe and useful in detecting lumps, and to check if it’s solid or cystic. Most specialists do not use ultrasound as a screening method as the majority of such lumps it detects are not cancerous.A diagnostic ultrasound can still be performed safely on pregnant women to assess their breast lump. If a subsequent biopsy confirms a cancer, she may then need a baseline mammogram, after discussing the pros and cons with her doctor. This is because early stage breast cancer may not form a lump yet, but may attract calcium spots, which can be detected using a mammogram. An abdominal lead apron may be used to reduce the baby’s exposure to radiation.<h2>Breast cancer treatment</h2>If the biopsy shows that the lump is non-cancerous (benign), then it may be left alone.However, if the biopsy shows that it is cancerous, the breast cancer treatment protocols will be modified for the expectant woman. Staging* has to be conducted to find out if the cancer has spread to other parts of the body, but only with liver ultrasound and chest X-ray. Depending on which trimester of the pregnancy she is in, the breast surgeon, oncologist and the ob-gyn will discuss what is best for the patient and her baby.Chemotherapy may be administered from the second trimester onwards, followed by surgery after she deliver the baby. As such management of the patient’s treatment is complex, it will involve good multidisciplinary care by experienced doctors.*Staging is a way to describe where the cancer is located, how much the cancer has grown, and if or where it has spread.

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Although common breast changes are normal in pregnancy, finding a lump can be worrying. Learn what are the recommended next steps, and when you should worry.

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Breast Lumps During Pregnancy: What to Expect and Do

