Our service diagnoses and treats breast diseases for both women and men for non cancerous (benign) conditions and breast cancer (malignancy). We offer a full assessment for all breast conditions such as breast pain, breast lumps, nipple discharge and other related breast changes.

Breast Clinics

Clinics are held in our general hospitals at Hexham, North Tyneside and Wansbeck throughout the week.

Diagnosis of breast conditions.

In the majority of cases we aim to investigate any breast problems in one visit and give you your diagnosis the same day. Sometimes this isn’t possible and you may be asked to return for another appointment.

Some diagnostic investigations take 5 to 7 working days to process so you will need to return for the results. For the majority of people who attend the clinic, the cause of the problem is a non cancerous (benign) condition. For some, a breast cancer may be diagnosed and further treatment may be necessary.

We encourage you to bring your partner or a family member along with you to the clinic. If you wish, they may accompany you into the interview room, and may stay with you while you are examined.

There are three steps to diagnosing your breast problem. You may not need all of these:

• A clinical examination of your breasts by the doctor or nurse practitioner.

• A breast x-ray (digital mammogram) and/or an ultrasound scan of the breast area.

• A needle test and/or a core biopsy of any lump or thickening of the breast tissue.

Sometimes further diagnostic investigations are also required and where possible all the investigations will be carried out on the same day, although sometimes you may be asked to attend for further appointments.

Please note that if you have investigations all on the same day - you may be in clinic sometime (between two to four hours).

All patients are discussed in a multidisciplinary team meeting each week. If you require further investigations or are diagnosed with breast cancer your surgeon and breast care nurse specialist will discuss your treatment options with you and any choices available to you. Should an operation be required this will also be carried out at our general hospitals.

Breast surgery

Breast surgery is provided in our general hospitals in North Tyneside, Wansbeck and Hexham. You may be able to choose where you would like to go for your operation, please speak to your clinical nurse specialist or consultant. When in hospital, you will be cared for on same-sex ward or in a single room. At Hexham General Hospital you are likely to be given a single room. Where possible we offer early discharge soon after your surgery and you are supported at home by our community nursing teams.

Breast reconstruction

Our service is run by highly skilled breast and plastic reconstructive surgeons and is available as part of the treatment for breast cancer. Sometimes this can be as an immediate procedure at the time of surgery and delayed breast reconstruction options are also available. Your plastic surgeon and your reconstruction clinical nurse specialist will discuss your options with you and offer ongoing support.

Support groups are also available and allow you the opportunity to speak to other women who have had breast reconstruction. The clinical nurse specialists also offer nipple tattooing (micro-pigmentation) service following completion of your breast reconstruction.

Clinical nurse specialist in breast care

We have breast care nurse who have specialist knowledge and skills to help support you. They will provide:

• Ongoing advice and support for you, your partner and family.

• Information and advice about treatment options and research trials.

• A point of contact when questions or problems arise.

• Advise about possible problems such as arm swelling (lymphoedema), discomfort/pain, menopausal symptoms and fatigue.

• Offer expert emotional support regarding your worries or concerns such as fears for the future, financial worries and childcare.

• Practical advice regarding bras, clothing and breast prosthesis.

• Referral to specialist services such as lymphoedema specialists, psychology services, benefits advisors

• Co-ordinate care with your Primary Health Care Team such as GP's, and Community nursing services.

• Specialist support groups.

You may see the clinical nurse specialist when you come in for appointments or on the wards. They will contact you by telephone and may visit you at home. The nurses will speak to others involved in your care like your GP and district nurse. We have many leaflets readily available which may help you understand, and make decisions on, your care and treatment. The information most appropriate to you will be provided to you throughout your care and you can contact your clinical nurse specialist at any point for support and advice.

Oncology/chemotherapy units

Oncology units are based at our general hospitals as well as Berwick Infirmary. The Oncology units offer a chemotherapy service as well as offering supportive treatments. A new service should be available at Alnwick soon.

Radiotherapy is carried out at the Northern Centre for Cancer Care at the Freeman Hospital.

