What do I do?
Diagnosis
This is done by a triple assessment:
- Clinical assessment: This is a physical examination of the breast to look for any suspicious signs of cancer
- Imaging assessment: This is usually an x-ray of the breast (mammography), and there may also be ultrasound assessment.
- Biopsy: If any lump was found from clinical and imaging assessment, then it is investigated further by using a needles to obtain a small sample of the lump, and this is then analysed under the microscope.
To deliver these comprehensive diagnostic tests, I work in a tight-knit team including specialist breast radiologists and pathologists (doctors who assess the biopsy sample under the microscope) . I am also very grateful for the invaluable aid that the breast care nurses provide to both me and my patients.
Surgery
The treatment of breast cancer will vary depending on the stage at which it is diagnosed and the results of the personalised microscopic analysis of the cancer cells.
Most commonly, a treatment plan will include surgical removal of the cancerous cells, in conjunction with further treatment with radiotherapy (using targeted radiation to selectively kill the cancerous cells) and/or drugs (chemotherapy, hormonal treatments and biological treatments).
There are 4 main surgeries:
- Breast Conserving Surgery (BCS): This is where the cancer cells are surgically removed, leaving behind the maximum safe amount of the breast.
- Mastectomy: This is where the whole of the affected breast is removed.
- Lymph node surgery: One of the ways cancer can spread is through the lymphatic system (they are like the body's water drains). If we find cancerous cells in the lymph nodes, we can remove the nodes to try and prevent the cancer from spreading.
- Reconstruction: After mastectomies, we can recreate the breast with plastic surgery. This can be performed immediately after the mastectomy or it can be arranged to be done at a later date.
Choosing the right surgery will be based on a number of different factors. I strive to ensure that all the choices made are as a result of shared-decision making with the patient. As a team, we aim to maximise the patient's wellbeing, both physically and psychologically.