Breast cancer is the most common type of cancer in the UK, but with the treatments available there is a very good chance of recovery, particularly if it is detected at an early stage.
Women are advised to check their breasts regularly for any changes and to see their GP promptly if they are concerned. Men can also be diagnosed with breast cancer but this is much less common.
We also encourage you to attend your local screening appointments between the ages of 50 – 70 years.
A cancer diagnosis has a significant impact on people’s lives and we aim to provide the best possible care for all patients who are diagnosed with breast cancer. This includes emotional support and information for patients, their families and carers throughout the time you are under our care.
A breast cancer diagnosis covers a wide spectrum, ranging from non-invasive conditions such as DCIS (Ductal Carcinoma in situ) to invasive breast cancer. See below for more detail on the treatments offered.
DCIS (Ductal Carcinoma In Situ)
When cancer cells have developed within the ducts of the breast but remain within the ducts (‘in situ’), it is called DCIS. The cancer cells have not yet developed the ability to spread outside these ducts into the surrounding breast tissue or to other parts of the body. It is often picked up through the screening process.
It is usually treated with surgery and in some cases radiotherapy. The types of breast surgery you may be offered are similar to those with an invasive breast cancer and are discussed below. Lymph node testing may be discussed with a diagnosis of DCIS and a sentinel lymph node biopsy may be recommended. You can find out more on the Breast Cancer Now website.
Invasive breast cancer
The most common treatments for invasive breast cancer are surgery, radiotherapy and hormone treatments. Chemotherapy and targeted treatments such as Herceptin and bone strengthening drugs are also advised on an individual basis. We aim to start treatment within one month of your diagnosis.
The purpose of treatment is to remove the cancer (local treatment) and treat the rest of your body (systemic treatment) with the aim of reducing the risk of recurrence in the long term.
Breast Surgery
Surgery is usually the first treatment for invasive breast cancer, although sometimes chemotherapy or hormone treatments can be given first. If patients have other health conditions which limit their surgical options they may be advised hormone therapy to treat their cancer as first line treatment.
There are a number of surgical options available, depending on your cancer and your wishes.
Your surgical options are either:
- breast conserving surgery
- mastectomy - removal of all the breast tissue and nipple (depending on your cancer diagnosis and the size of the cancer in relation to the size of your breast)
- Breast conserving surgery is performed with the aim of maintaining the optimum breast volume and shape following removal of the cancer. The types of surgery this includes are:
- Wide Local Excision
- Therapeutic Mammoplasty
- Chest Wall Perforator Flap
- Localisation techniques - Wires/Magseed/ultrasound mark
- Sentinel Lymph Node Biopsy and Radioactive Isotape/Blue Dye
- Radioactive injection for SLNB (subject to change)
- Axillary treatment in node positive patients – Axillary node clearance/radiotherapy
- NeoAdjuvant Chemo Therapy/ Herceptin
- Oncoplastic and reconstruction options
- Primary endocrine Treatment and Neo Adjuvant Endocrine Treatment
All patients who are advised a mastectomy will have an opportunity to discuss breast reconstruction. If this is not appropriate for you, the Breast Care Nursing Service will provide you with external breast prosthesis.
Lymph node surgery
Lymph node testing is routinely advised for all women who have an invasive cancer and may be discussed if you have DCIS.
Sentinel Lymph Node Biopsy is performed at the same time as breast surgery and involves removing some of the nodes in your axilla (armpit) to test if they are affected.
If we know that the nodes are involved when you are diagnosed, an axillary clearance will be advised. Here, the majority of the nodes in your axilla will be removed as treatment.
Adjuvant treatments
Surgery is usually followed by medical (Adjuvant) treatments to help reduce the risk of the cancer coming back. The treatments you will be offered depend on the results of your surgery which gives us information about your individual cancer. You may only require surgery or a combination of one or all treatments including radiotherapy, hormone treatment, chemotherapy, targeted treatments and bone strengthening therapy.
We also provide a reconstruction service for women who are considering a mastectomy because of a high risk of breast cancer in the family especially those who carry the BrCa1 and 2 genes.
Lymphoedema is an accumulation (swelling) of protein rich fluid in the tissues as a result of an impaired, damaged or overloaded lymphatic system
It can affect any part of the body, and if left untreated, can have a significant and negative impact on quality of life.
Swelling in the arm is common, but the breast, chest and back areas can also develop lymphoedema and is becoming more common due to more conservative breast cancer treatments (i.e. surgery/radiotherapy.)
Symptoms
- Area feels heavy/full
- Skin changes texture, feels tight
- Local aching/discomfort
- Reduced movement/flexibility (joints)
- Clothing/jewellery feels tighter
- Altered sensations/numbness/heat/cold
If you have symptoms, seek help as soon as possible to ensure prompt treatment.
