鶹Ӱ

Appointments, assessments and patient pathways

Patients will be seen in a 'new patient clinic' following referral to the hospital by their GP with any of the following symptoms:

  • A lump or a swelling in the breast, upper chest or armpit.
  • A change to the skin (puckering/dimpling)
  • Nipple changes eg, flattened/inverted/rash or crusting
  • Any unusual discharge from nipple
  • Change in size or shape to your breast

These clinics are also referred to as fast track or triple assessment clinics.

Most people referred to the clinic will be discharged without needing any further treatment.

Breast clinics

Breast clinics

Timetable

Consultant and Associate Specialist led clinics

Monday Tuesday Wednesday Thursday Friday
Am Results and follow-up clinic (no imaging)

Two week wait (mammo and ultrasound available)

Results and follow-up clinic (no imaging)

Two week wait (mammo and ultrasound available)

Results and follow-up clinic (no imaging)

Pm Two week wait (mammo and ultrasound available)

Specialist nurse led clinics

Monday Tuesday Wednesday Thursday Friday
Am Alternate FH/Hormone only (Endocrine) and EOT (5 years)

Alternate Prosthesis Fitting Clinics

Alternate PIFU

EOT (from 6 months)

Alternate PIFU

Pm PIFU (Patient Initiated Follow Up) PIFU

Where to find us

Breast Clinics are held in the Outpatients Department: Level 1

Breast Care Nursing service based in the Breast Care Unit: Level 2

Meet the team

Breast surgeons:

Mrs Anna Conway
Consultant oncoplastic breast surgeon, department lead

Anita Sharma
Consultant oncoplastic breast surgeon

Jenny Banks
Consultant oncoplastic breast surgeon

Contact via breast unit secretary: 01271 322422

Breast Clinical Nurse Specialists:

Claire Herlihy (lead) (NMP)
Amy Barrow
Karen Hillman (NMP)

Amanda Disney
Abigail Osbourne(Assistant Practitioner)
Jackie Cockwill – Secondary Breast Care Clinical Nurse Specialist

Pippa Clifton – Breast Oncology Clinical Nurse Specialist

Contact number: 01271 349115

Radiology team:

Dr Sandra Owen
Consultant radiologist

Dr Milos Balvin
Locum consultant radiologist

Mrs Heather Mower
Advanced practitioner radiographer and lead mammographer

Mrs Ruth Glover

Advanced practitioner radiographer and lead mammographer

Contact number: 01271 311678 (ext 3678 or 3793)

Oncology team:

Dr Peter Stephens
Consultant medical oncologist

Contact number at NDDH: 01271 311898
Contact number at RD&E: 01392 404578

Contact number at NDDH: 01271 311898
Contact number at RD&E: 01392 406204

Histopathology team:

Dr Adetope Adegbayibi
Consultant histopathologist

Lymphoedema Team
At Barnstaple Health Centre near Green Lanes

Georgina Martin
Macmillan lymphoedema specialist practitioner

Angela Ives

Lymphoedema Specialist Nurse

Contact number: 01271 341551

Contact us

The Breast Care Unit is open Monday to Friday, 8am - 4pm.

To change an out-patient appointment please contact our booking office on:

Telephone: 01271 349149 (stating your NHS number).

If you have an appointment for surgery and need further information about this appointment or need to make changes please contact the secretary of your designated consultant, by calling the hospital switchboard: 01271 322577

Oncology appointment bookings contact number: 01392 406181

Tests, assessments and procedures

You might be asked to attend our breast care unit to have:

Mammogram:

This is a special type of X-ray, used to examine the breast in detail. Both breasts will be examined. The breast is held gently but firmly between two plastic plates. Two X-rays are taken of each breast at different angles. Some patients find the mammogram uncomfortable and occasionally painful but this is usually only for a very short time.

Ultrasound:

An ultrasound scan is a painless test, which takes just a few minutes. A small device called an ultrasound probe is used, which gives off high-frequency sound waves. Special gel is placed on the breast and the probe is moved over the area being investigated. Images are then recorded on the ultrasound machine.
You may feel some pressure because sometimes the probe needs to be pressed firmly against your skin to get a clear picture.

Core biopsy:

During a core biopsy very small samples of tissue are taken from your breast for further examination. Local anaesthetic numbs the area before a needle is used to collect the sample. We aim to keep you as comfortable as possible through the biopsy procedure and you will be supported by the radiographers and radiography assistants. The biopsy can be done using ultrasound or mammogram as a guide. If mammogram guidance is advised you will be given an appointment on another day to have it done. The specimen of breast tissue taken is then sent to our laboratory to be examined. Your breast can bruise and be tender after a core biopsy, but this generally settles within a week.

You will be given an aftercare advice leaflet by our staff before you leave the department.

After your tests, you might be asked to return to the surgical outpatient department to discuss the results of the investigations with the doctor. If a biopsy is taken you will return to the clinic in 1 to 2 weeks' time to discuss the results. Otherwise, you will be contacted by letter with your investigation results.

If further tests or scans are needed and they can't be done on the same day, you may have to return for a further appointment.

Breast MRI

In addition to triple assessment, breast MRI (Magnetic Resonance Imaging) has a useful role in selected cases (young patients and implants) as a problem-solving tool to help diagnose breast cancer or to give further information.

MRI does not involve x-ray irradiation but uses a very strong magnetic field. It requires specially trained radiographers to perform the test and takes 45-60 minutes. All breast MRI examinations are carried out at the 鶹Ӱ & Exeter Hospital and double-read by experienced breast-dedicated radiologists.

