Coronavirus covid-19 breast lump what to do

Discovering a lump in your breast can be very worrying, especially during the current climate. It can be more distressing not knowing what subsequent steps you should take while measures to reduce the spread of the coronavirus are in place.

As we know, many medical appointments are either being delayed, carried out over videoconference or even cancelled until further notice, to not unnecessarily expose people to the virus. So, we asked one of our top breast surgeons, Mr Haresh Devalia, to explain the changes to standard procedures women should expect during the COVID-19 pandemic and what they should do if they discover a lump in their breast.

If a woman notices a breast lump, what steps should she follow?

The safety of our patients is paramount and that is our primary aim. Therefore, we are following the advice provided by The Association of Breast Surgery which takes into account the risks and benefits of breast cancer treatment versus the risks and potential seriousness of developing a COVID-19 infection.

Due to this, we have changed the way we practice at our clinics and have chosen to conduct the majority of our appointments via telephone and video conference, to not ask our patients to travel unnecessarily and risk exposing them to the coronavirus. So, if you have discovered a lump it is important to use our video conference or telephone services at one of our breast units to speak to a Specialist.

It is important to remember that most breast lumps are not cancerous, so you should not panic. If you are premenopausal and the lump is tender, then we would advise you to monitor it over the following menstrual period to see if it subsides. If it persists, then you must call either your GP, insurance company or directly to our private secretary at one of our breast units to get the right subsequent support.

What should women expect during the tests and diagnosis procedure?

All hospitals right now have taken the necessary steps and precautions to minimise the risk of you developing a COVID-19 infection.

In normal circumstances, it would be very usual to offer you our One Stop Breast Clinic, where you could see a specialist breast surgeon and receive the necessary assessments and scans to diagnose you in one visit. However, that is not the case anymore, and instead, we have changed to video conference and/or telephone consultations, where you will speak to one of our specialists who can then advise you on the next steps.

If you are over the age of 70, you fall into the high-risk group. Therefore, we try to avoid asking you to come in. If you are under 30, it is unlikely to be breast cancer, but you should call anyway to get a professional opinion.

The current pathway to a diagnosis can at times take slightly longer right now; however, there should be no delay in diagnosis if a biopsy is performed. We are very confident that during this pandemic, we will not miss any cancer and allow this to affect the high level of treatment we offer.

What advice can you offer to worried patients?

The first thing to do is to seek advice by calling your GP surgery or one of our specialists at our breast unit. We are always available to talk by phone and video conference and we will always do our best to offer you the best course of action and the reassurance you need.

How can they reduce their risk of contamination at hospital appointments and treatments?

Right now, all hospitals have taken extra necessary precautions to safeguard all their patients by adopting national guidance on social distancing.

At our breast units, we have taken extra steps to reduce the exposure to health professionals as minimal as possible. For example, if after a video conference you have been advised to get tested, you will only be seen by a radiologist who will carry out the necessary investigations and biopsies. Your subsequent results are then given by telephone or video conference.

What should women expect during cancer treatment?

As far as breast cancer treatment is concerned, this will be discussed by the multidisciplinary team and the most suitable treatment decision is taken, concerning the type and feature of the breast cancer you have been diagnosed with. We do this with a view to protecting the patient from COVID-19 infection and at the same time, ensuring that the survival from breast cancer remains unaffected.

All the treatments are based on the individual’s case. For example, patients with hormone-positive breast cancer can be treated with endocrine treatment (in tablet form) to prevent the cancer spreading and allow for the shrinkage of the breast tumour. This treatment is normally recommended in patients with large tumours in small breasts. It also preserves the breasts and avoids the need to undergo a mastectomy. However, because of the coronavirus situation, we have now decided to use this treatment for smaller tumours too, to prevent it from spreading so we can carry out surgery once the COVID-19 situation settles.

For hormone negative cancers, treatment with hormone therapy drugs do not work, so in this case, we would carry out the necessary surgery. We are currently carrying out surgery both in the NHS and the private sector.

What extra services are you providing at Southeast and London Breast Care Ltd?

Our multidisciplinary team works together to ensure that the video conference service still offers you the highest calibre of care. We also have a few designated private hospitals to meet our radiologists who are available to carry out a radiological investigation and biopsy if needed. This can be accessed directly through Top Doctors or our Breast Clinic website.

There are a total of five different private hospitals you can visit, so you can choose the location of your preference:

• London Bridge Hospital in Central London
• Nuffield Health Tunbridge Wells Hospital
• Spire Tunbridge Wells Hospital
• KIMS Hospital in Maidstone
• GenesisCare in King’s Hill

If you are worried about any of the symptoms mentioned in this article, you can have an e-Consultation with Mr Haresh Devalia via Top Doctors or his Breast Clinic profile.