Demystifying the QT Scan: Comfort Can’t Replace Confidence

The Quantitative Transmission (QT) Ultrasound scan is often promoted as the next frontier in breast imaging - automated, radiation-free, and compression-free. For patients, the appeal is clear: no discomfort, no X-rays, and a sleek sense of innovation. But for clinicians, comfort isn’t the benchmark - performance is. And here, QT scanning still has much to prove. While it may one day complement established tools, current evidence does not support replacing mammography or standard ultrasound in breast cancer screening. What is the QT Scan? Unlike conventional ultrasound, QT Ultrasound transmits sound waves through the breast to measure how tissue absorbs and refracts them, creating detailed 3D maps of internal structure [1]. The procedure takes about 10–20 minutes, involves no radiation or compression, and is fully automated [2]. It’s a patient-friendly innovation - but comfort alone doesn’t equal clinical validation. How Does it Compare to Standard Screening Tools? Mammography remains the only imaging method proven to reduce breast cancer deaths in large population studies [3,4]. Conventional ultrasound is an established adjunct, particularly in women with dense breasts [5]. QT scanning offers theoretical advantages — no radiation, greater comfort, and possible benefits in dense tissue [2,6,7]. However, these claims remain preliminary. No current evidence shows improved cancer detection, mortality reduction, or cost effectiveness compared with established tools. Why We Remain Cautious Unproven clinical outcomes: No studies yet show QT scanning improves survival or early detection [8]. False positives: High-resolution data can increase over-diagnosis and unnecessary biopsies [9]. Limited validation: Most studies are small or early-phase [1,2]. No guideline endorsement: Major societies, including the NCCN and American Cancer Society, have not added QT scanning to screening recommendations [4,5]. Access barriers: Availability, reimbursement, and standardization remain challenges [2]. Comfort Can’t Replace Confidence Improving comfort and reducing radiation are worthy goals, but accuracy must come first. A test that feels better but misses cancers - or triggers false alarms - risks harming the very patients it aims to help. Until QT scanning demonstrates outcomes equal to or better than mammography and ultrasound, it should remain an adjunct tool, used selectively and backed by ongoing clinical trials [10]. For now, mammography remains the gold standard, supported by decades of evidence and proven mortality reduction. Innovation is vital - but in medicine, innovation must be validated. References [1] Malik, B., Terry, R., Wiskin, J., & Lenox, M. (2018). Quantitative transmission ultrasound tomography: Imaging and performance characteristics. Medical Physics, 45(7), 3063–3075. [2] Klock, J. C., et al. (2020). Comparing Transmission Ultrasound to Mammography on Recall and Detection Rates for Breast Cancer Lesions. Academic Radiology, 27(12), 1667–1674. [3] Berry, D. A., et al. (2005). Effect of Screening and Adjuvant Therapy on Mortality from Breast Cancer. New England Journal of Medicine, 353(17), 1784–1792. [4] Oeffinger, K. C., et al. (2015). Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update from the American Cancer Society. JAMA, 314(14), 1599–1614. [5] Amin, A. A., et al. (2023). NCCN Guidelines Insights: Breast Cancer Screening and Diagnosis, Version 1.2023. JNCCN, 21(9), 900–909. [6] Fan, C. M., et al. (2024). Ultra-Low Frequency Transmitted Ultrasound Breast Imaging vs. Digital Breast Tomosynthesis: A Patient-Reported Outcome Study. Journal of Clinical Medicine, 11(9), 2419. [7] Jiang, Y., et al. (2024). Noninferiority of Quantitative Transmission (QT) Ultrasound to Digital Breast Tomosynthesis. Academic Radiology, 31(6), 2248–2258. [8] Berg, W. A. (2020). Emerging Technologies in Breast Cancer Screening. Radiologic Clinics of North America, 58(1), 101–118. [9] American College of Radiology (ACR). (2023). Practice Parameter for the Performance of Screening and Diagnostic Breast Ultrasound. Reston, VA: ACR. [10] ClinicalTrials.gov. (Ongoing). Quantitative Transmission Imaging Evaluation With MRI as Supplemental Screening to Mammography (QTI-E). NCT07216274.
