Breast Cancer Service

What is Breast Cancer?

Breast Cancer is cancer that starts in the breast tissue. Breast cancer starts when cells in the breast begin to divide and grow in an unusual and uncontrolled way.

Picture showing the breast and labels

DCIS ( Ductal Carcinoma In-Situ) DCIS is an early form of breast cancer. When cancer cells have developed in the ducts of the breasts and remain within the ducts , this is called DCIS.

Invasive Ductal Cancer is the most common type of breast cancer. Invasive means the cancer has escaped to outside of the ducts into the surrounding breast tissue.

breast ducts

Invasive Lobular Cancer is a type of breast cancer that starts in the lobules of the breast and accounts for 15% of breast cancers.

Inflammatory Breast Cancer is a rare, fast growing cancer, it is called inflammatory because the skin of the breast usually looks red and inflamed. This is caused by the breast cancer cells blocking the tiny lymph channels in the breast tissue.

Detailed signs and symptoms of breast cancer can be found on the Breast Cancer Now website : www.breastcancernow.org

Your Clinic Appointment at Dudley Group:

Referrals are usually made by GPs or other Health Care Professionals. We offer urgent access clinics and urgent oncology clinics, and work closely with the radiology department in the process of investigation and diagnosis. We offer a range of breast surgical options for the treatment of breast cancer, including reconstruction breast surgery. Breast cancer services work closely with the NHS Breast Screening Programme for Dudley, Wolverhampton , and South West Staffordshire Screening Service. (Please see separate Breast Screening page).

Breast clinics are provided in a dedicated outpatient area of radiology , with speciality trained staff.

Specialist Services include:

Mammography – A mammogram is a breast x-ray, your breasts will be placed one at a time on the x-ray machine, the breast will be placed down firmly on the surface of a clear plate. At least 2 x-rays will be taken. One from top to bottom, and then a second from side-to-side. It may be uncomfortable, but only takes a few seconds and the compression does not harm the breasts.
Tomosynthesis – Digital Breast Tomosynthesis ( DBT), is another, more detailed mammogram. It takes 3D images using x-rays. The breast is positioned in the same way as a mammogram.
Breast Ultrasound Scan– An ultrasound scan uses sound waves to produce an image of the breast tissue. It is painless and is generally done in a few minutes. The person doing the scan will move a hand held probe over the breast to look at the underlying breast tissue. The area under your arm ( axilla) may also be scanned.
Breast MRI – This is imaging that uses radio waves and strong magnets to make detailed pictures of the inside of the breast. You will be given detailed instructions and guidance on this procedure if this type of imaging is recommended.
Core Biopsy- Sometimes a small sample of breast cells or breast tissue may need to be taken to make a diagnosis. This will usually be done using a core biopsy, sometimes a fine needle aspiration(FNA), or another procedure such a punch biopsy. A mammogram or ultrasound may be used to help pinpoint the area. If you are taking any anticoagulants or aspirin, please advise your doctor before the procedure. Local anaesthetic is given prior to this procedure. A small dressing or plaster will be applied after the procedure, and there may be some bruising after this.
Vacuum Assisted Biopsy ( VAB)- After an injection of a local anaesthetic a small cut is made in the skin, and a hollow probe connected to a vacuum device is placed through this. Using a mammogram, or ultrasound as a guide, breast tissue is sucked through the probe by the vacuum into a collecting chamber. This means that several samples of tissue can be collected without removing the probe.

For any investigations that you may require, a full and detailed explanation will be given. Additional information on each procedure can be found on the Breast Cancer Now website : www.breastcancernow.org

Multi-Disciplinary Team

All patients with a suspected or confirmed cancer are discussed at a Multi-Disciplinary Team Meeting ( MDT), which includes Surgeons, Radiologists, Pathologists, Oncologists, and Clinical Nurse Specialists. The benefit of this approach is that all of the specialists need to discuss different treatment options, and are able to reach a joint decision about your individual treatment plan.