“It all started with a persistent pain in the left breast, and I was referred by my General Practitioner for a mammogram and ultrasound. Both the mammogram and ultrasound results showed an abnormal lump, and I was further scheduled for a breast biopsy to determine if the lump was benign or malignant. Questions started to fill my mind. What is breast biopsy and how is it performed? And is it painful?”For many patients, pain is a very common symptom and is the most common complaint that brings them to see a doctor. For a small group, there happens to be an abnormal lump found that needs a biopsy. Most times, pain is not a sign of cancer, and any lumps found may not be the cause of the breast pain you experienced.Some of us may face a similar situation when a lump is detected. It is normal to have many questions. This article aims to address some of your preliminary questions while you arrange for a consult with a professional specialist. It is important to seek timely professional diagnosis and treatment.Here’s what you need to know about a breast biopsy and what to expect.<h2>What is a breast biopsy?</h2>A breast biopsy is a process where a small sample of breast tissue is removed through a special biopsy needle. The tissue samples removed from the breast lump will be further examined under a microscope. Typically, the breast biopsy is performed if there is an abnormality detected from your previous mammograms or breast ultrasounds. The goal of the biopsy is to determine what the abnormality is and the best treatment to move forward with.Although ultrasounds and mammograms are useful ways to identify breast lumps, a breast biopsy is the only way to confirm what the lump is. Breast screening is to be done, even if you are well and have no symptoms at all, and annual mammograms should start from age 40.If you experience any symptoms, please see a doctor for early diagnostic imaging tests:<ul><li>Breast lump</li><li>Changes in the colour or contour of the breast or nipple or dimpling of skin</li><li>Discharge from the nipple</li></ul>Most breast biopsies are quick and painless. Many of the breast lumps may turn out to be benign as there are a variety of conditions that can cause lumps in the breast. However, your doctor will usually want to take precautions and order breast screening tests to rule out early <a href="https://www.thomsonmedical.com/blog/breast-cancer" target="_blank">breast cancer</a>.<h2>How to prepare for a breast biopsy?</h2>Before your breast biopsy, you can prepare by informing your breast surgeon if you:<ul><li>Have any allergies</li><li>Are taking any blood-thinning medications</li><li>Have consumed aspirin in the last seven days</li><li>Not able to lie face down for more than an hour</li></ul>You will likely meet with your specialist prior to the procedure. Your doctor would be able to advise you on the procedure and give you advice such as:<ul><li>What type of breast biopsy procedure will be done?</li><li>What is the location of my biopsy?</li><li>Will a part or all of the lump be extracted?</li><li>Will it leave a scar?</li><li>How soon will I receive my results?</li><li>How soon can I resume normal activities?</li><li>What type of anaesthesia will be used?</li></ul>Make sure to wear a sports bra and loose clothing to have ease in dressing after the procedure. You may also want to have a designated driver or someone to accompany you home safely.<h2>What are the different types of breast biopsies and how are they performed?</h2>Once your breast surgeon decides that a biopsy is needed, they will determine the best type of biopsy for your situation. There are a few breast biopsy procedures to obtain samples of a patient’s breast lumps. Your breast surgeon will recommend based on the location, size, and other characteristics of the breast abnormality.Your breast surgeon will take a tissue sample either through a minimally invasive biopsy procedure or surgery. Minimally invasive procedures are ideal because they offer:<ul><li>Less pain</li><li>Less scarring</li><li>Faster recovery time</li><li>Lower risk of infection</li><li>Lower hospital costs</li><li>Able to return to usual activities quickly</li></ul><h3>Ultrasound-guided breast biopsy</h3>This procedure is performed through ultrasound guidance. An ultrasound is a method that utilises high-frequency sound waves to generate precise images.The breast surgeon will locate the lump within the patient’s breasts using the breast ultrasound device before a small incision is made for the biopsy needle to retrieve tissue samples. With an ultrasound-guided breast biopsy, the breast surgeon can identify <a href="https://www.radiologyinfo.org/en/info/breastbius" target="_self">lumps near the chest wall or under the arms</a>.It can be used in conjunction with vacuum-assisted core biopsy, core needle biopsy, or fine needle aspiration biopsy. This ultrasound-guided breast biopsy procedure is also more cost-effective than other methods like open surgical biopsy.<h3>Stereotactic biopsy</h3><img src="https://images.contentstack.io/v3/assets/blt5f400315f9e4f0b3/bltdc27a561fa0c5072/6545217008cc0104077ce311/Stereotactic_Biopsy.jpeg?branch=uat_release_3" height="auto"/>With a stereotactic biopsy, a 3D image of the breast is created from the mammogram results. The doctor uses the image to pinpoint the exact location of the suspected breast lump and guides the needle there. The patient will lay <a href="https://www.healthline.com/health/breast-biopsy-stereotactic#procedure" target="_self">facing down on a padded biopsy table</a> with one of the breasts positioned in the hole in the table. The patient’s breast will be compressed with two plates while the biopsy site is located using a targeted mammogram. The breast surgeon or radiologist will then create a small incision into the biopsy site and insert a large core needle to remove tissue samples.<h3>RI-guided core needle biopsy</h3>Instead of using an ultrasound device, a biopsy can be performed under the guidance of an MRI. This imaging device captures cross-sectional images of the breast so that the hollow needle can be guided to the site of the breast lump. This procedure can be used with core needle biopsy, vacuum-assisted core biopsy, or wire localisation.he different types of breast biopsy vary in terms of how invasive the procedure it can be. Your breast surgeon will advise on the procedure that is the best for you.<h3>Open (surgical) biopsy</h3><img src="https://images.contentstack.io/v3/assets/blt5f400315f9e4f0b3/blt4155c1fcecc004d3/654521990970dd001bd16e10/Open_(Surgical)_Biopsy.png?branch=uat_release_3" height="auto"/>The breast surgeon will remove part or the entire lump. If the lump is small and deep, a very thin needle and a thin wire will be placed inside the breast before the operation to help guide the breast surgeon.Generally, a surgical biopsy is performed in an operating room usually under general <a href="https://en.wikipedia.org/wiki/Anesthesia" target="_blank">anaesthesia</a>.