What to expect at your first appointment with the Breast Service. Please note this appointment can take up to 5 hours in order for all the tests and examinations to take place. www.bhrhospitals.nhs.uk @BHR_hospitals Barking, Havering and Redbridge University Hospitals NHS Trust 1
Your doctor has asked you to visit this clinic because of your breast symptoms and feels that you would benefit from an examination by a breast specialist. In most cases changes in the breast are benign, or non-cancerous, but any unusual symptoms must be checked out fully by our specialist breast care team to confirm what these changes are. WHERE IS THE APPOINTMENT? You have been offered an appointment at: King George Hospital, Barley Lane, Goodmayes, IG3 8YB on either Elm Ward or Base 3 in outpatient department. Please check your letter to confirm which one you are attending. WHO WILL I MEET? We are a team of specialist doctors, nurses, radiographers and other team members who all work together to investigate, treat and care for patients with breast conditions. *Please note that all the Consultant Breast Specialist doctors in this clinic are male. If you wish to be seen by a female doctor you will need to cancel this appointment and ask your GP for a referral into a different hospital. WHAT WILL HAPPEN DURING MY APPOINTMENT AND HOW LONG WILL IT TAKE? Your visit to the breast clinic may take several hours- sometimes up to and over 5 hours. This is so that all the necessary tests can be carried out. You may wish to bring a friend or relative with you for company or support. You can eat and drink as normal before and during the appointment. Due to the length of time you will be at the 2
appointment it is advisable not to bring small children with you, although we realise that this may not be practical. A doctor experienced in diagnosing and treating breast problems will see you. You will be asked questions including any family history of breast problems, any medication you are taking (including hormone replacement therapy or the contraceptive pill) or any previous breast surgery (including implants). This will be followed by an examination of your breasts. As part of this it is usual to examine the lymph nodes (glands) under your arm. You may then need to have further tests explained later. Please DO NOT wear spray deodorant or talcum powder as this can affect the quality of the x ray. You can use roll-on deodorant if you wish. It is advisable for you to wear clothing which can be easily removed for your examinations (It may be necessary to remove your upper clothing on more that one occasion during your visit.) WHAT OTHER TESTS MIGHT I HAVE ON THE DAY? You may need to have some or all of these tests during your visit and using more than one test makes the breast assessment more thorough. A breast examination, mammogram/ultrasound scan and FNA/core biopsy of the breast are known as a triple assessment. Mammogram- this is a breast X-ray which shows soft tissue in detail. The breasts are placed, one at a time between two special plates and x-rays taken. You may find this a little uncomfortable. Two or more images of each breast will usually be taken so that the breast tissue can be viewed from different angles. Mammograms are not often used in women under 3
35.Younger women s breast tissue can be more dense which can make the x-ray image less clear and any changes harder to identify. However for some younger women mammograms may still be needed to complete the assessment. Please tell a staff member if you are pregnant or think you may be pregnant before a mammogram. The report of the mammogram will be available on the day. Ultrasound- This scan uses high frequency sound waves to produce an image of the breast tissue. This is similar to the type of technique used to scan babies in the mother s womb during pregnancy. It is completely painless procedure and is done regardless of age. The report of the ultrasound will be available on the day. Fine needle aspiration (FNA) -This involves taking one or more samples of breast cells using a fine needle and syringe. This can be uncomfortable but rarely requires local anesthetic. This sample is then sent to the laboratory and you will need to return for another appointment for the results. If you are taking aspirin or any blood thinning medication let the doctor know before the FNA or cone biopsy. Core biopsy- this is similar to a FNA but uses a larger needle to obtain a sample of breast tissue. Because the tissue is taken rather than the cells it gives more detailed information. You will be given a local anesthetic but you may be a little bruised afterwards. Results take about 2 weeks to process. You will be given another appointment to return for this result. WHAT WILL HAPPEN AFTER MY APPOINTMENT? Having investigations for a breast problem can be a 4
worrying and stressful time. The staff will know that you want results as soon as possible and your specialist may be able to tell you what they think the outcome might be. But usually the results of all the investigations and tests you have had are needed before you are given more detailed information. The clinic will let you know how and when you will get your results. This usually means returning to the hospital for another appointment. It may be a good idea to bring someone with you when you get your results as support. They may also think of questions you may forget. A summary of your breast assessment and results will be sent to your GP. CONTACT DETAILS For further information please contact the Breast Care Nurses on: 0208 970 8476 Monday Friday 09.00-17.00. Answer phone available. If you need to change this appointment please ring the appointments number at the top of your appointment letter. Monday Friday 08.00 18.00 This information is available in alternative formats and languages. For more information, please ask a member of staff or ask to speak to the PALS office. If you require an interpreter for this appointment please ask your GP to arrange one. 5
PLEASED WITH OUR CARE? Do tell us and share your experience with others in the comments section at www.nhs.uk You can also give feedback on your care in our Outpatient Departments using a link to our patient experience survey on our website: www.bhrhospitals.nhs.uk THINK WE COULD DO BETTER? Please tell us so we can take immediate steps to put things right, and improve care for other people in the future. You can ask to speak to the nurse in charge or your doctor, or get in touch with our PALS team: Available King George Hospital 08.30-17.30 hours. Email: PALS@bhrhospitals.nhs.uk King George Hospital: 0208 970 8234 24 hour answer phone 0800 389 8324 References: Barts Health NHS Trust- The On stop Breast clinic. Breast Cancer Care- Your breast clinic appointment. Date of preparation: July 2015 draft Revision date: July 2017 6