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Information for Professionals

Clinics
One-stop clinics for patients with breast symptoms run on a Monday afternoon, Tuesday morning, Thursday morning and Thursday evening. All of these clinics have full triple assessment facilities for all patients, with the exception of Thursday morning which is for under 35s only as mammograms are not routinely available.

Female doctors are usually available in all clinics except a Thursday morning; chaperones and Breast Care Nurse Counsellors are routinely present in all clinics. We will send all patients with a breast symptom an appointment within 2 weeks of receipt of referral regardless of urgency of referral. Patients requiring biopsy should have their results by the Friday if seen on a Monday or Tuesday; if seen on a Thursday results are available the following week.

Family history clinics are held on a Thursday morning. The family history questionnaire will be sent out once a referral is received; once this has been returned a letter will be sent inviting the patient in for an appointment if appropriate.

Referrals regarding cosmetic problems will be seen in follow-up clinics or redirected to the Plastic surgeons as appropriate; these will be sent the next available appointment but this unlikely to be within 2 weeks. We are happy to see patients who have cosmetic problems after breast cancer surgery or who would like to discuss delayed reconstruction even if their treatment was many years ago.

Making a referral
Referrals for one-stop clinics can be made via Choose and Book or by letter; please refer family history or cosmetic problems via letter to avoid inappropriate use of one-stop slots.

Advice
If you require advice regarding referral or any other queries you can write to us, use the Choose and Book advice option, or contact the Breast Unit secretaries on 01582718009. If you need verbal advice it is useful to provide an alternative method of contact than the practice number, such as an email address or mobile number, as we may return your call outside of normal working hours.

Follow up
Our follow up schedule after breast cancer surgery is to keep all patients under review for at least 5 years. After treatment for invasive cancer patients will have a follow up schedule decided at the multi disciplinary meeting according to their disease risk: all patients will have open access to clinic review as require for five years, higher risk patients will also have routine clinic visits.  In addition patients may be seen in Research clinics if they have entered into a Trial, and all patients will have open access back into the one-stop or follow up clinics as required by contacting their Breast Care Nurse. For patients with non-invasive disease (DCIS) surveillance is by mammographic follow-up only with clinical review as required on contacting the Breast Care Nurses. Mammographic surveillance continues yearly for all patients until 5 years post surgery. After 5 years, provided they have reached the age entry into the Breast Screening Programme (currently 50 years of age) they are asked to continue their mammograms on a 3 yearly basis through this. For younger patients we will continue to arrange mammograms until they reach the age of 50.

Follow-up mammograms are reviewed and reported on by radiologists and these results then sent to the surgical team. The surgical team then review each patient’s follow up schedule and treatment required in conjunction with the mammogram report before issuing a results letter with advice as needed. This process can take 2-3 weeks.

Procedures of Limited Clinical Value
There are constraints upon certain types of breast surgery being performed by the National Health Service. These are gynaecomastia surgery, breast reduction, breast augmentation and mastopexy (unless as a part of symmetrisation following cancer treatment) and nipple inversion surgery. Patients requesting these types of operations will need funding applied for by their GPs to the CCG. Please see here and here for more information.