I'm a breast cancer surgeon. AMAZING

[Gincision]

What the thread title says. I've been a consultant for nearly 2 years. Open for questions...

Erm right I don't know if I will word this properly but here goes.... my aunt had breast cancer and went for chemo all looked successful and basically she had both her breasts removed (private as nhs would only do 1 and she wanted both gone), her second week recovering from op it was obvious something was wrong and they did some test and there were tumours in her brain and near her heart.... what I don't understand is why they did the surgery to begin with? I would have thought that after the chemo they would have scanned her or something? I don't know a lot about treatment etc but I've always thought this was really strange although someone told me that the surgery may have sent the cancer cells to her brain etc I'm really unsure.

Ranoutofquinoa so sorry to hear this. Your head must be spinning. I suspect going private won't make things happen sooner, cancer treatment in the NHS is usually brilliant.

How do you feel about having a mastectomy? Ladies are very varied in how they feel about this. Ask about possible reconstruction if the thought of losing your breast is upsetting as it's unusual for this not too be an option.

Another thing to ask if you'd prefer to keep your breast is the possibility of neoadjuvant treatment that might shrink the cancer before surgery. This isn't always an option but it's worth asking.

What else are you worried about? That might sound ridiculous but you'd be surprised at how varied people's concerns are

Missconduct agreed the are some surgeons who think they're amazing. I think I do some amazing things (curing people of cancer is a good day at the office by anyone's standards) but that doesn't make ME amazing

Whatsforu there is no association between fibroadenomas and breast cancer

ranout - I know that must have been a shock. I would think they know a little about the grade, type and stage, if it is hormone receptive etc to have said that you'll probably need a full mx and chemo as well as radio.

As a breast cancer survivor, I think my breast surgeon is amazing :)

@knowledge we don't routinely scan to look for spread of breast cancer because it usually hasn't spread at the point we find it. We do so when the cancer is bigger than 5cn, in more than 4 lymph nodes or there are other concerns it isn't straightforward.

The surgery wouldn't have caused the cancer to spread to her brain, she sadly is probably a very unusual case where the breast cancer was more aggressive than was expected based on her first results. I'm so sorry to hear this.

Hi there. Thk you for starting this thread. My dad had agressive prostrate cancer: caught early thkfully & he’s fine. Two of his brothers had similar experiences. Now 3 of his sisters are being treated for aggressive breast cancer. One was terminal at diagnosis.Is there a known genetic link & should my siblings & I be concerned for ourselves?

Thanks for the replies at the moment I'm in bed! Parents are asleep on a camp bed downstairs, husband and kids asleep!
At the moment I don't give a monkeys about losing a breast! I just want the bad bit out! To be honest I don't even know if I'm bothered about reconstruction at the moment. I just want to be cancer free!
I think I need to know what my treatments will be a week on Tuesday then I'll take each day as it comes.
Thanks for the info re private v nhs. That's my DH talking! He's obviously worried and wants to see if my treatment can be hurried up!

This thread just reminded me to do a check. I haven't done one in too long, so for that alone thanks very much. I have very lumpy fatty breasts anyway, so sometimes it's difficult to tell if it's a lump or a normal lump - I usually check the other side to see if there's a matching one - any other tips before heading to a GP?

Despondent that your dad has 3 sisters with breast cancer is probably relevant. Worth speaking to your GP with the details (their age at diagnosis is very relevant) to confirm

So not worried at the moment at losing a breast. I'm sure that may change. Anything I need to ask at my next appointment. Thanks all.

Ranoutofquinoa your reaction of not being bothered about your breast is very normal. And decision about reconstruction or not is very personal. Just remember that the likelihood is your breast cancer will be cured, so thinking about how you feel after treatment is relevant. Of course you want to be cancer free, but you might be able to have both. Possibly worth asking, or at least thinking about....

Reassure your husband that a couple of weeks now will make no difference to your outcome. Being confident in the team treating you is more important.

All the very best. Come back and ask me anything you need to x

Hello, I am just finishing taking aromatase inhibitors after 5 years.

Some reports say it should be taken for longer, do you have any opinion on this?

My tumour was 1.7 cm with no lymph node involvement.

Thank you

Diabolical the key thing is flagging anything that wasn't there before. Google breast cancer care breast awareness info leaflet which explains things better than me

Thk you.

Freyanna there is new evidence for benefit of 10 years aromatase inhibitors. Are you having any side effects? If not then keep taking them. If you are then I'd make an appointment with the team treating you to weigh up the pros and cons

Ranoutofquinoa I don't want you to think I'm trying to push you into reconstruction if that's not an issue for you. Like I said, it's a personal thing. Just want you to know you can usually have both this and get rid of the cancer IF both are important to you x

Gincision

Thank you for your reply. I'm having too many side effects and I've had enough. Nothing they have given me for side effects has helped. (nausea).

I've cut out dairy, I don't drink or smoke so I hope that may help me.

I would like to have a bone scan at the end of the treatment ( I have a lower spine problem, in pain) as both my parents had osteoporosis, do you think the Doctors would agree to that?

I don't have anything to ask - I was diagnosed with BC at 35 and had a mastectomy with immediate recon, chemo and radio. I just wanted to say that what you and your colleagues do is incredible and without the amazing surgeons and oncologists I've been lucky enough to see I wouldn't be here with my two little boys right now. So thank you all, very very much.

How do you deal with the emotional side of your job? As in patient (and family) anxiety regarding their darkest fears? Does it affect the way you are with some patients if they're particularly anxious? Did you get training into how you deal with patient fear and dread? And questions with answers that can't be sugar coated?
I ask because I work in radiology and have been asked to consider performing breast ultrasound scanning and biopsy. Although I do many other types of scans, there's something about breast cancer and dealing with breast cancer patients that makes me incredibly ...uncomfortable and nervous. I'm not sure why - perhaps I'm projecting my own fear.

Gincision Fri 20-Jul-18 23:59:48
Ranoutofquinoa so sorry to hear this. Your head must be spinning. I suspect going private won't make things happen sooner, cancer treatment in the NHS is usually brilliant.

sorry a bit behind in the thread but this is one of the questions I'm regularly asked and agree with Ginc - yes maybe for scans/appointments etc going private will get you seen quicker - the biopsy results/histology results however take the same time to process whether NHS or private.

Hello. I was 26 when I had my lump removed followed by radio and chemo. I had to demand the chemo as it hadn't spread via lymph but I knew that the Marsden were giving it to all women with aggressive bc which I knew mine was.
A year later a has a bilateral prophylactic mastectomy which was the best thing I've ever done asit gave me my life back.
I already had 3 boys and later went on to have my two daughters.
A few years ago aged 46 I found I had BRCA1 so opted for oophtectomy (is that right?) and have been fine since.
My eldest Dd is 16 and we are wondering what age she should be tested?
Bc has really affected my life but I'm so lucky to be here and don't regret my surgeries for a second.

Oh yes. I did go private as was told it would be at least a 6/8 week wait.
I like to think I was helpful in the 2 week rule as I write to just about everyone I could about my case.
My surgeon actually never charged me either as he said I'd done the right thing.

Thanks for the replies. I didn't mean to take over the thread! I'm a big believer in fate, so can't believe this thread started last night. It was just what I needed. I will look at reconstruction but it's the last thing I'm bothered about at the moment. Each day at a time, I think. Good luck everyone else who is in the same situation.

What do you think of the recent NAP6 findings about blue dye? Will this change your practice?