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From Burden to Confidence: Combining Breast Cancer Surgery with a Breast Reduction or Breast Lift

For women with excessively large or heavy breasts (macromastia), symptoms like back, neck and shoulder pain can be a daily reality. It’s not just uncomfortable—it can cause skin irritation, strain posture, and lead to self-consciousness or even embarrassment [1]. If they’re diagnosed with breast cancer and need surgery, some women choose to have a breast reduction or lift at the same time. This can help reduce discomfort and improve how their breasts look and feel. While a breast cancer diagnosis can be overwhelming, surgery can also be a chance not just to treat the disease, but to improve their overall comfort, confidence, and quality of life. What Affects Your Surgical Options? Each woman’s relationship with her body – and her journey through cancer – is deeply personal. That’s why there’s no one-size-fits-all approach – only what feels right for you. Studies show that fears of cancer returning and concerns about body image and sexuality can also play a big role in these decisions [4] [5]. Many women worry about losing their breasts or how their body may change, which can bring feelings of grief, shame, embarrassment and low self-esteem [6]. The decisions you make should support both your medical needs and emotional well-being. Ultimately, the goal of breast cancer surgery is to remove the tumour while maintaining a satisfying post-operative appearance. Combining Cancer Surgery with Macromastia Relief Fortunately, for women living with large or sagging (ptotic) breasts, procedures like breast reduction (reduction mammoplasty) or breast lift (mastopexy) can be safely combined with cancer surgery [1] [7] – offering both medical treatment and meaningful relief. Do note that this is subject to eligibility and surgeon recommendation. Reduction mammoplasty removes excess breast tissue, fat and skin, creating a breast appearance that’s more balanced with the rest of the body [1]. Mastopexy lifts, reshapes and tightens the breasts for a more youthful appearance [8]. While these may seem like cosmetic procedures on the surface, they can carry deeper meaning. For many women, addressing both breast cancer and macromastia in a single session can bring lasting physical relief and emotional healing, with positive outcomes well into recovery [1] [9]. Breast reduction can improve physical function, alleviate pain, reduce skin complications and enhance their body image and mental health [1]. The breast lift can help restore confidence, offer a renewed sense of control and help women feel whole again [7]. For women navigating breast cancer alongside macromastia, combining surgery can be a powerful way to reclaim comfort, health and self-confidence – all in one procedure. “But no matter what treatment path you take, always remember: You are brave. You are bold. You are beautiful. And you are making the choices that are right for you.” Care That Sees the Whole You At Solis, care doesn’t end in the operating theatre. The experienced and dedicated breast surgeons understand that healing is both physical and emotional, supporting each woman through her unique journey. Specialising in advanced surgical techniques such as oncoplastic surgery – a method that combines cancer removal with plastic surgery techniques to reshape the breast – they collaborate closely with Luma Women’s Medical Centre, where an in-house pathologist examines surgical specimens in real time to ensure complete cancer removal and reduce the need for a second surgery. This integrated approach allows for compassionate and reassuring breast care that respects your body, your choices and your well-being every step of the way. If you’re exploring your options, we’re here to help. Contact us to schedule a consultation or speak with our team about how we can support your journey. Article contributed and reviewed by Dr Lim Sue Zann, Senior Consultant & Breast Surgeon at Solis Breast Care & Surgery Centre. References: [1] National Library of Medicine, Breast Reduction [2] Decision-Making in the Surgical Treatment of Breast Cancer: Factors Influencing Women’s Choices for Mastectomy and Breast Conserving Surgery [3] Cancer Research UK, Types of Breast Cancer Surgery [4] The Emotional Status, Attitudes in Decision-Making Process, and Their Impact on Surgical Choices in Korean Breast Cancer Patients [5] Factors influencing surgical treatment decisions for breast cancer: a qualitative exploration of surgeon and patient perspectives [6] Decision-making process for breast-conserving therapy from the perspective of women with breast cancer: A grounded theory study [7] Mayo Clinic, Breast Lift [8] Aesthetic breast surgery: putting in context—a narrative review [9] Oncoplastic reduction mammoplasty for breast cancer in women with macromastia: long term aesthetic, functional and satisfaction outcomes
