27 October 2008
Breast Care at Mid Essex Hospitals
October is breast care awareness month which is why mid Essex Hospitals thought this was the ideal time to remind the public of the comprehensive and unique service it provides.
The service from the Chelmsford and Essex centre
After a GP referral the patients’ journey begins at the Chelmsford and Essex centre (C&E). The team here see approximately 3000 new breast care patients per year; one in ten of those will have breast cancer. Thanks to a number of new initiatives breast cancer is now being diagnosed quicker.
The team at C&E provide a comprehensive breast care service. The team consists of three breast care nurses, three surgeons two radiologists and two breast oncologists. Mr Simon Smith is the clinical lead for breast surgery. He is an ‘oncoplastic’ breast surgeon combining oncological surgical skills with those more usually associated with cosmetic breast surgeons, ensuring the optimal cosmetic as well as oncological outcomes for breast cancer patients.
Mr Simon Smith said:” At the C&E centre we can offer patients a one stop service. The patient receives a joint consultant with a surgeon and a radiologist and the majority of our patients leave the clinic with a diagnosis. We have made huge steps forward and can now see all patients who are referred to us with breast symptoms, within two weeks. This means we are able to see and diagnose a person quicker which has to be good news for the patient. Women with non cancerous breast problems leave reassured, those with more serious problems can rapidly be diagnosed, ensuring treatment is expedient.
“The Government’s Cancer Reform Plan compels all breast units in the UK to see all breast referrals (not only those suspected of having breast cancer) within two weeks of GP referral by the end of 2009. In Chelmsford, we are now able to achieve this, more than a year early, and we believe we are the only Unit in Essex able to do this.”
Simon adds:” In recent years there have been major advances in the treatment for breast cancer and the speed it is delivered. We are pleased to be ahead of the game as we are able to see all new ladies referred with breast problems of any sort within two weeks of referral, which is a major step forward. Whilst we see 50 new patients per week, the majority of these won’t have breast cancer and as we are now able to see and diagnose patients a lot quicker, any that are diagnosed have a greater chance of a full recovery.”
Breast care nurses
Carolyn Ollenbuttel, Teresa Dearson and Heidi Stubbings are the breast care nurses, who run their own nurse led clinics. Heidi said:” It is important that all women are breast aware, so any changes in their breasts can be reported early. At the C&E centre we provide a breast care service where patients are referred by their GP. We also provide the breast screening for women over the age of 50.”
The breast care nurses run a monthly support group for any woman who has had breast cancer. They have also run a one-off group for women under 35 who have been diagnosed with breast cancer. Heidi adds:” I have written a leaflet about fertility aimed at younger women to explain why their fertility may be affected by their breast cancer treatment, their options surrounding preserving their fertility during treatment, how the different types of preservation work and their success rates. This leaflet is now being used throughout the UK as it was a subject that was often talked about but had limited information on, the only information leaflet available was from breast cancer care.”
IBIS11 trial
The C&E centre is also involved in the IBIS 2 trial which is looking into the prevention of breast cancer and they also offer a family history screening service. Patients at the centre also get the opportunity to take part in research trials for cancer drugs as they work closely with the research nurses based at Broomfield and funded by the Helen Rollason cancer charity.
Breast reconstruction
Any patient who receives a mastectomy (breast removal) should have reconstruction discussed with them, as laid down in the NICE guidelines, and this is where Mr Venkat Ramakrishnan and his colleagues at the St Andrew’s centre come in.
Mr Ramakrishnan, consultant plastic surgeon, said:” At the St Andrews centre we run one of the biggest breast reconstruction services covering the whole of Essex and North East London. We probably perform more breast reconstructions than any other unit in the country and last year performed over 300. We can offer ladies every type of reconstruction available, mostly using the ladies own body tissue to rebuild the breast.”
The reconstructions available involve using body tissue from the tummy, buttocks or the thigh. When body tissue is taken from the tummy the surgeon can perform a tummy tuck at the same time that leaves a bikini line scar and a flatter stomach for the patient. This is an ideal choice if enough tissue is available in the tummy area!
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Mr Ramakrishnan adds: “When some women have a mastectomy they have an implant to rebuild the breast, or reconstruction using body tissue which is a far better option. By using the patient’s own body tissue it works much better as it behaves like a real breast and doesn’t ever have to be replaced. When the women increases or loses weight the reconstructed breast does the same. If a patient has one good operation using their own body tissue they are usually discharged by the consultant after six months whereas patients who have implants may need an operation for a new implant after five or ten years. Therefore over 20 years using body tissue for reconstruction is more resource and cost effective as well as being better for the patient.”
Breast Reconstruction Nurse
Jayne Knight holds the role of breast reconstruction nurse at St Andrews Centre and offers a service to women who are considering reconstruction following the removal of a breast (mastectomy).
Jayne said:” Previously a lot of ladies were not aware of breast reconstruction but now it should be discussed with all women who receive a mastectomy, which is good news for the patient.
Jayne, along with colleagues Annette Palmer, Fiona Saunders and Claire Easy run a nurse led breast clinic twice a week and are able to provide that personal touch for women who are considering breast reconstruction. The clinics free up the consultants to be able to see more patients which is beneficial all round.
Another service that the team offer is nipple tattooing that is carried out after the breast reconstruction surgery.
Jayne said: “I have been specially trained to carry out nipple tattooing which is really the icing on the cake for women who have had breast reconstruction as it is makes the breast look so realistic. Most of the consultants are more than happy for us to do this because it is time consuming so we also have women referred to us from G.P’s and other hospitals.”
In addition to her work in the clinic Jane started a special support group about five years ago, appropriately called BRA (Breast Reconstruction Awareness).
The group is for women who have undergone, or are thinking about, reconstruction and has grown over the years. A at recent meeting over 70 women attended.
Jayne adds:” The group has grown since myself, and former colleague Christine Moxom, began it five years ago. The aim of the meetings is to reassure women who are thinking about having breast reconstruction and even give them the chance to see some real-life reconstructions for themselves.”
A former patient and member of the BRA group said:” The information that the group gives to patients is invaluable. I had mixed feelings about having reconstruction so the group helped to reassure me. Some of the women actually let you see their reconstruction so that gives us an idea of what to expect. “
The BRA group meets once a month and is open to any women considering breast reconstruction. For further information please contact Jayne on (01245) 516136.
ENDS
Media contact : Jo Triggs tel: (01245) 514235 | Mobile : 0790 005 4948
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