WHAT TO EXPECT

On your first visit to see Michelle, you will be greeted by a receptionist, who will collect any referral letters, x-rays, test results or other information you have brought with you.  It is helpful if you can arrive at least 15 minutes prior to your appointment time so that Michelle has time to review the information prior to your consultation and any outstanding personal information can be obtained.
 

You can then take a seat in the waiting room, where a medical secretary may see you if any personal information is still required.  A breast care nurse will then take you to meet the Michelle.  A spouse, partner, relative or friend can accompany you, or the nurse can stay with you during your consultation and examination. 


Initial Consultation

Whether you have referred yourself, or been referred because of concern about a breast lump, pain, discharge, or your genetic background,Michelle will discuss the nature of your problem and any other relevant information, such as your general medical history and family history.  A thorough breast examination will follow.  The breast care nurse can be present during this examination.



Michelle will then discuss your care, and may request further diagnostic investigations, such as mammography and/or ultrasound.  Normally these investigations will have been booked when you made your initial appointment.  If they are required, you will be given the relevant forms to present to the onsite X-Ray and Imaging Unit.  

If an abnormality is found, either during physical examination, mammography or ultrasound, fine needle aspiration cytology (FNAC) or sometimes core biopsy is performed to draw off some cells or tissue for investigation by the cytologist or histopathologist.  

If a follow-up consultation is required to discuss the results of your investigations, this appointment can be booked with a medical secretary.  Appointments for any other recommended diagnostic tests can also be made at this time.  The follow -up appointment will be offered as soon as the results of your tests will be available between 24-72 hours, depending on the test.
 

Michelle will then write to your GP and any other referring doctor, with copies to you (if requested) and other relevant specialists, summarising your consultation and the planned investigations.  Letters are also sent after all subsequent consultations or when the results of investigations become available. 


Follow Up Appointment

Michelle will discuss with you the results of the investigations carried out.  She will recommend appropriate treatment and you will have the opportunity to ask questions and discuss the benefits and any contra-indications of the treatment proposed.
 

If surgery is indicated, the proposed operation will be explained.  All our patient care is based on informed consent, you will not be asked to agree to further or alternative procedures.  You will always know exactly what operation you will be undergoing before admission to hospital. 


Breast Surgery

You will always know what operation you will be having before being admitted to hospital.  All our patient care is based on informed consent and you will not be asked to consent to further or alternative measures.

 Please see our conditions/treatments page here for more information on specific treatments and procedures.


Breast Care and Counselling

To ensure continuity of care and that we have and an understanding of your situation all practice nurses have under gone specialist breast care training.

They are available for: 

• Health and screening advice
• Advice regarding self-examination
• Pre-operative advice and information both as an out-patient and in-patient
• Post-operative advice and care, before and after discharge from hospital
• Breast reconstruction advice
• Breast prosthesis information and fitting
• Hormone replacement therapy advice with reference to the breast


Surgical Outcomes

54,821 patients underwent mastectomy last year. Among patients ≥70, 11,927 did not have reconstruction, 109 had reconstruction. Among patients <70, 40,755 did not have reconstruction and 2040 had reconstruction. Patients without reconstruction had a significantly higher number of co-morbidities compared to those having reconstruction (P = 0.001). The 30-day complication rate for patients without reconstruction was 4.2% in patients ≥70 compared to 4.4% for those <70 (p = 0.4). In patients with reconstruction, the 30-day complication rate was 6.4% in patients ≥70 compared to 5.6% for those <70 (p = 0.7).

Miss Mullan reports a haematoma rate of <1%.

For more information on the surgical outcomes of breast cancer surgery, please visit the breastcancer.org website here.


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