We offer a daily service for patients who have seroma problems following surgery. If you have problems please contact the Breast and Gynaecology Ward directly on 01282 803270
The Consultants offer a range of breast surgery for benign and malignant conditions including a wide range of Breast Reconstruction options.
Sometimes surgery is required for non-cancerous conditions. This may be done to rule out a cancer or pre-cancerous condition or to treat an infection. The potential risks and benefits of such surgery is discussed in the clinic with the patient.
Following a cancer diagnosis each case is discussed by the cancer team and a treatment plan is made. This may be amended, if it is safe to do so, if following discussion with the patient it appears they have requirements that had not been taken into account when making the original plan.
The first line of treatment is often surgery. This may take the form of a wide local excision (also known as a lumpectomy), a mastectomy (removal of the breast) if a wide local excision is not possible (or if the patient requests it) or sometimes where a woman has a generously proportioned breast she may be offered a therapeutic mammoplasty (a breast reduction which incorporates the tumour in the removed tissue).
Where women are offered a wide local excision for cancer or a therapeutic mammoplasty this is followed by radiotherapy some weeks later.
Where a woman is advised to have a mastectomy the option of immediate breast reconstruction will be discussed with her.
If invasive breast cancer is diagnosed the lymph nodes of the armpits will also be assessed. We routinely scan the armpits of women who have breast lumps to check for abnormal looking lymph nodes. If a woman is found to have cancer cells in the lymph nodes then she will also be offered surgical treatment of the lymph nodes by removing them all, an axillary node clearance.
If the lymph glands look clear, then she is offered a sentinel node biopsy. A sentinel node biopsy involves using 2 types of dye which get trapped in the same lymph nodes that would trap cancer cells. The dye helps us to find these nodes and remove them – typically there are less than 4 sentinel nodes.
Where a woman requires a mastectomy breast reconstruction can be offered as an immediate or delayed procedure.
An immediate reconstruction offers the benefit of keeping some of the breast skin which can give a better cosmetic outcome in the long run. However there may be times when the surgeon advises against immediate reconstruction because of the likelihood of further treatment to the chest wall being needed. Locally we can offer reconstructions with tissue expanders and implant based procedures.
Nipple reconstruction is offered using a variety of techniques. Under local anaesthetic a small piece of skin can be folded and sutured to create the promontory of the nipple (the bit that sticks out) and then tattooing is done at a separate outpatient appointment by our specialist micropigmentation technician to create the areola (the coloured circle around the nipple.)
Sometimes women choose simply to have a picture of a nipple tattoed on, and this can be very effective. Sometimes where suitable, we offer nipple sharing, where part of the opposite nipple is placed as a graft onto the reconstructed breast.
Breast cancer care may involve additional treatments with radiotherapy, chemotherapy, endocrine therapy and immunotherapies. These are provided by our oncology service. Although the service is based at LTHT outpatient appointments and some chemotherapy services are provided at Blackburn and Burnley hospitals. Radiotherapy is provided at the Rosemere Centre at Royal Preston Hospital.
Cancer surveillance follow up programme Patient led follow up.) –
Women who have been treated for breast cancer are traditionally followed up for 5 years post diagnosis. We are reviewing our follow up programme in order to meet the needs of modern day cancer survivors. This is an evidence based approach to providing the best care. The emphasis is on providing general information about breast cancer survival to each group but also tailored one to one information about the treatments received and personal risks for each patient. We aim to provide an information half day at the end of treatment and a separate one to one session. Following this they would be invited to attend for an annual mammorgam and at that point each year they would be asked to complete a short questionnaire in order to highlight if there are any issues that hadn’t been picked up in that last year.
In between mammograms we plan to offer a rapid access service if problems appear. In this way we will be able to see patients quickly when they need to be seen (and not bother them when they are well).