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Breast Cancer

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Galsworthy Road Kingston upon Thames Surrey KT2 7QB
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Breast Cancer

Breast cancer is the most common type of cancer in the UK. Most women diagnosed with breast cancer are over the age of 50, but younger women can also get breast cancer. In rare cases, men can also be diagnosed with breast cancer.

About one in eight women are diagnosed with breast cancer during their lifetime. There's a good chance of recovery if a breast cancer is detected in its early stages.

Breast cancer can be non-invasive or invasive:

  • A non-invasive breast cancer (ductal carcinoma in situ - DCIS), is where some cells in the lining of the ducts of the breast tissue have started to turn into cancer cells. It hasn’t yet spread outside the ducts into the surrounding breast tissue. It's usually found during a routine mammogram (breast screening) and rarely shows as a breast lump.
  • An invasive breast cancer is the most common type of breast cancer. Invasive cancer means the cancer cells have grown through the ducts/lobules into the surrounding breast tissue. An invasive breast cancer has the potential to spread to other areas of the body. This doesn’t mean that it has or will spread, and treatment aims to reduce the risk of this happening. The main type of invasive breast cancer develops in the cells that line the breast ducts (invasive ductal breast cancer).

There are other types of breast cancer and further information about these can be found on Breast Cancer Care’s website

Kingston Hospital's breast unit provides diagnostic and treatment services for benign breast conditions and breast cancer. These may come as GP referrals or via the breast screening programme.

We work in partnership with the Royal Marsden Hospital and with the support of our breast care nurses (clinical nurse specialists) team, we provide an integrated, comprehensive and sympathetic breast care pathway.

We aim to see everyone suspected of having breast cancer within one week of the referral to the unit, and within a maximum of two weeks, via our one stop clinics. Last year 3235 women were referred to the breast clinic and of these 249 were diagnosed with breast cancer.

Treatments for breast cancer

These may include:
surgery to breast/s and/ or lymph nodes under the arm
chemotherapy
radiotherapy
hormone (endocrine) therapy
targeted (biological) therapy
medication including bisphosphonates

In early breast cancer, surgery is usually the first treatment provided. Then depending on the type of surgery and what is learnt about your cancer after looking at it under the microscope, you may be advised to have one or a combination of the treatments listed above.

Sometimes chemotherapy or hormone therapy may be given before surgery. This is called neo-adjuvant treatment.

In a very small number of women, breast cancer is found after it has spread to another part of the body (secondary breast cancer).

Secondary cancer, also called advanced or metastatic cancer is not curable and the aim of treatment is to control and slow down the disease, relieve symptoms and maintain quality of life.

Breast cancer patients being treated at Kingston Hospital may be invited to take part in a clinical trial into different aspects of their care. The results of past clinical trials help doctors when planning treatment.

You can read more about the different treatment options here

Holistic needs assessment

People with cancer often require care, support and information in addition to the management of their cancer or condition.

A holistic needs assessment (HNA) is a discussion with your breast care nurse about your physical, emotional and social needs. The focus is on you as a whole – not just your illness. However, you decide how much information you would like to share about your current situation.

The HNA is an opportunity for you to talk about any worries or concerns you may have. It will help to clarify your needs and refer you to any relevant services and signpost to other organisations for additional information and support.

In order to prepare for this discussion, you may be asked to complete a questionnaire to bring to your next consultation. This is not compulsory and not having this assessment will not affect your care. However, many patients find having an assessment helpful as it can help to identify what help is available.

An HNA is offered at different times during your care, including:

  • Around the time of diagnosis or start of your treatment
  • The end of your treatment – when your surgery, chemotherapy or radiotherapy has been completed
  • Any time that you ask for one

We will carry out an HNA either over the phone or at one of our nurse-led clinic appointments depending on what is more convenient for you.

With your agreement the nurse carrying out your assessment may refer you to other services that may be of help to you. Alternatively, you will be given written information about these services then you can take it further yourself.

Key staff

There are many health care professionals involved in a person’s breast cancer treatment – known as the multidisciplinary team (MDT).

