What to expect from a breast clinic appointment

Breast cancer is one of the most common cancers that affect women. Additionally, women can experience lumps or other worrying signs that can be caused by benign conditions. Attending a breast clinic appointment is an important but often daunting task that women undertake. What can you expect from your breast appointment and how should you prepare? Highly esteemed consultant oncoplastic breast surgeon Mr Robert Milligan, who is based in Newcastle-upon-Tyne, offers his expertise in the area and has provided a one-stop guide that everyone should read prior to their breast clinic appointment. 

What does a breast clinic evaluate?

Patients often attend breast clinics because they are referred by their GP or self-referral. They often come to the clinic because they've developed a new symptom or something that they find worrying in the breast. This can be breast pain, discharge from a nipple, inverted nipples, skin changes, a breast lump, or a lump in the armpit. All of these symptoms are assessed in the breast clinic. 

It's important to attend your appointment to make sure that, if you do develop one of these symptoms, it's not cancer that's causing it. The vast majority of patients who attend breast clinics, even with these symptoms, don't have breast cancer, but about 1 in 20 patients with these symptoms will have breast cancer. 

How can people best prepare for a breast clinic appointment? 

One of the most important things is to try to remain calm and avoid worrying too much before your visit to the clinic. It's very normal when you develop signs that could be breast cancer to be anxious, but the vast majority of patients won't have cancer. When the patients attend the clinic, they'll be assessed by a consultant breast surgeon. The assessment involves taking a detailed medical history and then a clinical examination, so it's vital to have clothes on so that the top can be removed easily. The bra will also be removed so that both breasts and armpits can be fully examined. 

It's recommended that moisturisers and deodorants are not used prior to an appointment since they can disrupt some of the views on mammograms. Other than that, patients don't need to prepare too much from a physical point of view, but psychologically, they should know that they could be told there's an abnormality in the breast and it could be serious. Often, it's useful to bring someone along to the clinic to have support in this case. 

What can patients expect during a breast clinic appointment? Which tests are carried out?

When patients attend a breast clinic appointment, they are typically given a triple assessment, which includes a clinical assessment, a radiological assessment (imaging tests), and some patients will go on to have further tests such as biopsies. 

The clinical assessment involves the breast surgeon speaking to the patient. They will take a clinical history, asking about the breast symptoms and assessing that patient's risk of breast cancer. They will ask about, for example, if the patient uses the oral contraceptive pill or hormone replacement therapy, the number of children the patient has, and if they've breastfed.  A family history will also be taken. Then there will be a physical examination, so both breasts and both armpits will be examined to assess for signs that could be breast cancer or another form of abnormality within the breast.

Following the examination, patients will go down for some imaging tests on the same day. Depending on the age of the patient, they may require mammograms, which are x-rays of the breasts, and an ultrasound scan, which is a jelly scan like the type used in pregnancy which gives us a good look at the area of the breast causing concern. If the imaging and the examination were normal, then often patients are discharged at the time and told that there's no need for any further tests. 

Some patients will have an abnormality in the breast and biopsies are often taken. This is where a small amount of tissue is removed from the breast with a needle under local anaesthetic, often with ultrasound guidance. The patient will be informed at the time whether the biopsy has been taken to prove something is benign or if it's suspicious for cancer, so they have time to prepare for when the results are available the following week. 

How soon do patients find out their test results?

If no biopsies have been taken, the patients will find out on the same day if their imaging tests were normal. Generally, they will be discharged from the clinic unless they have any specific symptom that requires follow-up. This is the case for the vast majority of patients. Approximately, one in ten patients in a breast clinic will require a biopsy. 

The biopsy tests must be sent to a lab, where specific tests are performed on them. The results take time but the patients are usually asked back to the clinic one week later when the results are available. The waiting period between the biopsy and results can be a difficult time. However, a conversation with the surgical team at the time might give you some indication of their concern, regarding it being cancer or a benign (non-cancerous) result.

What support is available at a breast clinic after a breast cancer diagnosis?

When someone is newly diagnosed with breast cancer, it is obviously a very difficult time, so support is hugely important. You will have a consultation with the surgeon who will explain the next steps of the process; often that's an operation but sometimes can be other treatments such as chemotherapy. You will be assisted by a breast care nurse, who will support you through the diagnosis and be a point of contact to get in touch with if you have any questions regarding the specific treatments. Information leaflets will be provided regarding the condition that you have and the treatment option that has been selected. 

Also, there are lots of cancer charities around, both locally and nationally, which are able to support patients. They may also be directed towards patient support groups which some patients can find very useful on social media. There's lots of support for breast cancer patients these days, you certainly shouldn't feel that you're fighting this alone!

Leading consultant oncoplastic breast surgeon Mr Robert Milligan, based in Newcastle-upon-Tyne, is an expert in the treatment of breast lumps and breast cancer. To book a consultation with him, visit his Top Doctors profile today.