<h3>Fine needle aspiration (FNA) cytology</h3>In this procedure, a thin needle attached to a syringe is inserted into the breast lumps. The syringe will collect the sample of fluid or cells from the lump and small tissue samples are removed. Your doctor will advise if this is suitable for you.<h3>Sentinel node biopsy</h3>This procedure removes the <a href="https://www.cancer.gov/about-cancer/diagnosis-staging/staging/sentinel-node-biopsy-fact-sheet" target="_self">sentinel lymph node</a> or the first node to which cancer cells are most likely to spread. The surgeon uses blue dye or a radioactive tracer to identify the node. Then, the node is removed and tested for cancer. Cancer could have spread to other lymph nodes if the sentinel node tests positive. However, if it is negative, the likelihood of cancer spreading to other lymph nodes is lower.<h3>Vacuum-assisted core biopsy</h3>This procedure is performed with an ultrasound or mammogram unit and can be seen as an upgraded form of the core needle biopsy. Like the core biopsy, a larger needle is used and allows for several tissue samples to be taken at one time.A probe or hollow tube is inserted into a cut made on the skin. Then, a vacuum-assisted device is used to pull the tissue into the needle while a rotating cutting device takes the sample. Using a suction device is beneficial because it can get more cells and fluid through the needle, which cuts down on the number of times the needle will need to be inserted to retrieve multiple samples.<h2>Benefits and risks of breast biopsy</h2>Before proceeding with breast biopsy procedures, you may want to discuss with the breast surgeon and weigh the benefits and risks to determine the suitable procedure that is right for you. Fortunately, most procedures are less invasive compared to surgical biopsy and some will leave minimal to no scarring. The biopsy results will indicate whether the breast lump is malignant or benign which would either allow you to rest easy or quickly get the treatment that you need.Although these procedures are generally safe, there are some risks involved. Possible complications that can incur from a breast biopsy include:<ul><li>Mild pain and bruising</li><li>Infection</li><li>Prolonged bleeding</li><li>Soreness at the biopsy site</li></ul>Many of these side effects are simply temporary. However, if they persist, contact your <a href="https://www.thomsonmedical.com/find-a-doctor/breast-surgeon-singapore" target="_blank">breast surgeon</a> for treatment. Generally, following the aftercare instructions will greatly reduce these risks and limit the odds of infection.<h2>FAQ</h2><h3>Why is a breast biopsy done?</h3>A breast biopsy can be done for several reasons:<ul><li>To identify any lumps in your breast</li><li>To check for the potential causes of any nipple problems such as bloody discharge</li><li>To evaluate whether the breast lump or breast mass is cancerous or non-cancerous.</li><li>To check the severity of a problem seen from the breast imaging results, such as a fluid-filled cyst or calcium deposits in breast tissue (microcalcifications)</li></ul><h3>How often are breast biopsies positive for cancer?</h3>&gt; 80% of the patients who undergo the biopsy procedure do not have cancer, while only &lt; 20% of breast biopsies are malignant. When the results are negative, the breast lump is benign.<h3>Does a breast biopsy hurt?</h3>The breast surgeon may use local anaesthesia to help numb the biopsy area during the procedure. It may be slightly uncomfortable, but most patients describe it as tolerable. Once the site is numb from the local anaesthetic, one should only feel pressure but no pain from the biopsy.Typically, only local anaesthesia is required. However, general anaesthesia may be used in severe cases, meaning the entire body is numbed.<h3>How long does it take to recover from breast biopsy?</h3>Biopsy procedures do not cause significant pain to your body. However, you may experience some bruising, tenderness, or soreness for a few days after the biopsy procedure. Patients can take non-aspirin pain relievers that contain acetaminophen and apply cold packs to help ease the pain and discomfort. However, it can take longer to recover from surgical removal procedures when compared to nonsurgical procedures.With all breast biopsy procedures, except for the surgical biopsy, you will be able to go home without a patient caregiver. You will likely have bandages and a cold pack over the biopsy site. Most patients can resume usual activities within a day after the procedure.Tell your breast surgeon if you notice the following problems after the biopsy:<ul><li>Pain that gets worse</li><li>Chills or fever</li><li>Swelling, redness, drainage, or bleeding</li></ul><h3>How soon should you expect to receive your breast biopsy results?</h3><img src="https://images.contentstack.io/v3/assets/blt5f400315f9e4f0b3/blt3ce74f2f0f705f43/654521d254447604077cfdc6/Breast_Biopsy.jpeg?branch=uat_release_3" height="auto"/>Once the procedure is done, the breast tissue samples are sent to the lab. A pathologist will evaluate the samples using specialised tools and then create a report to send to the breast surgeon, who will share the results with you.Generally, it takes a few days before the results are ready. However, it can take as long as two weeks before the test results are available if the lab needs more time to process your specimen.Sometimes a clear diagnosis is not possible based on the sample given. In this scenario, you may need another biopsy performed so that the breast surgeon can obtain more breast tissue for further evaluation.The results will share details about the consistency and size of the breast tissue samples, the location of the biopsy site, and whether there are cancer cells present. If it is malignant, the report will detail the type of breast cancer you have. Based on the findings, your breast surgeon will advise on the next steps for treatment.<h2>Book Your Appointment at Thomson Breast Centre</h2>Prevention is always better than cure! Our clinical team at <a href="https://www.thomsonmedical.com/breast" target="_blank">Thomson Breast Centre</a> offers different services for all <a href="https://www.thomsonmedical.com/blog/breast-screening-mammogram-ultrasound" target="_blank">breast screening</a> needs with the assurance that you will be well taken care of. It is important to detect signs of breast cancer early. The sooner it is detected, the faster the treatment can start. At Thomson Medical, our doctors will evaluate the lump and provide the appropriate tests for diagnosis.Most patients start with a specialist consultation for a personalised clinical breast assessment. We offer a wide range of biopsy procedures, from minimally invasive removal to more advanced surgical options if a biopsy is needed. Book a specialist consultation with Thomson Breast Centre and start your breast health journey today.