Women's health physiotherapy

Specialist advice and guidance is given throughout your treatment by women’s health physiotherapists. They will devise individual programmes for you to help prevent complications and restore movement.

Psychological support

Psychological therapy is available to help you adjust to your diagnosis and treatment. Counselling therapy, self help guides and hypnotherapy are some of the treatments available. For further information or to discuss a referral with one of the team please contact our administrator Kathryn Dickson or Nicky Asbury consultant health psychologist on 0191 293 4193.

Lymphoedema services

Services for lymphoedema (arm swelling), which can occur following treatment for breast cancer, are available at North Tyneside and Wansbeck General Hospitals. Treatment includes skin care, exercise regimes, simple lymphatic drainage massage and compression sleeves. We also offer Kinesio taping. More complex treatments are available such as manual lymph drainage and multi-layer bandaging through referral to other services.

Prosthesis fitting service

All our general hospitals offer a prosthetic service, providing personal and professional advice on breast prosthesis (a silicone breast). The prosthesis is available in many shapes, sizes and skin shades to suit each individual. Advice on underwear and swimwear for women who have undergone breast surgery is also available. Clinics are held weekly and are accessed by appointment only.

Follow up clinics

Clinics are held at our general hospitals as well as our community hospitals in Alnwick, Berwick, Blyth and Morpeth. Your clinic appointments will be tailored to your needs depending on the treatment you have had. Depending on the type of treatment you have had, your follow up will either be with the Oncology or Surgical Team. You will be given the opportunity to discuss any worries or concerns when you attend the clinic. You will be discharged from regular follow up when the time is right for you and in keeping with regional & national guidelines. You are also likely to be asked to attend for mammograms every year for the first five years after your diagnosis, or every 2 years until you are aged 48 if this is later. After this you will be returned to the National Breast Screening Programme and you will be invited to attend for mammograms every three years. For further information on breast screening please click on the link http://www.cancerscreening.nhs.uk/

Family history clinics

The trust also offers a service for patients who have a family history of breast cancer. Depending on your age and risk this will involve annual exanimations and imaging such as mammography and/or MRI scans. As required we also refer into the Northern Genetic Service based in the Centre for Life in Newcastle

Clinical trials

As part of your treatment you may be offered the opportunity to take part in a clinical trial. These are medical research studies looking at ways of improving care for our patients. Clinical trials are the only way to compare new treatments with the best existing treatment currently available, to see which is better. If you are invited to participate in a clinical trial, the possible benefits and drawbacks will be discussed with you and you will be given written information to take home. You will also have time to discuss the trial with your family and friends and have any questions answered before you are asked to make a decision regarding participation. If you do agree to participate in a clinical trial you may leave the trial at any time, without giving a reason, even after signing the consent agreement. For more information about clinical trials contact:

• Lynn Mann, north tyneside general hospital 0844 811 8111 extension 2800

• Zarine Razvi, wansbeck general hospital 0844 8118111 extension 3023

• Nicola Johnson, hexham general hospital 01434 655 386

The team

During your treatment you may be cared for by a number of health care professionals including clinical nurse specialists, oncologists, surgeons, plastic surgeons, pathologists, physiotherapists and radiologists.

North Tyneside General Hospital

• Mr Ian Goulbourne, consultant breast surgeon

Mr Sebastian Aspinall, consultant breast surgeon

• Mr Ramesh Kasaraneni, associate specialist – breast care

• Dr Wendy Carr, breast physician

• Ms Paola Serra, consultant plastic surgeon (working across the Trust hospitals)

