Contents

• Introduction

• Services Available

• Which Surgeons Specialise in Breast Disease?

• Are All Lumps Cancerous?

• What Are The Symptoms of Breast Disease?

• How Do We Diagnose Breast Disease?

• How is Cancer of the Breast Treated?

• How are the Lymph Nodes (Glands) in the Armpit Treated?

• What is Sentinel Node Biopsy?

• Does Breast Cancer Run in Families?

• What is BreastScreen and Should I Take Part?

• How to Make an Appointment with LapSurgery Australia

• Links

/\  Introduction

LapSurgery Australia has the ability to treat all breast conditions. We have the most modern hospital and diagnostic facilities available through the Breast Clinic at The Valley Private Hospital.

/\  Services Available

• A breast nurse counselor

• State of the art surgical techniques

• Advanced radiological investigatory techniques

• Hook wire identification

• Ultrasound localization and biopsy

• Stereotactic biopsy (via Monash Radiology)

• Sentinel node identification and biopsy

/\  Which Surgeons Specialise in Breast Disease?

Mr Richard Gilhome is our principal Breast surgeon and sees all breast related problems at The Valley Private Hospital Breast Clinic (referral from your family doctor is ALWAYS required). Backup for Mr Gilhome during leave is provided by Mr Ray McHenry who has over 20 years experience in treating breast disease.

/\  Are All Lumps Cancerous?

Many breast symptoms are related to benign (non-cancerous) breast conditions. However it can be difficult to separate benign breast symptoms from symptoms that may be due to a cancer of the breast.
It is important to realize that only 1 out of 10 breast lumps are due to cancer. Many more women survive breast cancer than die from it. There are techniques to detect early breast cancer - breast symptoms should never be ignored!

/\  What Are The Symptoms of Breast Disease?

The main symptoms of breast disease are:

• Skin tethering
• Lumps
• Pain
• Nipple retraction
• Nipple discharge
• Inflammation
• Abnormal Xrays

/\  How Do We Diagnose Breast Disease?

To diagnose a benign breast condition the doctor needs to use 3 modes of diagnosis

1. Clinical history and examination
2. X-ray and ultrasound investigations
3. Cell diagnosis with needle aspirate, core biopsy or open biopsy

Once the tri-modal diagnosis confirms a benign lesion, then it is benign.

/\  How is Cancer of the Breast Treated?

Breast cancer is treated in a multidisciplinary clinic with surgeon, breast nurse, radiotherapist and oncologist (chemotherapy doctor).
The surgery required to treat the cancer may differ, depending on the type of breast cancer and where it is. The majority of breast cancers can be treated without mastectomy by wide local excision (WLE) followed by adjuvant radiotherapy and possibly chemotherapy. Thus the breast is not removed and no prosthesis (artificial breast) is needed.
Unfortunately, some breast cancers may require total surgical removal of the breast (mastectomy) in order to have the best chance of curing the cancer. With mastectomy radiotherapy is not usually necessary.

In suitable cases, WLE+Radiotherapy has the same cure rate as mastectomy.

/\  How are the Lymph Nodes (Glands) in the Armpit Treated?

When an invasive cancer is diagnosed it is important to establish whether the lymph nodes (glands) in the armpit (axilla) on the affected side contain cancer. This usually requires removal of a considerable number of nodes from the axilla (axillary lymph node clearance). If the cancer has spread to the lymph nodes it indicates that the disease is more advanced and in most cases adjuvant chemotherapy will be recommended. If the lymph nodes are not involved with cancer then in most cases chemotherapy will not be recommended. After axillary lymph node clearance there is a 15% risk of developing lymphoedema which is swelling of the arm due to interruption of the lymphatics of the arm by the surgery.

/\  What is Sentinel Node Biopsy?

Recent advances allow the surgeon to remove the sentinel lymph node(s) for testing. A sentinel lymph node is a “guarding” lymph node which is the first node to which tumour would spread. The advantage of sentinel node biopsy is that if the sentinel node is negative for cancer cells then axillary lymph node clearance is not required and the risk of developing lymphoedema of the arm is avoided. If the sentinel lymph node is positive for cancer cells then a second operation is required to perform an axillary node clearance. This is vital to give the best chance of cure of the cancer.
Sentinel node biopsy is a very specialized area requiring sophisticated equipment and training. It is not applicable to all breast cancers. Your surgeon will inform you whether it is the correct form of lymph node treatment for you.

/\  Does Breast Cancer Run in Families?

Breast cancer is a very common cancer of women, although very rarely it can occur in men. It affects 1 in every 12 women and is more frequent with advancing age. Most cancers of the breast are sporadic but there is a very small group of families that can carry a cancer gene in their body that can be passed on to their children. This represents only 2% of all breast cancers in Australia.

If breast cancer develops in more than one first-degree relative (mother, daughter or sister) or bilateral cancer develops in a family member, then there is an increased risk of developing breast cancer in that family. It is important to discuss any family history with your family doctor. He/she will be able to explain any associated risk. If a risk exists then close surveillance should be initiated.

/\  What is BreastScreen and Should I Take Part?

BreastScreen is a nationally run mammogram (breast x-ray) screening program. All women 50 and over are automatically called every second year to have a free screening mammogram. If you are aged 40 to 49 you may have a free screening mammogram if you initiate the test yourself. Speak to your family doctor if you feel you would like to take part in the screening program.
The screening program aims to pick up very early breast cancers and has been highly successful for those who participate. It is very important to understand that the screening mammogram will miss a small number of breast cancers and there is a small risk of developing breast cancer between screening mammograms. It is therefore vital that you learn and practice breast self examination and attend your family doctor at least once a year for a breast examination. If you notice a lump or any of the symptoms indicated in the diagram above you should seek immediate advice from you family doctor.

/\  How to Make an Appointment

If you are concerned that about your breasts, FIRST CONTACT YOUR FAMILY DOCTOR. Referrals MUST come from your family doctor. He/she can arrange appropriate investigation and then refer you to the Valley Private Breast Clinic. For Appointments phone (03) 9790 9333 and ask for the Breast Clinic.

/\  Links

Please be advised that information on this page is not intended and MUST NOT be taken or used in any way as personal medical advice. If you have any concerns about your breasts you should seek immediate advice from your Family Doctor.