Individual treatments may include surgery, chemotherapy, targeted therapies, hormonal therapies and radiotherapy. Information on all treatments and investigations can be obtained from the Breast Care Nurses.

The Breast MDT takes place on Wednesdays and Fridays.

The Breast Cancer Multidisciplinary Team:

Name	Role	Extension Number
Mr P Stonelake	Consultant Breast Surgeon Secretary Mrs N Bussey	01384 244013
Mr V Voynov	Consultant Oncoplastic Breast Surgeon Secretary Mrs J Ensor	01384 244015
Mr M Abdullah	Consultant Breast Surgeon Secretary Mrs D Wright	01384 244014
Dr D Tripathi	Consultant Clinical Oncologist Secretary Mrs V Pardon	01384 456111 ext 3611
Dr V Kuriakose	Consultant Clinical Oncologist Secretary Mrs V Pardon	01384 456111 ext 3611
Dr Amin	Locum Consultant Medical Oncologist Secretary Mrs V Pardon	01384 456111 ext 3611
Dr S Ibrahim	Consultant Clinical Oncologist Mrs S Dibernardo	01384 456111 ext 2596
Mr D Mohan	Consultant Plastic Surgeon Secretary Ms E Baker	01384 456111 ext 3459
Mr M Ali	Consultant Plastic Surgeon Secretary Ms E Baker	01384 456111 ext 3459
Mrs A Mannion	Consultant Breast Radiographer	01384 456111 ext 2177
Mrs B Moran	Consultant Breast Radiographer	01384 456111 ext 2177
Mrs S Matsenhura	Trainee Consultant Breast Radiographer	01384 456111 ext 2177
Mrs R Willetts	Breast Nurse Consultant Secretary Ms J Wallage	01384 244065
Mrs N Whitehouse	Trainee Breast Nurse Consultant	01384 244065
Mrs J Cooke	Breast Clinical Nurse Specialist	01384 244065
Mrs S Ralph	Metastatic Breast Clinical Nurse Specialist	01384 456111 ext 2347
Mrs L Park-Davies	Breast Care Sister	01384 244065
Mrs H Hulme	Breast Care Sister	01384 244065
Mrs C Dyas	Breast Care Sister	01384 244065
Mrs J Jackson	Breast Care Sister	01384 244065
Mrs R Rudge	Breast Care Sister	01384 244065
Mrs S Stubbs	Person Centred Follow Up Co-ordinator	01384 244065
Mrs E Foster	Breast Care CSW	01384 244065
MDT Co-ordinator	Mrs K Thandi	01384 456111 ext 4241

The Breast Care Nurses offer a range of additional services including, holistic needs assessments, prosthesis fitting, lymphoedema service, nipple tattooing, and they run a Family History Clinic once a month. You will be offered a named nurse (key worker) if you are diagnosed with breast cancer to provide you with on-going support, information and co-ordination of your care. The Breast Care Nurses offer a comprehensive follow up pathway, but patients have the option to choose a self- management pathway (Person Centred Follow-up). This enables a greater choice for patients according to their needs.

We also have a dedicated metastatic Clinical Nurse Specialist to support patients diagnosed with secondary breast cancer.

Support Contacts:

MacMillan Citizen’s Advice Bureau Benefits Team : 01384 817721

Action Heart : 01384 456111 ext 1470

The White House Cancer Support: 01384 231232 www.support4cancer.org.uk

Breast Cancer Now: 0333 20 70 300 www.breastcancernow.org

MacMillan Cancer Support: 0808 808 0000 www.macmillan.org.uk

British Lymphology Society: 01452 790 178 www.thebls.com

Lymphoedema Support Network: 020 7351 4480 www.lymphoedema.org

Cancer Research UK: 0808 800 4040 www.cancerresearchuk.org

Look Good Feel Better : 01372 747 500 www.lookgoodfeelbetter.co.uk

NHS Choices : www.nhs.uk