The Breast Service is a fully integrated diagnostic specialist service which provides all the examinations and tests necessary to diagnose both benign and malignant breast disease affecting men and women.
Our Breast Service consists of a highly qualified multidisciplinary team including consultant breast surgeons and experienced nurses who have specialist knowledge and skills in caring and supporting both women and men with breast problems.
The Breast Service is one of the busier units in the region and treats approximately 150 new breast cancers per annum including referrals from Regional Breast Screening Units and GPs.
All new breast referrals (suspected cancer and symptomatic referrals) are seen within two weeks of referral in accordance with national guidelines. They are seen on Tuesday all day, Thursday and Friday mornings in One Stop Breast Clinics that take place in the main outpatient department.
The one stop assessment of care provides the following:
- fine needle aspiration (FNA)
- core biopsy tests if required
Patients attending breast clinic appointment; same day reporting for the results of imaging however pathology *(biopsy) results can often take up to two weeks.
Why you might Breast MRI:
- To rule out implant rupture
- For women diagnosed with lobular breast cancer doesn't show up well on mammogram or breast ultrasound.
- Sometimes to assess the size of the cancer to check which kind of surgery is possible
Sentinel Node Biopsy (SNLB) is now embedded in our breast services. SNLB is just when one or two lymph nodes need to be removed to determine if the cancer has spread to axilla (armpit). Use of this technique will spare many women unnecessary surgery, and in turn, lead to a shorter stay in hospital and a faster overall recovery. SNLB is now the standard of care for all patients.
We offer full surgical options including wire guided surgery, oncoplasty and breast reconstruction. All patients undergoing mastectomy have the opportunity to discuss their breast reconstruction and are offered immediate reconstruction. There are in addition weekly specialist outpatient clinics at Homerton Hospital in the following areas:
- Breast nurse specialists administer hormone injections for medical oncology patients
- Breast nurse led follow up telephone clinic
- Seroma clinic (collection of body fluid following a breast surgery)
- Breast Inflation Clinic
- Breast prosthesis fitting appointment based monthly service run by Truelife
Intravenous chemotherapy and radiotherapy treatments are given at Barts health (St Bartholomew’s Hospital NHS Trust).
Other breast conditions treated at the Homerton Hospital
- non-cancer breast lumps
- breast pain
- nipple discharge
- male breast lumps and gynaecomastia
- large breast requiring reduction (augmentation)
- other breast symptoms that are of concern including breast abnormalities
Waiting times for surgery
The average operation waiting time is between three to four weeks.
Early discharge from hospital after breast surgery
The 23 hour stay model is now firmly embedded in the trust. The aim of the one night stay breast surgical pathway is to improve the quality of care for all breast patients, by improving clinical outcomes and reducing unnecessary lengths of stay. Some patients are even able to be discharged home on the same day as their surgery.
Open Access Clinic
The open access follow up programme has been specially designed to support you when you have completed your treatment. It is a nurse led model called Open Access Follow Up (OAFU). It replaces the ‘traditional’ model of consultant led follow up which included patients attending follow-up appointments, even when they had no symptoms or feeling well.
With the OAFU model you will still have the routine tests but you will get the results either by post or phone. This model is based on evidence that shows there is no real advantage to attending fixed time follow up appointments. OAFU reduces unnecessary anxiety and trips to hospital. The programme will educate you how to manage your health and identify any concerning signs and symptoms.
OAFU is a quick access arrangement that allows patients and their GPs to report any worries, concerns or symptoms of possible progressive disease in a timely manner. It is now been established that within OAFU programme, patient experience has improved by providing tools and access to multi disciplinary support which is centred around the patients needs.
Meet the team
Key core consultant, nurse and multi-disciplinary team members
Chatzakis, Mr Emmanouil; Consultant breast surgeon
Consultant oncoplastic and reconstruction breast surgeon specialising in benign, malignant breast disease and breast surgery, breast and nipple reconstruction, revision and delayed reconstruction
Parvanta, Miss Laila
Consultant in endocrine and breast surgery
Lead consultant oncoplastic breast surgeon specialising in benign, malignant breast disease and breast surgery and reconstruction.Also has a special interest in thyroid and parathyroid surgery (e.g thyroid nodule, MNG (Multi Nodular Goitre), thyroglossal cyst)
Laura Humphrey; Breast Physician
Salim Tayeh; Senior Registrar
Dr Peter Hall and Dr Melissa Phillips; Consultant medical oncologist based at St. Bart’s Hospital
Kathryn Hawkesford; Consultant medical oncologist
Joint oncology clinic with St. Bart’s Hospital. Outpatient clinic at Homerton on Friday morning
Prem Natarajan; Breast Advanced Nurse Practitioner (assessing new patients who have been referred to us by their GP or Regional Breast Screening Unit. This involves examination of the breasts and armpit area and arrangement of various tests – this may include mammogram, ultrasound and /or sampling of the area)
Shristee Damree (keyworker); Breast care nurse specialist
020 8510 5555 and ask for bleep 237
07768 482 847
Sonia Hussain (keyworker); Associate breast care nurse specialist
020 8510 7023 or 020 8510 5555 and ask for bleep 323
Krystal Maxime; Macmillan Cancer CNS Support Worker
They help the Clinical Nurse Specialist (Key worker) in their day to-day activities but can help with administrative queries or to leave a message for the CNS’s.
As they are not medically qualified, they are unable to give medical advice.
Telephone: 020 8510 8969
Elizabeth Knapp; MDT Coordinator
Adlene Hickson; Team Secretary
020 8510 7930 or 7276
How we support you
Dr Sylvia Puchalska;Clinical Psychologist in Cancer Care for City and Hackney
Working days – Monday, Wednesday, Thursday
Steve Young; Counselling Psychologist in Training & MBACP
Working days – Tuesday, Wednesday, Friday
Macmillan Cancer Information and Support Service, between 8am to 4pm, Monday to Friday. Based at the main entrance of the hospital.
We are at the end of the phone for cancer patients, their relatives and carers to answer your questions or to direct your call to the appropriate person. We want to make sure that you get all the assistance you need to live well with – and after – cancer. There’s a wide range of support available to help you cope with cancer, including physical, emotional and practical advice for you, your family, friends and carers.
Madhu Agarwal; Macmillan Cancer Information and Support Manager
Telephone: 020 8510 5191
Katie Ryan: Acute Oncology (only cancer emergencies)
Financial Support at Homerton
Macmillan Toynbee Hall Welfare Rights Service
Telephone: 0207 392 2958
Welfare support by appointments only available on Tuesday 1pm – 4pm and Wednesday 9.30 am -12.30pm.