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Hanoi
I shadowed the oncologists in the breast cancer clinic along with other Vietnamese
medical students. I learned that there is always a large number (approximately
60) patients a day waiting to be seen. There are no appointments so the patients
take a number and sometimes can not been seen that day and must come back the
next day. The breast examination is extremely rushed compared to ones performed
in the United States. The examination is not performed with the patient lying
down. Instead, the patient sits in a chair across from the oncologist while the
oncologist feels the breast for lumps. Usually, the patient will point out to
the oncologist where she suspects a lump to be. This is not an uncommon practice
as there are no annual mammograms required in Viet Nam. Patients often only come
to the hospital once they suspect a suspicious lump. The average Vietnamese women
is uneducated on how to perform self-breast examinations correctly and thus will
often mistaken normal breast anatomy as lumps and masses. This common mistake
makes the oncologist very skeptical of the patient’s self diagnosis. However,
sometimes the patients are correct when pointing out suspicious masses, but since
the oncologists rush the procedure so much these masses can still be missed.
I also had the opportunity to observe breast surgery, mostly lumpectomy. The characteristic surgical attire consisted of a green cotton shirt and pants, a matching headpiece, a surgical mask and white plastic sandals (no socks). This is rather odd for surgery, especially the sandals, since they are using dangerous surgical knives, etc. The surgery room is on a separate floor of the hospital and different types of surgeries are performed in different rooms (there are four rooms).
I discussed the differences regarding surgical set-ups between the
U.S. and Viet Nam, with the head chairman of the Breast Cancer Department.
Linda and Dr. Lin at the breast cancer clinic
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