What can you expect in a consultation?
The consultation (usually 30 minutes), is first aimed at knowing you and understand your concerns in detail. In the presence of a specialist nurse, a thorough examination will help make an initial clinical diagnosis. Generally, this is followed by imaging of the breast such as a breast x-ray (mammogram) and an ultrasound. I discuss these images and their results with the consultant radiologist who sits in the next room.
Following your scans, I will see you again to discuss the interpretation of the results and plan the next steps. If you need to have a needle biopsy, it can normally be done right away. You will receive those results at your next appointment within a few days.
Second opinions: A number of our patients come for a second opinion and these consultations can take up to an hour to enable us to have a thorough conversation and an expert opinion. I believe that your opinion about your treatment is of paramount importance and that you should always have a choice. Consultations can be about hormone replacement therapy, family history and complex decisions about various types of cancer (oncology) treatments and finely balancing the benefits vs the side effects.
If you have found a lump in your breast, it is important that it is comprehensively examined and tested. It important to remember that most lumps are not cancerous. Under the age of 35, benign lumps such as fibroadenoma are the most common and between 35 to 55, cysts are common. A new lump appearing after menopause has a higher chance of being cancerous, but reassuringly, the treatment of breast cancer today is excellent and has been improving over the last three decades and there is a high success rate.
Facing a cancer diagnosis can be one of the most difficult situations to be in. A million thoughts, worries and scenarios will be running through your mind. It’s totally normal to feel that way, but you’re not alone. Together with your family and friends, we’re here. Your care is our focus, every step of the way. We believe care should be available when and where you need it most and it should be designed to help give you the best life outcomes possible. Over 90% of patients treated by our team are back to their normal life with little impact on their life span.
If you have any breast symptom, we can do a thorough check in our one-stop-clinic. More than 90% of women with breast symptoms do not have breast cancer and we can provide reassurance. If a cancer is diagnosed we can provide world-class care. We work as a multidisciplinary team and undertake comprehensive breast cancer treatment for you.
Breast cancer treatment usually starts with making sure the diagnosis is correct and complete. Thorough clinical examination, breast x-ray (mammogram), ultrasound and checking tissue from a needle biopsy. Sometimes more tests such as MRI or PET CT scan are necessary.
Treatment of breast cancer involves surgery such as a lumpectomy which is removal of the cancerous lump along with some normal tissue around it. Sometimes the cancers is too large which means it may need the whole breast to be removed and this is called a mastectomy.
Sentinel (the 1st node) node biopsy is done during surgery to check if the cancer has spread to the armpit and more lymph nodes may need to be removed (axillary clearance).
Radiation treatment (radiotherapy) is normally necessary when breast is preserved. This can be given during the surgery itself (TARGIT-IORT) or afterwards as a 3 to 6 week course of daily treatments.
Some breast cancer cells may spread before operation and depending on the stage of the cancer, treatment with hormonal (endocrine) tablets or treatment with drugs (chemotherapy) is advised.
Throughout the journey we aim to ensure that you are well supported with compassionate care from our team, all evidence-based options will be discussed in detail in an understandable manner, making it easy for you to make an informed choice about everything from every test, to every treatment aimed at getting rid of breast cancer.
We provide a multidisciplinary approach to breast cancer diagnosis and treatment. Our team includes surgeons, medical oncologists, radiotherapists, radiologists and pathologists, breast care nurses, and genetic specialists.
We believe in compassionate evidence-based practice, for every individual’s health, circumstance and perspective, making diagnosis and delivering treatment of breast diseases along with on-going support and care, putting the patient first
TARGIT-IORT: intraoperative radiotherapy for breast cancer
Most women who have breast-preserving surgery for breast cancer have radiotherapy afterwards, in a 3-6 week daily course. However, another option is to have TARGIT-IORT, and receive a single, targeted dose of radiotherapy during the cancer operation. This means you don't have to come in for repeated daily doses of radiation for several weeks.
My colleagues and I pioneered the TARGIT-IORT technique in University College London in 1998, and it has been clinically proven to be effective. It is now offered as a standard treatment for suitable patients in 35 countries around the world, and over 30,000 patients have been treated.
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We believe that treatments should be optimised and tailored for every individual patient. It should be based on sound clinical judgment, have a scientific basis and supported by evidence from clinical trials, and importantly, compassion.
My Latest Research
My work on Intraoperative Radiotherapy (IORT) was inspired by my original laboratory work in 1994, leading to the idea that breast cancer treatment with surgery and radiotherapy needs to be focussed and targeted. During this time I worked closely with Professor Michael Baum and Professor Jeffrey S Tobias, in UCL, London.
I developed the concept, tools (Intrabeam) and the surgical operative procedure (TARGIT IORT) to give targeted intraoperative radiotherapy to the tissues immediately around a breast cancer, after it is surgically removed (lumpectomy). I named this technique TARGIT- for TARGeted Intraoperative radioTherapy and it is commonly called Intrabeam TARGIT IORT.