Breast cancer is the most common type of cancer in the UK. Most women diagnosed with breast cancer are over the age of 50, but younger women can also get breast cancer. In rare cases, men can also be diagnosed with breast cancer.
About one in eight women are diagnosed with breast cancer during their lifetime. There’s a good chance of recovery if a breast cancer is detected in its early stages.
Breast cancer can be non-invasive or invasive:
Non-invasive breast cancer (ductal carcinoma in situ – DCIS), is where some cells in the lining of the ducts of the breast tissue have started to turn into cancer cells. It hasn’t yet spread outside the ducts into the surrounding breast tissue. It’s usually found during a routine mammogram (breast screening) and rarely shows as a breast lump.
Invasive breast cancer is the most common type of breast cancer. Invasive cancer means the cancer cells have grown through the ducts/lobules into the surrounding breast tissue. An invasive breast cancer has the potential to spread to other areas of the body. This doesn’t mean that it has or will spread, and treatment aims to reduce the risk of this happening. The main type of invasive breast cancer develops in the cells that line the breast ducts (invasive ductal breast cancer).
There are other types of breast cancer and further information about these can be found on Breast Cancer Now’s website
We work in partnership with the Royal Marsden Hospital and with the support of our breast care nurses (clinical nurse specialists), we provide an integrated and comprehensive breast cancer pathway.
Treatments for breast cancer
These may include: surgery to breast/s and/ or lymph nodes under the arm chemotherapy radiotherapy hormone (endocrine) therapy targeted (biological) therapy bisphosphonates IV treatment Immunotherapy (metastatic setting only)
In early breast cancer, surgery is usually the first treatment provided. Then depending on the type of surgery and what is learnt about your cancer after looking at it under the microscope, you may be advised to have one or a combination of the treatments listed above.
Sometimes chemotherapy or hormone therapy may be given before surgery. This is called neo-adjuvant treatment.
In a very small number of women, breast cancer is found after it has spread to another part of the body (secondary breast cancer).
Secondary cancer, also called advanced or metastatic cancer is not curable and the aim of treatment is to control and slow down the disease, relieve symptoms and maintain quality of life.
Breast cancer patients being treated at Kingston Hospital may be invited to take part in a clinical trial into different aspects of their care. The results of past clinical trials help doctors when planning treatment.
You can read more about the different treatment options here
People with cancer often require care, support and information in addition to the management of their cancer or condition.
A holistic needs assessment (HNA) is a discussion with your breast care nurse about your physical, emotional and social needs. The focus is on you as a whole – not just your illness. However, you decide how much information you would like to share about your current situation.
The HNA is an opportunity for you to talk about any worries or concerns you may have. It will help to clarify your needs and refer you to any relevant services and signpost to other organisations for additional information and support.
In order to prepare for this discussion, you may be asked to complete a questionnaire to bring to your next consultation. This is not compulsory and not having this assessment will not affect your care. However, many patients find having an assessment helpful as it can help to identify what help is available.
An HNA is offered at different times during your care, including:
Around the time of diagnosis or start of your treatment
The end of your treatment – when your surgery, chemotherapy or radiotherapy has been completed
Any time that you ask for one
We will carry out an HNA either over the phone or at one of our nurse-led clinic appointments depending on what is more convenient for you.
With your agreement the nurse carrying out your assessment may refer you to other services that may be of help to you. Alternatively, you will be given written information about these services then you can take it further yourself.
MDT Meeting
The MDT meets weekly- Tuesday afternoons, to discuss the results of investigations and surgery. We follow evidence based national guidelines and local protocols to agree individual treatment plans.
Breast Care Nurses – Keyworker
All breast cancer patients receiving treatment at Kingston Hospital will be introduced to one of our team of breast care nurse specialists, who are registered nurses and have had specialised training in all aspects of breast care.
The breast care nursing team is able to provide expert advice and guidance on a patient’s specific breast cancer treatments and possible side effects and provide psychological and emotional support to both them and their family members.
To ensure our patients have sufficient information when they need it, written information is offered at appropriate stages during their treatment pathway.
The breast care nurse also takes on the role of the patient’s key worker. The key worker acts as the co-ordinator by working closely with the consultant surgeons and other clinicians involved in the patient’s care.
The keyworker will keep in close contact with the patient from diagnosis and throughout the patient’s care pathway. This offers continuity for patients, carers and families, as they have a point of contact for advice and support as they need it. The patients are given their keyworker’s mobile number which they can text and call.
Patients can also contact the breast care nursing team on the designated number below., where their calls will be answered during that day before 4pm, Monday to Friday. Tel: 020 8934 6363
The Breast CNS team facilitate a lymphoedema clinic for mild lymphoedema assessment and management for those who have been treated for breast cancer at Kingston Hospital only.
The Breast CNS team provide a nipple/areola micropigmentation (tattooing) service for women who have had breast reconstruction following breast surgery for breast cancer at Kingston Hospital only.
Kingston Hospital provides a surgical appliance service such as external breast prostheses, post-surgical bras and bra fillers. A prosthesis fitter facilitates a breast prosthesis clinic on a Friday once a month. Referrals to this service can be made by your breast CNS. However, if you are no longer under the care of the breast team, the NHS will continue to provide a replacement prosthesis as necessary (minimum 2 yearly). Your GP can email a referral to ORTHOTICS at Kingston Hospital NHS Foundation Trust. khft.orthotics@nhs.net
Further support/charities
Some treatments for breast cancer can affect a woman’s fertility. Younger women recently diagnosed can be referred to our fertility service at Kingston for a discussion about their individual situation. You can read more about fertility and breast cancer treatment here
Breast cancer treatments such as chemotherapy, hormone therapy or ovarian suppression (stopping the ovaries working either permanently or temporarily) can cause menopausal symptoms during and beyond treatment. You can read more about menopausal symptoms and breast cancer treatments here
Breast Cancer Now provides an online Moving Forward course – a programme of information sessions to help you adjust and adapt after a diagnosis. To find out more contact Breast Cancer Now 0808 800 6000 or email movingforward@breastcancercare.org.uk
Kingston Hospital Macmillan Information Centre, also facilitate health and well-being events 020 8394 5001
The physiotherapists at Kingston provide a Post Breast Cancer Exercise Class for women recovering from their treatment for breast cancer. It is a 6 weeks course for an hour each week. Referrals to this service can be made by the breast CNS team.
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