Your journey through the Breast Assessment Unit

The Breast Clinic is run and staffed by a multidisciplinary team who are all specialists in breast disease.

We aim to complete your assessment and initial investigations at your first visit so you will need to allow at least 3 to 4 hours for your visit.

Assessment

Your assessment will consist of a discussion and examination by a specialist breast doctor, breast imaging in the form of a mammogram, ultrasound or both. These images will be reviewed during your visit and we aim to give you a provisional or definite diagnosis by the time you leave the clinic. Sometimes, depending on your problem, you may not require imaging or tissue biopsies.

However, as some cases are more complex than others and may require a tissue biopsy, there are a minority of cases where patients will be asked to return to clinic for these results. It takes at least a week to analyse the tissue from a biopsy and an appointment will be made for you to return a week later for the results and we suggest that you bring a friend or relative with you at this time.

How long does it take? 

You will be given a time to attend the clinic and your assessment journey will begin either by completing a questionnaire, being reviewed by the breast doctor or undergoing imaging. The order of these events can be different for each person’s individual journey, and this is so that we can help you through your assessment as quickly as possible. However, sometimes the assessment is more complicated or the results are occasionally distressing. We spend more time with these patients and we would appreciate your patience and understanding if clinic becomes delayed. It is unfair and often upsetting for other patients if another patient shows aggressive or impolite behaviour, and anyone doing so would be asked to leave.

The assessment period can be as long as 3-4 hours, but we hope for most, the wait will be shorter. We do, however, suggest that you bring some reading material, a friend for company or a quiet activity to keep you occupied. We always try to perform the imaging or biopsy on the same day but sometimes this is not possible. If it cannot be done on the same day, an appointment will be made for another time before you leave.

Space in clinic waiting areas

The clinic waiting space can be limited and therefore we will offer you the opportunity to go for a coffee whilst awaiting your results. We will contact you on your mobile phone, if you have one, as soon as the results become available. We have a number of cafés that serve different types of food and beverages nearby within the hospital.

Bringing your children

We recommend that you do not bring children to the clinic if you can possibly avoid it. This is due to the time an assessment can take and the potential need to carry out procedures that children cannot attend, such as biopsies and x-rays. We do however, understand that at times childcare may be difficult and that you need to bring children with you, but please be aware that our facilities are limited and restrictive for children. 

Diagnostic Tests

We perform a number of diagnostic tests within the Breast Service, some of which you may undergo as part of your assessment:

Breast ultrasound is particularly helpful in younger patients with dense breast tissue and in patients presenting with a lump. If under 40 years of age this may be the only breast imaging required. It is performed generally by a breast imaging radiographer.

The test will be carried out whilst lying down. Gel is spread over the breast and a small handheld probe is gently pressed against the skin surface and then moved around so that the breast can be viewed from different angles. It is usually the area of concern that is scanned. The scan only lasts 5-10 minutes and has no known risks.

Mammogram is an x-ray of the breasts and is usually performed on both breasts and on patients over 40 years of age. It can be performed by either a mammographer or an assistant practitioner.

During the mammogram the breast will be compressed between two perspex plates for a few seconds in order to visualise the breast tissue. This pressure may be uncomfortable however, the test is over quickly with the process only lasting for about 10 minutes. This may be followed by an ultrasound.

Magnetic resonance imaging (MRI) is a type of scan that uses strong magnetic fields and radio waves to produce detailed images of the inside of the body. An MRI scan can be used to examine almost any part of the body. 

An MRI scanner is a large tube that contains powerful magnets. You lie inside the tube during the scan. The scan lasts 15 to 90 minutes, depending on the size of the area being scanned and how many images are taken. You’ll be able to talk to the radiographer through an intercom and they’ll be able to see you on a television monitor and through the viewing window throughout the scan.

After imaging, further tests may be required:

The procedure uses a needle which is quickly fired into the lump using a biopsy device (which normally makes a loud clicking noise), removing a piece of tissue from the breast. The breast tissue can then be sent away to be looked at under a microscope to see if there are any abnormalities.

After the biopsy, the area will be pressed for a few minutes to help stop any bleeding, and a dressing will be applied. Several samples are usually taken.

The procedure is carried out whilst lying down and will normally take 15-20 minutes. A local anaesthetic will be used to numb the area so the amount discomfort during the test should be minimal.

Some women may have a procedure called fine needle aspiration instead of a biopsy. This involves removing a sample of cells from inside the breast using a very thin needle, similar to a blood test and the cells sent away to be looked at under a microscope and checked for any abnormalities.

The procedure is usually carried out while you are lying down and takes about 10-15 minutes.

A vacuum assisted core biopsy may be necessary. This test involves tissue being sucked through a needle after a local anaesthetic. The procedure is carried out whilst lying down or whilst sitting and it normally takes 45-60 minutes. It reduces the need to have surgery to determine what is going on in the breast.

The Breast Multidisciplinary Team

The Breast Multidisciplinary Team (MDT) is a group of healthcare professionals who are specialists in the field of breast disease. The team meets on a weekly basis to discuss the patients in our care.  We make decisions to create individual treatment plans around you and your disease type. We use a combination of our knowledge of you, evidence-based medicine and the multidisciplinary expertise within the meeting. The outcome aims are to achieve the highest possible standards in breast cancer treatment.

Core Members of the MDT:

  • Consultant Surgeons
  • Consultant Oncologists (radiotherapy and chemotherapy doctors)
  • Consultant Radiologists (x-ray doctors)
  • Consultant Histopathologists (doctors who analyse tissue samples)
  • Breast Care Nurse Specialists
  • Specialist Research Nurses
  • Breast Radiographers
  • MDT Co-ordinators

All discussions at the MDT are documented in your medical notes and the electronic patient record called “Patient Pathway Manager” (PPM). The outcome will be discussed with you at your next clinic appointment. Your treatment journey is about you and we encourage you to ask questions and voice any concerns at every point in the treatment pathway.

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