Breast cancer

About Breast Cancer

Approximately 45,000 cases of breast cancer are diagnosed every year, usually in women who are over 50 years of age and who have reached the menopause. However, it is possible for women of any age to be affected by breast cancer and, in rare cases, the condition can also affect men.

What do we offer at St George’s Hospital

St George’s University Hospitals NHS Foundation Trust offers a comprehensive diagnostic service. Advanced Nurse Practitioners have led on the development of Breast Diagnostic services and also that of virtual clinics, a concept that is now being considered by other providers. Advanced Nurse Practitioners are involved in every stage of the patient pathway. The Breast Unit at St George’s University Hospitals NHS Foundation Trust is co-located with the South West London NHS Breast Screening Service.

To further aid diagnosis, the Radiology Department at St George’s University Hospitals NHS Foundation Trust provides a comprehensive imaging service (including MRI, CT and ultrasound technologies) whilst the Pathology service provides expert analysis of blood, cells and tissues.

A supra-regional Clinical Genetics services is also located on site.

St George’s Hospital is a large teaching hospital with the full range of skills and support services needed to be able to carry out complex cancer surgery. These include intensive care (ITU), anaesthetic and pain management services which are all available on site.

All GP referrals regarding suspected Breast cancer are subject to the two-week rule referral criteria and are therefore considered as urgent. Appointments may be booked at short notice however you should be available to receive an appointment in the Breast clinic at any time within a two-week period after your GP has referred you.  

What is the Breast  clinic?

The breast clinic is an outpatient clinic where you can see a specialist. You may have all of your investigations at this first visit within the Rose Centre which helps to speed up the process of identifying problems. It can take up to four hours to complete so please allow plenty of time. Some of the results may be available on the same day; others will be available the following week.

Who is the clinic for?

It is for patients who have been referred with a breast lump or other breast problem.

Before you come to the clinic

You may wish to bring a member of your family or a friend to keep you company and to provide support for you. It is not a good idea to bring young children with you as they may get bored during the visit. If not, and you wish to have a chaperone for your appointment, please let one of the nurses know on your arrival to the clinic.

You may find it helpful to write down your concerns or questions before your appointment and to bring them with you as a reminder.

Details about possible Investigations or Tests

During the course of your appointment, you may be asked to undergo an investigation or test to help the specialist in making a diagnosis. These may include the following:

Mammogram

This is an x-ray of your breasts. Each breast is held firmly between two plates and several images will be taken of each breast. Some women may find this uncomfortable but it only lasts a few seconds. Mammograms are offered to most women attending the clinic over the age of 40. If necessary, please ask during your appointment to see further information on mammograms.

Ultrasound Scan

An ultrasound examination is a painless way of obtaining a picture of the inside of your breast without using x-rays. It involves gently moving a sensor over the breast, which picks up sound waves that produce a picture on a screen. This is a useful test for younger women – and it may be the only test needed. For women over 40 this test may be offered as well as a mammogram.

Needle Biopsy

Following a local anaesthetic to numb the area the specialist will insert a needle to remove a small sample (core biopsy) of the breast tissue, which is then sent to the laboratory for more detailed examination.

Fine Needle Aspiration (FNA)

This is a quick and simple test, similar to a blood test. A needle is inserted into the breast lump to draw off cells or fluid. It can be a little painful, but it only takes a few moments. The cells are then sent to the laboratory for analysis.

Are there any complications?

Both the fine needle aspiration (FNA) and core biopsy tests are very safe procedures but there are some possible complications, such as:

• Pain
• Bruising/bleeding
• Infection
• Pneumothorax collapsed lung  – rare

Your specialist will discuss these with you in detail beforehand.

Please note that x-rays can be harmful to an unborn child so you must tell the radiographer if you think that there is a chance that you could be pregnant.

Following your investigations

If your results are available on the day of your appointment then your specialist will discuss your results with you. A breast care nurse will also be available to offer information and support.

Please note that given the nature of these investigations, you may be asked to attend the clinic again for a further follow up appointment which will be booked by the clinic reception staff following your initial appointment.

What happens next?

If necessary, your specialist will discuss the options for further investigations and treatment. If you require surgery then you will be offered a date for the operation.

What if I need to change an appointment?

If you have been referred by your GP through the two week rule process and you have been called to arrange an appointment which you need to change, please call: 0208 725 1111.

If you have been referred by your GP through the Choose and Book system and need to change your appointment, please call the Choose and Book Appointment Line on: 0345 60 88888.

If you have a follow up appointment booked with the Breast team which you need to cancel or re-arrange, please call: 0208 725 3000.

A downloadable leaflet containing information about your appointment is available here.