Breast Cancer Surgery

If you are in a situation where you have just received a diagnosis, I understand that this is a very stressful and a confusing time. As a breast surgeon, I am usually the first specialist you would see in your treatment team. The role of your breast surgeon is extremely important, and this is not just because it is the surgeon who removes your cancer during surgery. There is good evidence from research that the initial interactions are fundamentally important to build trust and confidence. The research shows that this trust is essential in coping with stress, and with the demands of your treatment.

Personally, I believe you deserve a 100% personalised treatment plan. That is why I take the time to get as much information as possible in the early phase. As a team, we use the information to build your treatment plan specific to the biology of your cancer cells and your preferences. You may come across new information in those consultations, for example about the many different types of breast cancer. Of course, these different types of cancer need different treatments.

No longer do all women have the same treatment - we can do better than that. Some cancers are small and slow-growing and need a relatively simple plan. But if your breast cancer is biologically aggressive we create a comprehensive treatment plan. It may then involve other measures such as radiotherapy and systemic drug treatment after surgery. In my consultations, it is important to give you an insight in the progress that has been made over the decades. We now have many effective ways to successfully treat breast cancer and long term outcomes are improving all the time.

Surgery will often be the starting point of your treatment plan. We remove the tumour, and we test some of the lymph nodes. The pathologist examines the tissue in detail, which gives us extra information on top of the initial core biopsy pathology.

We then use all that information to build a ‘risk profile’. It is important to know that surgery is an excellent first step, but that it does not ‘cure’ the majority of breast cancers on its own. You will often hear that many women need radiotherapy, to reduce the risk of local recurrence. They may also undergo systemic drug treatment to reduce the risk of developing secondary disease, and we call these other treatments ‘adjuvant therapies’.

So after your initial assessment you will hear me talk about the multidisciplinary team. It means that we work together as a team of specialists: radiology and pathology experts, radiotherapists and medical oncologists, and myself as a breast surgeon. To fully tap into the expertise of the team, and with your consent, I then present your data to the bigger group. Together, we produce consensus recommendations and it is then my role to explain and clarify the information, and to make sure you get the appropriate referrals. Your health situation is unique and we always tailor your treatment plan to your needs. The referrals may also include genetic testing, fertility services, clinical psychology or other specialised medical help if appropriate.

The breast cancer team encompasses many people with special skills. An essential member of the team is our specialist breast nurse who helps guide and support you as a patient from the first consult through your hospital admission for surgery and onwards if required. You will receive care and support from our wonderful nurses at Mount Hospital both in theatre and in the wards. Most patients undergoing breast cancer treatment or surgery will also see the physiotherapist prior to discharge for advice on how to smoothly return to normal activities.