St Joseph’s BreastCare Centre of Excellence offers you the leading team of breast care specialist professionals in Wales and the south west of England, working in a 5 Star environment, supported by the most advanced equipment available, and of course the exemplary standards of care for which the hospital is widely recognised.
St Joseph's believes that in order to truly offer a 5 Star service to our patients they should have all of their BreastCare examinations and diagnostic procedures in the same visit, thus providing a rapid access service without unnecessary delays.
If your GP has examined you and has identified an abnormality, you will in all likelihood be referred directly into our One Stop Breast Clinic to see a breast consultant. Our highly experienced consultant breast surgeons are each specialists in the field of breast disease. Your breast consultant and staff within the BreastCare team will keep you informed about how you will progress through our One Stop Breast Clinic.
Ideally, you will be referred into our BreastCare Centre by your GP or another consultant. However, we appreciate that time is of the essence and we will be happy to accommodate you with a self-referral for a breast consultation.
Your visit to One Stop Breast Clinic will commence with an in-depth review and discussion about your clinical history. The breast consultant will perform a comprehensive Clinical Breast Examination (CBE). This is an accurate way to detect any palpable abnormality in your breast. CBE is suitable for women and men of all ages, however it is especially valuable in younger women as cancers can present in this age group. If you have already had this performed by our BreastCare nurse as part of a free BreastCheck the consultant will re-examine you to corroborate any clinical findings.
We offer timely access for breast assessment that is suitable for all women and men who have developed breast symptoms such as a breast lump or breast pain and nipple changes, including discharge, inversion and rashes.
The way in which we assess your breast may vary depending on your age and sex.
Your typical journey through the One Stop Breast Clinic includes the following stages:
Unless you have already been diagnosed elsewhere, you will need a GP referral for breast imaging, ensuring quick access to advanced diagnostics and highly specialised care.
St Joseph's Hospital is able to offer all of the diagnostic testing with virtually immediate access, reducing the time to diagnosis and providing the opportunity to commence treatment without delay.
Mammography involves taking an x-ray picture of each breast while it is being gently compressed. Although it may cause mild discomfort, mammograms can detect breast cancer and other breast lesions at an early stage before changes can be felt in the breast by you or your doctor. Modern 3D mammography units, rather than taking a single image, take multiple images (tomosynthesis) which increase the diagnostic value of the mammogram.
Tomosynthesis is a process whereby multiple projection images of the breast are reconstructed to allow visual review of thin breast sections offering the potential to unmask cancers that may be obscured by normal tissue located above and below the lesion.
St Joseph’s has invested in the market leading Hologic Selenia Dimensions 3D mammography system which has several clinical benefits, including:
If your mammogram shows an abnormality your radiologist and breast surgeon may decide that you need a biopsy to assess the lesion further. This is usually performed under ultrasound guidance but when the lesion cannot be seen on ultrasound, the biopsy has to be performed using x-ray guidance (known as stereotactic biopsy).
St Joseph's is the only private hospital in South Wales that can offer you stereotactic tomosynthesis biopsy. This ground-breaking technology integrates your mammogram data and biopsy procedure for unrivalled accuracy. The biopsy sample taken can be immediately assessed to ensure the radiologist is in the correct location using our Daax Faxitron core sample imaging system, which means our patients are confident in the knowledge that they will not have to return for a further biopsy procedure.
St Joseph's mammograms are reported by highly trained consultant breast radiologists who work in symptomatic as well as screening clinics.
St Joseph’s utilises the state-of-the-art Toshiba Aplio 500 ultrasound system.
Ultrasound sends harmless high-frequency sound waves through your breast and converts them into images on a screen. Ultrasound is not a stand-alone screening test for breast cancer disease. If an abnormality is seen on mammography, or felt by clinical examination, ultrasound is a sensitive and essential diagnostic test to find out if the abnormality is solid (such as a benign fibroadenoma, or breast cancer) or fluid-filled (such as a benign cyst).
If your mammogram or ultrasound investigations show a solid abnormality in your breast then a targeted biopsy may be recommended. Ultrasound is used to guide the needle in to the lump so that a tissue sample can be taken for analysis. The biopsy will be performed after injection of local anaesthesia and will take up to fifteen minutes to perform. If an abnormality is identified by mammography but not seen on ultrasound, a mammographically guided biopsy will be performed. The biopsy will be sent to the histopathology laboratory for analysis.
If your mammography investigation and ultrasound shows a fluid-filled cyst (benign) an ultrasound-guided breast cyst aspiration may be required to drain the fluid from the breast cyst. This procedure takes only a few minutes and is performed by one of St Joseph’s consultant radiologists.
Once the results are available from your diagnostic investigations you will receive an immediate appointment to see your consultant to explain and discuss the results.
Your consultant will advise whether any further treatment or follow-up is required.
|Aspiration of cyst under ultrasound|
|Biopsy breast under ultrasound|
|Block dissection of axillary lymph nodes (axillary clearance) levels 1-3|
|Excision biopsy of breast lesion after localisation|
|Excision biopsy of breast lesion after localisation bilateral|
|Excision of breast lump/fibroadenoma|
|Excision of mammary fistula|
|Local mobilisation of glandular breast tissue to fill surgical cavity|
|Lymph node biopsy|
|Lymph node clearance|
|Mastectomy - radical|
|Mastectomy - simple|
|Mastectomy and immediate reconstruction of breast using extended latissimus dorsi flap|
|Mastectomy and immediate reconstruction of breast using latissimus dorsi|
|Mastectomy for gynaecomastia bilateral|
|Mastectomy for gynaecomastia unilateral|
|Microdocchectomy or mammodochectomy (Hadfields procedure)|
|Modified radical mastectomy|
|Modified radical mastectomy (including lymph node clearance)|
|Modified radical mastectomy (including lymph node sampling)|
|Plastic procedures on nipple|
|Prophylactic mastectomy - bilateral|
|Prophylactic mastectomy - unilateral|
|Radical mastectomy (including block dissection)|
|Re-excision of lesion of breast if resection margins are not clear|
|Reconstruction of the breast using extended latissimus dorsi flap (including delayed reconstruction)|
|Sampling of axillary lymph nodes|
|Sentinel node biopsy|
|Sentinel node mapping and sampling with blue dye and radioactive probe for breast cancer|
|Subcutaneous mastectomy with immediate implant|
|Wide excision of lesion of the breast|
|Wide local excision of breast +/- mobilisation of glandular breast|
|Wire localisation under x-ray control|