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Endoscopic Mastectomy: Cost and Insurance Coverage in Singapore

Endoscopic mastectomy, also known as minimal access or keyhole mastectomy, is a surgical technique gaining attention for potential benefits including smaller incisions and better cosmetic outcomes compared to traditional mastectomy approaches. However, many patients wonder about the cost of this novel procedure and whether it is covered by insurance in Singapore. What is Endoscopic Mastectomy? Endoscopic mastectomy is a minimally invasive surgical technique that removes breast tissue through small “keyhole” incisions using specialised long thin instruments. The procedure aims to minimise scarring and promote quicker recovery time, while maintaining effective treatment outcomes.  Despite these benefits, endoscopic mastectomy remains a relatively new and evolving approach in breast cancer surgery, with availability varying across hospitals and clinics. One of the biggest considerations for patients is whether insurance will cover the cost. Cost of Endoscopic Mastectomy in Singapore Endoscopic mastectomy is generally more expensive than traditional mastectomy due to the specialised equipment and expertise required. Costs can vary based on the hospital, surgeon, and complexity of the case.  Is Endoscopic Mastectomy Covered by Insurance? Insurance coverage for endoscopic mastectomy is not always guaranteed, as it may be deemed as a “non-standard” procedure. In such cases, patients may need to cover the difference out-of-pocket or seek additional financial support. In Singapore, medical costs are typically covered through a combination of government-subsidised systems, employer health benefits, and private insurance. Coverage for endoscopic mastectomy depends on several factors: 1. Type of Scheme Medical financing schemes in Singapore generally fall into three main categories: 2. Medical Necessity and Approval A key factor in insurance approval is whether endoscopic mastectomy is considered "medically necessary" by the insurer. Mastectomy is a common procedure for breast cancer treatment, and while traditional mastectomy is often straightforward in terms of insurance coverage, the endoscopic approach may require additional justification. Insurance companies may request supporting documents from the treating surgeon to confirm that this method is the best option based on: 3. Hospital and Surgeon Choice Another factor affecting insurance coverage is the choice of hospital and surgeon. As endoscopic mastectomy is a specialised procedure, not all hospitals and surgeons in Singapore may offer it. Some insurers may have preferred hospital networks or surgeons, and the specific hospital or surgeon performing the surgery may impact the level of coverage. If the procedure is performed at a private hospital or by a surgeon outside of the insurer’s preferred network, patients may face higher out-of-pocket costs or no coverage. How to Navigate Insurance Coverage for Endoscopic Mastectomy If you are considering endoscopic mastectomy, it's crucial to be proactive in understanding your insurance coverage. Here are some steps you can take to navigate the insurance process: Conclusion: Is Endoscopic Mastectomy Worth the Cost? Endoscopic mastectomy offers significant advantages in terms of cosmetic outcomes, reduced scarring, and potentially faster recovery times. However, these benefits come at a higher cost, and insurance coverage is not always guaranteed in Singapore. For patients prioritising aesthetics and a quicker recovery, and who can afford potential out-of-pocket expenses, endoscopic mastectomy may be a worthwhile choice. However, for those whose primary concern is cost or who lack comprehensive insurance coverage, traditional mastectomy remains a more accessible and equally effective option for cancer treatment. Ultimately, the decision depends in your medical needs, financial situation and personal preferences. Consult your healthcare providers and insurers to make an informed choice that best suits your needs. Article reviewed by Dr Esther Chuwa, Senior Consultant and Breast Surgeon at Solis Breast Care & Surgery References: [1] Lee, W. T., Tan, S. K., & Kwek, S. K. (2015). Mastectomy rates and breast cancer treatment trends in Singapore. Singapore Medical Journal, 56(8), 444-448. [2] Ministry of Health, Singapore. (2020). MediShield Life and Integrated Shield Plans. Retrieved from https://www.moh.gov.sg/costs-financing/health-insurance/mediShield-life  [3] Central Provident Fund Board, Singapore. https://www.cpf.gov.sg/member/healthcare-financing/using-your-medisave-savings/using-medisave-for-hospitalisation [4] Tan, W. C., & Teo, C. H. (2018). An overview of keyhole surgeries in oncology. Annals of Breast Surgery, 24(2), 87-92. Tan, S., & Lee, W. (2021). Health insurance in Singapore: A guide for expats and citizens. Singapore Press Holdings.
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