One Stop Breast Clinic
When a patient complains of breast symptoms such as a lump, thickening, nipple discharge or pain you will often be referred to a breast clinic. This should be a “one stop clinic” which offers triple assessment of your breast symptoms. For instance if you have found a lump we would assess you in 3 different ways:
1 History and examination of your breasts and glands under your armpit. When taking a history we build up a picture of of your symptoms and come to a working diagnosis of what we think the problem is. In younger women it is important to ask you about any family history of breast cancer and if so, how old your relatives were when they were diagnosed. It is also important to note if you are taking medication such as hormone replacement therapy (HRT) and the oral contraceptive pill (OCP). We would also like to know the number of pregnancies you have had and how many children you breast fed. All this information is used to build up a picture of your risk of developing breast cancer.
We would then move on to the examination. This very important and will be performed sitting up and lying down. Both your breasts and lymph glands underneath your arms will be examined. If a lump is felt we estimate its size and position within the breast and assign it a score between 1-5 (1 being normal and 5 being cancerous).
2 Radiological investigations are performed after a physical examination. If you are over 35yrs we would normally perform a mammogram which is an X-ray of your breasts. We look for lumps , deformities and tiny flecks of calcium called micro calcification. Again a score will be given by the radiologist indicative of its nature 1-5 (1 being normal and 5 being cancerous). An ultrasound scan is usually done after a mammogram which helps us determine whether a lump is solid or fluid filled (e.g. harmless breast cyst). If we suspect cancer an ultrasound scan will be performed under your armpit to look at the lymph nodes which gives us important information prior to treatment. In more complex cases we sometimes send patients for an MRI (magnetic resonance image) scan which is more time consuming but in younger women with dense breasts provides us with additional information that may improve our diagnostic accuracy.
3 Needle test/Biopsy if we detect a lump or abnormality on any of the images we routinely perform a biopsy in the clinic. This is performed under local anaesthetic and is tolerated very well. Shortly after the procedure you can go home but you may want to bring someone with you to drive you home just in case you do not feel like driving. The biopsy result is often back within 48-72 hrs and we will see you back in the clinic to discuss the result. Occasionally we need to repeat the biopsy if the first one was inconclusive.
The triple assessment approach ensures an accurate timely diagnosis and all my clinics are run to this standard providing women with a rapid diagnosis.
Please note Mr Johnson offers a one stop clinic at both 52 Alderley Road and Spire Regency Hospital with the assisstance of an expert Breast Radiologist