An MDT consists of;

  • Consultant breast surgeons: Miss K Shenton and Miss C Richardson
  • Medical oncologists - visiting from the Royal Marsden Hospital: Dr M Parton and Dr S McGrath
  • Clinical oncologist – Royal Marsden Hospital: Dr A Kirby
  • Radiologists and radiographers: Dr H Constanti, Dr H Richardson, Dr W Pienaar, Dr A Rhodes, Dr P Scott-Mackie, Dr. P Marin and L Forgan
  • Pathologists: Dr G Knee and Dr S Gharrie
  • Advanced nurse practitioners: Paula Dallimore and Kay Laurent
  • Breast care nurses (keyworkers): Jackie Harris, Margaret Lewis, Paula Williams and Sarah Dyer
  • MDT co-ordinator (administration): S Brewster

The MDT meets weekly to discuss the results of investigations and surgery. We follow evidence based national guidelines and local protocols to agree individual treatment plans.

Breast Care Nurses - Keyworker

All breast cancer patients receiving treatment at Kingston Hospital will be introduced to one of our team of breast care nurse specialists, who are registered nurses and have had specialised training in all aspects of breast care.

The breast care nursing team is able to provide expert advice and guidance on a patient’s specific breast cancer treatments and possible side effects and provide psychological and emotional support to both them and their family members.

To ensure our patients have sufficient information when they need it, written information is offered at appropriate stages during their treatment pathway.

The breast care nurse also takes on the role of the patient’s key worker. The key worker acts as the co-ordinator by working closely with the consultant surgeons and other clinicians involved in the patient’s care.

The keyworker will keep in close contact with the patient from diagnosis and throughout the patient’s care pathway. This offers continuity for patients, carers and families, as they have a point of contact for advice and support as they need it. The patients are given their keyworker’s mobile number which they can text and call.

Patients can also contact the breast care nursing team’s office number, where they can leave a message at any time and one of the nursing team will return their call between 2-4pm Monday to Friday.

Tel: 020 8934 6363

Further support/charities

Some treatments for breast cancer can affect a woman’s fertility. Younger women recently diagnosed can be referred to our fertility service at Kingston for a discussion about their individual situation. You can read more about fertility and breast cancer treatment here

Breast cancer treatments such as chemotherapy, hormone therapy or ovarian suppression (stopping the ovaries working either permanently or temporarily) can cause menopausal symptoms during and beyond treatment. You can read more about menopausal symptoms and breast cancer treatments here

We are working in partnership with Breast Cancer Care to provide a Moving Forward course – a four week programme of information sessions to help you adjust and adapt after a diagnosis. These take place twice a year over four Mondays in June and then again in November. To find out more contact the breast care nurses 020 8934 6363 or Breast Cancer Care 0345 077 1893 or email movingforward@breastcancercare.org.uk

Kingston Hospital provides a post–surgical appliance service such as external breast prostheses, post-surgical bras and bra fillers. A prosthesis fitter facilitates an afternoon breast prosthesis clinic on a Friday once a fortnight.  Referrals to this service can be made by your health care team.

The Breast Care Nurses facilitate a lymphoedema clinic for mild to moderate lymphoedema assessment and management on the 2nd Monday of the month for women who have been treated for breast cancer. Referrals to this service can be made by your health care team.

The Breast Care Nurses provide a nipple/areola micropigmentation (tattooing) service on the fourth Monday of the month for women who have had breast reconstruction following breast surgery for breast cancer. Kingston patient referrals only.

The physiotherapists at Kingston provide a Post Breast Cancer Exercise Class for women recovering from their treatment for breast cancer. It is a 6 weeks course for an hour each week.  Referrals to this service can be made by your health care team.

Other information and support organisations

Anxiety UK

https://www.anxietyuk.org.uk/

 

Breast Cancer Care

https://www.breastcancercare.org.uk/

 

Breast Cancer Haven

http://www.thehaven.org.uk/

 

Breast Cancer Now

http://breastcancernow.org/

 

Cancer Research UK

www.cancerresearchuk.org

 

Macmillan Cancer Support

https://www.macmillan.org.uk/

 

NHS Choices

http://www.nhs.uk/pages/home.aspx

 

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