Reducing the risk of Lymphoedema
1. Skin care to the ‘at-risk’ limb/breast
2. Avoiding trauma/injury (prevention of infection – Cellulitis) to the ‘at-risk’ limb/breast
3. Exercise – keep active and keep the lymph moving!
4. Keeping weight within normal limits
Reporting a problem
If you are at all worried about developing lymphoedema – or feel that you are developing swelling in your ‘at-risk’ arm/hand or breast, please refer to Kendal Lymphology Centre.
An external breast prosthesis is an artificial breast, which can be worn inside your bra to replace the volume of the breast that's been removed.
You will be fitted with a soft prosthesis prior to leaving the ward after a Mastectomy. This is fibre filled and is worn for around 4-6 weeks post-operatively while the surgical wounds are healing
You will then be invited to a prosthesis clinic at Lancaster or Barrow in Furness to be fitted with a silicone prosthesis around 4-6 weeks post-operatively. We stock both Trulife and Amoena prosthesis and supply full, partial, expandable, and swimming prosthesis.
Lancaster clinics are alternate Tuesday afternoons, and Barrow in Furness clinics take place on the first Wednesday of the month. To be booked into a prosthesis clinic, or to order a replacement, please call the breast care nurses on 01524 584170 option 3.
Breast cancer starts as a lump in the breast – this is known as “primary” breast cancer.
“Secondary” breast cancer is the term used to describe breast cancer that has spread beyond the breast or axilla (armpit) to other parts of the body, such as the bones, liver, lungs or brain. If the breast cancer cells spread to the brain for example, it is known as “secondary or metastatic breast cancer of the brain”.
Secondary breast cancer is also referred to as “metastatic breast cancer”, “stage 4 breast cancer”, or “advanced breast cancer”.
Secondary breast cancer is often diagnosed years after a primary breast cancer, however, for some patients, secondary breast cancer is their first diagnosis of breast cancer.
In the UK, there are around 35,000 people living with secondary breast cancer and although secondary breast cancer cannot be cured, the aim of treatment is to control further spread of the disease and for many, this can be done for a number of years.
All patients with secondary breast cancer (SBC), will be cared for by a Consultant Oncologist and will have access to a Clinical Nurse Specialist (CNS) and a Cancer Support Worker (CSW).
Treatment
The aim of treatment for secondary breast cancer is to:
- Control and/or slow down the rate the cancer can spread
- Relieve symptoms
- Give you the best quality of life possible by helping you to maintain your health and wellbeing
There are different treatment options available for secondary breast cancer such as hormone therapy, chemotherapy, radiotherapy and targeted therapies.
Meet the Team
Anna - Cancer Nurse Specialist
Nichola - Cancer Nurse Specialist
Humairaa - Cancer Support Worker
Contact us
If you need any information, advice or support please contact us: 01524 512148
We work Monday to Friday 8:30 – 17:00, an answer machine is available for messages if we are not available. Please leave your name and telephone number and a member of the team will contact you as soon as possible.
Symptomatic appointments 01524 584170 option 1
Surgery dates 01524 584170 option 2
Medical Secretaries 01524 584170 option 5
PALS (Patient Advice and Liaison Service) 01539 795497
UHMB Macmillan Information and Support Service – 01524 519578
Macmillan Cancer Support Helpline 0808 808 00 00
Resources
Our dedicated team is made up of surgeons, oncologists, radiologists, breast clinical nurse specialists, cancer support worker and radiographers.
Consultant Breast Surgeons
- Penny McManus - Consultant Reconstructive and Oncoplastic Breast Surgeon
- Rishi Parmeshwar - Consultant Reconstructive and Oncoplastic Breast Surgeon
- Santosh Somasundaram – Consultant Reconstructive and Oncoplastic Breast Surgeon
- Ms Shaziya Ali – Consultant Reconstructive and Oncoplastic Breast Surgeon
Registrars
- Adel Ben-Hamida
- Anusha Balakrishnan
Macmillan Breast Care Nurse Specialists
- Carol Brearley
- Debbie Tysver-Robinson
- Kate Whiteside
- Shelley Hindle
- Sarah Webb
- Josephine Pimentel
- Rose Harpley
- Danica Guanzon
- Louise Ogden
Cancer Support Worker
- Karen Lightfoot - 07977 815431
Medical Secretaries
- Sharon Nicholson - Secretary to Mr Parmeshwar
- Sam Wadey - Secretary to Ms McManus
- Gail Gaffney - Secretary to Mr Somasundaram
Clinical Service Manager
- Pam Fleming
Assistant Service Manager
- Emma Breslin
Breast Care Coordinator
- Julie King
- UHMBT Breast Screening
- National Breast Screening office 01524 518699
- Symptomatic appointments 01524 584170 option 1
- Surgery dates 01524 584170 option 2
- Breast care nurses 01524 584170 option 3 then option 1 for RLI, option 2 for FGH
- Cancer Support worker 01524 517811 / 07977815431
- Medical Secretaries 01524 584170 option 5
- PALS (Patient Advice and Liaison Service) 01539 795497
- UHMB Macmillan Information and Support Service – 01524 519578
- Macmillan Cancer Support Helpline 0808 808 00 00