There are many types of breast cancer. The type of breast cancer diagnosed impacts upon what type of treatments are offered. The most common types include:
- Ductal carcinoma in situ (DCIS)
- Invasive ductal breast cancer (IDC)
- Invasive lobular breast cancer (ILC)
- Inflamatory breast cancer
- Paget’s disease of the breast
- Other types of breast cancer
Referral from GP
Patients referred by their GP to a hospital for specialist breast advice and treatment will receive a letter from Belfast City Hospital. The letter will ask the patient to ring the hospital to make an appointment to attend the outpatient breast clinic.
Patients are seen at this clinic by one of the specialists within the breast team.
National Health Service Breast Screening Programme (NHSBSP)
The Public Health Agency has established a screening service that covers all of Northern Ireland to detect breast cancers early. Please follow the link for information on the breast cancer screening program.
Breast Outpatient Clinic
The breast clinic is located in Wing A of the Outpatient Department on the ground floor of Belfast City Hospital Tower.
The breast clinic is managed by Consultant Breast Surgeons, Radiologists and Cytopathologists. They are assisted by Registrars, Breast Clinicians and a Breast Nurse Practitioner who are experienced in the management of breast cancer and benign breast disease.
At the clinic, a member of the nursing team will call your name and take you into a consultation room. Patients may be asked to remove their clothes to the waist and given a cape to wear so they can be examined easily.
At the clinic patients may be asked questions about:
- Symptoms- pain, lumps, nipple discharge
- Whether they have been on the pill or HRT
- If they have children
- History of family breast disease.
At the clinic patients may be sent for further diagnostic investigations. These are detailed in the next section, a link to be which can be found on the right hand side of this page.
- Investigations and Diagnosis
Breast Care Nurses
Specialist Nurses in breast care are present at clinics. They are able to provide information, advice, education and support to people attending the clinic.
For patients with a diagnosis of breast cancer the Breast Care Nurse can play a vital role and provide specialist support as a ‘key worker’. They will give patients time to ask questions and to talk about how their diagnosis is affecting them. Breast Care Nurses provide this specialist care from the moment a patient is diagnosed and continue to offer support throughout their care.
Patients will be given a number for a Breast Care Nurse / Key Worker who they can contact if they require support or information. This number is linked to an answer machine. Callers should leave a message with their name and telephone number and a Breast Care Nurse will ring back as soon as possible.
In order to provide the highest level of care possible, a team of people are involved in the care of breast cancer patients. This team is known as a multi-disciplinary team (MDT). The team consists of:
- Consultant Breast Surgeons
- Consultant Breast Radiologists
- Pathologists / Cytologists
- Breast Care Nurses
- Breast Nurse Practitioner
- Administration Staff
The Breast MDT meet each Friday afternoon in Belfast City Hospital to discuss patients who are suspected to have or are diagnosed with breast cancer, as well as patients with non cancerous breast diseases.
The Breast MDT discuss each patient’s case in detail. This ensures that there is an individualised care plan put in place for every patient. A record of this discussion will be sent to the patient’s GP.
There are several ways of treating breast cancer. Each person is different and your surgery and / or treatment will be tailored to your needs and discussed fully with you before proceeding. Throughout your care, procedures, surgery and treatments will not be carried out without your consent.
Please click on one of the links below for more information on surgery / treatment options:
- Herceptin (Her2)
- Clinical Trials
Most primary breast cancers will be treated with surgery to remove the tumour. Each person is different and surgery will be tailored to each patient’s needs.
There are 3 common types of breast cancer surgery:
- Wide Local Excision / Lumpectomy
- Breast Reconstruction
Surgery may also involve the testing of or removal of lymph nodes from the armpit. Read more information on lymph node surgery.
Patients having surgery will be given an appointment to attend the Pre-Assessment Clinic before their operation. At the appointment the pre-assessment nursing staff will perform a pre-operative assessment which will involve taking a full medical/nursing and social history. This appointment is to ensure patients are fit and it is safe for them to have surgery.
The Anaesthetist will also talk to patients at the pre-assessment clinic. They will ask about general health and any previous experiences with anaesthetics including side effects such as sickness.
In some cases patients are asked to have an anaesthetic assessment, this may require an overnight stay.
A member of staff will explain the operation, potential complications and mark where the lump is on the skin of the patient’s breast. The patient will also be asked to sign a consent form before surgery. This form will state what operation is planned. It is important that patients read and understand this form before signing it.
Day of Surgery
A Breast Care Nurse Specialist will visit each patient whilst they are in hospital and will discuss the planned surgery and answer any questions patients they may have and provide ongoing support.
A nurse will prepare each patient for theatre. Patients will be asked to remove jewellery (except wedding ring), and remove dentures, contact lenses etc.
No medical treatment can be given without patient consent.
Patients may have one treatment type or in some cases may have a combined cancer treatment. Please click the links at the top of the page for further details on cancer treatments.
After treatment has finished, patients will be asked to come back up to the hospital for a check-up.
Patients should go to their GP or specialist doctor for advice if they have a symptom between follow-up visits they cannot explain which last more than a week or is not getting better.
A Consultant and/or Breast Care Nurse will explain follow up services to patients after their cancer treatment. The type of follow up will depend on the individual circumstances of each patient.
Self Directed Aftercare
There is a new model of follow up for breast cancer patients which is called ‘self directed aftercare’. Once treatment for breast cancer is complete, some patients may be able to take part in Supported ‘Self Directed Aftercare’ arrangements. This allows individuals to take responsibility for and control of their own healthcare.
A doctor or nurse will discuss this with a patient if it is appropriate.
- Useful Links