It is most often used to give further information following a mammogram and ultrasound. In many cases, an additional breast ultrasound is performed after the MRI to clarify its findings. It is sometimes used to assess the response of a cancer to chemotherapy or hormone treatment prior to surgery.

In addition to its role as a diagnostic tool, breast MRI is useful in screening younger women at a significantly increased risk of breast cancer either as a result of a very strong family history or a mutated breast cancer gene (BRCA1 or BRCA2), or following chest mantle irradiation for Hodgkin’s disease at a young age. MRI is often helpful for these women because it is effective in dense breast tissue and many youn­­­g women have dense breasts.

However, mammography and ultrasound remain the most useful diagnostic breast imaging methods and even where MRI is recommended for women at high risk of the disease, it is used in conjunction with mammography and ultrasound for selected women. Breast MRI is a very specialised technique and the results take longer to process.

If the test has been performed for a suspicious or known breast cancer, you will be given an appointment to return to the clinic to discuss your results with a specialist. Following the Breast MRI examination, many patients are called back for a further ultrasound of the breast as this helps the radiologist to interpret the MRI findings. This is known as a “second look ultrasound”

Treatment

Treatments will depend on any scan or biopsy findings. Most benign conditions do not need any further investigation or treatment.

For benign conditions we aim to offer any recommended treatment within three months but we must always prioritise patients with cancer. When the demand for cancer surgery increases, waiting times for non-cancer surgery can be up to a year.

Patient information leaflets

We produce a wide range of leaflets which provide information about our services and about the treatment you might receive in our clinics or during your stay in hospital.

We also produce these in different formats including large print, please contact the department you are visiting for more information.

Supporting you

Having cancer can have an impact on every aspect of your life and on those around you. We understand that this is a difficult and often frightening time for you and your loved ones, which is why we have put together a wide range of information to help you live with and beyond cancer.

Some of these services are available locally, whilst others cover Devon and/or the South West Peninsula as a whole.

Find out more

Patient Initiated Follow-Up

Follow-up appointments and mammogram arrangements

Your follow-up and the time between appointments will depend on your individual needs and on the arrangements at the hospital you are being treated in.

The first five years

You will be invited to an End of Treatment appointment with the Breast Care nurses approximately 6 months after you have completed your treatment.

Important information at this appointment includes:

Breast awareness
Planned follow-up
What to report to the Breast Care Nurses
How to access a clinic appointment via Open Access Follow-up
Common problems after diagnosis and treatment.

Mammograms

Depending on your surgery you are likely to require a mammogram every year for 5 years following diagnosis.

You should receive a result for you routine follow-up mammogram within a month of it being performed. If you have not, you should contact the Breast Unit Secretary.

We will not routinely see you in the clinic as you will be under Patient Initiated Follow-up. This means you remain under the care of the breast team for 5 years after diagnosis and can contact the breast team directly (do not need to see GP). This can enable quick access to the breast care team and the hospital when required.

After the five years

If you are younger than 50when diagnosed, you will be given a yearly mammogram at NDDH until the age of 50 is reached.

If you are over the age of 50, you will be invited to have three-yearly mammograms up to your 71st Birthday as part of the NHS Breast Screening Programme.

If you are over the age of 71, you are still eligible to be screened by request. This can be arranged by contacting the local NHS Breast Screening Programme on 01392 262600 or through your GP.

Who to contact if you have a concern

During follow-up

Many patients find that speaking to their Breast Clinical Nurse Specialist can be an easy way to discuss any concerns. They may organise an earlier appointment if you both feel you need to see the specialist sooner.

You can contact the Breast Clinical Nurse Specialist on 01271 349115

If you have any new symptoms you are worried about, you can see your GP between appointments for advice. If they feel it is necessary, they can refer you back to hospital for an earlier appointment.

After your five-year End of Treatment Summary

In the UK the survival of people with breast cancer has improved greatly over the past decade and many will have no further problems after they finish their treatment.

If you have had no further problems, you will be discharged from Patient Initiated Follow Ups. After you have been discharged from follow-up appointments, your GP will be your main contact to get concerns checked quickly.

If you have any concerns, see your GP. Make sure they know about your breast cancer, particularly if you were diagnosed some time before, or if you have a new GP. If you feel you need to be seen in clinic again, your GP can arrange this quickly for you, or alternatively you could contact your breast care nurse at the hospital directly.

Symptoms you may want to report

  • Pain in the back or hips that does not improve with painkillers and which is often worse at night
  • Unexplained weight loss and a loss of appetite
  • A constant feeling of nausea
  • Discomfort or swelling under the ribs or across the upper abdomen
  • Feeling constantly tired
  • A dry cough or a feeling of breathlessness
  • Severe headaches, usually worse in the mornings
  • Any new lumps or swellings, particularly in the area of your previous surgery, or in the neck area

Long-term side-effects of breast cancer treatment

Some breast cancer treatments can cause temporary side-effects that stop soon after treatment finishes. However, your treatment may also cause longer-term side-effects.

Some common side-effects include:

  • Menopausal symptoms
  • Hair regrowth after chemotherapy
  • Pain
  • Fatigue and sleep problems
  • Lymphoedema
  • Osteoporosis
  • Effects on fertility

To find out more about the possible side-effects of your treatment and how best to manage them, please see the individual treatment information booklets or contact the Breast Clinical Nurse Specialist who can signpost you to the appropriate help and advice.

What does a typical patient pathway look like?

Last updated: November 15, 2022

Cookies

Our site uses cookies to help give you a better experience. By continuing to use it you consent to the use of cookies as set out in our privacy policy.