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Worried about a breast lump? Don't panic. A breast biopsy is a simple procedure that can help determine if the lump is benign or malignant. Learn more about the process and what to expect from this article.

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Everything You Need to Know About Breast Biopsy

Just as there are skin issues that arise during pregnancy, skin conditions can also develop after you give birth. Fortunately, they are largely treatable, so there is no need to fret – your postpartum skin and hair will bounce back in no time. We take a look at some of the most common conditions.<h2>Acne</h2>Caused by an inflammation in the facial oil glands, acne may be aggravated by hormonal changes. Most of the time, acne clears within a few weeks or months, but medical treatment should be sought to prevent the risk of scarring. There are many topical agents that can be safely used even when breastfeeding. In more severe cases, oral medications such as antibiotics may be required.<h2>Melasma</h2>Also known as “the mask of pregnancy”, this pigmentation condition is due to increased melanin production and is caused by a combination of genetic and hormonal factors, as well as sun exposure. It tends to affect Asian skin more, appearing as brownish patches over the cheeks, forehead, temples, nasal bridge, upper lips and jawline.It is best controlled by avoiding the sun and with regular use of sunscreen, lightening creams and topical agents, although it can persist in some cases. Other treatments include chemical peeling, intense pulsed light therapy and certain forms of laser therapy. Inform your doctor if you are breastfeeding – certain ingredients such as tretinoin and hydroquinone that can be found in some skincare products should be avoided by breastfeeding mums.<h2>Dermatitis/eczema</h2>Eczema or dermatitis is a relatively common yet noninfectious condition, so it will not spread to your baby. Often it is an aggravation of an underlying sensitive skin condition that has been present for some time. For new mothers, it can also develop as a result of excessive water contact due to frequent handwashing.Use moisturiser regularly to soothe inflamed and itchy skin. Topical steroid creams are prescribed to calm inflamed skin and are safe to use even when breastfeeding. Use a gentle soap substitute and continue to moisturise even after the skin rash has settled.<h2>Stretchmarks</h2>Affecting at least 90 percent of pregnant women, stretchmarks are a form of scarring that appear red when fresh, but most will fade to white after delivery. During pregnancy, intensive use of moisturisers may help the condition, and there are specially formulated stretchmark creams on the market that you can continue using after delivery. For more severe cases, dermatologists may prescribe tretinoin cream to use postpartum when you are not breastfeeding. Some skin-tightening laser treatments are safe options to remove stretchmarks even if you are breastfeeding, but these usually require multiple sessions.<h2>Telogen effluvium</h2>This condition results in hair fall that usually occurs about three months after delivery. Though increased hair fall can be distressing to new mothers, it is almost always a self-limiting condition, and you will usually recover within six months. If you notice increased hair fall, consult a doctor to exclude other causes of hair loss (such as low iron levels). Topical medications can be used if you are not breastfeeding.

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Postpartum skin problems like acne, melasma, and stretch marks are common but temporary. Learn how to relieve and prevent the 5 most frequent postpartum skin woes.