• Dr Gary Bristow, consultant radiologists

• Dr Mary McElroy, consultant radiologist

• Dr Tony Branson, consultant clinical oncologists

• Amanda Walshe, macmillan clinical nurse specialist breast care

• Lara Brinskey, clinical nurse specialist breast care

• Debbie Foreman, breast reconstruction clinical nurse specialist

• Beverley Elliott, senior macmillan breast care physiotherapist

Wansbeck General Hospital

• Mr Mike Carr, consultant breast surgeon

• Mr Magdi Youssef, consultant breast surgeon

• Dr Wendy Carr, breast physician

• Mr Neil McLean, consultant plastic surgeon

• Dr Gary Bristow, consultant radiologist

• Dr Mary McElroy, consultant radiologist

• Dr Helen Turnbull, consultant clinical oncologist

• Kath Atkinson, clinical nurse Specialist breast care

• Karen Edwards, clinical nurse specialist breast care

• Pamela Turnbull, clinical nurse specialist in breast disease

• Lynn Turner, clinical nurse specialist in breast disease

• Hilary Lynch, clinical specialist women's health physiotherapist

• Emma Jardine, senior women's health physiotherapist

Hexham General Hospital

• Mr Ian Goulbourne, consultant breast surgeon

• Nicola Johnson, macmillan clinical nurse specialist breast care

• Brenda Kaye, consultant radiologist

Your appointment If you need to change your appointment please call 0844 811 8118 and one of our patient care advisors will help you re-arrange it.

Contacts

If you have a question or concerns contact our Clinical Nurse Specialists. They work Monday to Friday between 9am and 5pm, however are often in clinic so please leave your name, telephone number and a short message on the answering machine and the nurse will return your call.

• North Tyneside General Hospital - 0191 2934183 or 0844 811 8111 ext 4687

• Wansbeck General Hospital - 01670 529 319

• Hexham General Hospital - 01434 655 386

If you need help out of hours If you need urgent medical advice at nights or the weekends, please ring the switchboard on 0844 811 8111 and ask for the ward where you had your surgery. There are also out of hours contact numbers for services. 

Patient Support Groups

There are breast cancer support groups in all the areas. They offer information, support and practical advice if you have experienced breast cancer. Some also offer complimentary therapies and support for carers. You are welcome to attend the meeting that is most convenient for you, they are held at:

North Tyneside General Hospital in the Education Centre on the first Monday of the month between 7pm and 9pm. Contact Elsie Grounsell on 0191 2516823 or the Clinical Nurse Specialists on 0191 293 4183.

Blyth Community Hospital in the canteen on the second Monday of the month between 6pm and 8pm. Contact the Clinical Nurse Specialists on 01670 529319.

Hexham General Hospital in the Tynedale Patients Centre every Tuesday at 7pm. Contact Pat (0191 410 2679), Mary (01661 842 029) or Jim or Dee (01434 230 458).Log onto www.northumberlandcancersupportgroup.co.uk Trinity Methodist Church, Beaumont Street, Hexham in the Community Room every Friday 10am to 12noon. Contact Jennie (01434 605 602) or Margaret (01661 833 042).

Reconstruction support groups

Our Breast Reconstruction Clinical Nurse Specialists run a reconstruction patient support group with volunteer patients who have had breast reconstruction using various reconstructive procedures discuss their treatment and show their results. If you would like to attend or for information contact the breast care nurse specialist on 0844 811 8111 ext 4687 01670 529319.

Benefits Advisors

The Macmillan Welfare Benefits Teams offer a free confidential welfare benefits advice service for those people affected by cancer.

Berwick District Julie Holden Tel: 01289 332186 E-mail macmillan@berwickcab.cabnet.org.uk

Alnwick District Graham Gillie Tel: 01665 604714 E-mail macmillan@alnwickcab.cabnet.org.uk

Tynedale District Eva Atherton Tel: 01434 606770 E-mail macmillan@wncab.cabnet.org.uk

Castle Morpeth Dave Phillips Tel:01670 512831 E-mail macmillan@morpethcab.cabnet.org.uk

Wansbeck District Paul Robinson Tel: 01670 52208 E- mail macmillanwansbeckcab@fsmail.net

Blyth Valley District Chris Marples Tel:01670 369712 E-mail macmillan@blythvalleycab.cabnet.org.uk

NorthTyneside Steve Ridd and Mark Lloyd Tel: 0191 6437640 E-mail welfarebenefit.team@northtyneside.gov.uk