Heartbeat: Breast surgery team commended by patients

February 17, 2022

Every year our patients, visitors and carers have the opportunity to nominate a service that has truly made a difference to them or their families as part of the annual Star Awards.

At the 2021 ceremony, the breast surgery team came out tops in the Quality of Care category which recognises colleagues and teams that have provided excellent care in line with our quality plan, producing improved outcomes for patients and those who have consistently upheld and demonstrated our nine Care Promises.

Heartbeat caught up with Melissa Tan, Consultant Oncoplastic and Reconstructive Breast Surgeon who was delighted with the win.

She said: “We were so surprised to learn of the nomination and when we were announced as winners on the night, it was truly humbling. Each member of this team strives to work in partnership with our patients, where they are educated and empowered throughout their treatment journey. We were absolutely delighted to see that our work is having such an impact on our patients and their loved ones.”

The breast surgical team has a vision to provide high quality, individualised patient centred care. The team consists of seven consultants (four breast surgeons and three oncoplastic and reconstructive breast surgeons), one nurse consultant, one speciality doctor, one trainee, two fellows, and five secretarial and administrative staff.

They work within a multi-professional and multi-disciplinary team environment (including radiology, breast screening, pathology, oncology, genetic, and psychology teams) to formulate the best possible management plan. The service is also supported by six Macmillan breast specialist nurses.

Melissa also told us how the team managed to maintain a full service during the pandemic. “Despite the challenges the team faced during the COVID-19 pandemic, where some team members were deployed or isolating, we adapted. Each member went above and beyond their existing roles to ensure a high quality service was maintained.

“Urgent two week wait referred patients were triaged and assessed and the cancer detection rate did not change. This triaging system was peer reviewed, published and later refined. Patients needing surgery were operated according to risks stratification with some having their procedures in the NHS and others with private providers as appropriate.

“The team’s day case surgical pathway is well recognised and the British Association of Day Surgery has invited us to share our ambulatory surgical practice. The unit’s day case and 23 hours stay procedures for oncoplastic and reconstructive surgeries like, reduction mammoplasties, breast implant reconstructions, and chest wall perforator flaps reconstructions has gained much interest. Breast conservation rates have increased with fewer women losing breasts. Our expertise is being disseminated nationally and internationally.

“We are most proud that we came out of the pandemic with no backlog of cancer cases and we were continually meeting our targets. This is a true reflection of our effectiveness and efficiency.”

The team has also shown innovation by introducing new services to patient pathways. Non-palpable breast cancers were surgically excised using modern radiofrequency identification localisation TAG technique resulting in improved patient experience. Oncotype test, a multigene assay was utilised to help spare women from having chemotherapy. Patients were entered into an end of surgical treatment Patient Initiated Follow Up programme, where not only did they have defined annual surveillance investigations, but also given open access to their Macmillan nurses via a telephone messaging system.

Melissa added: “As part of the survivorship programme, patients are also invited to attend a Holistic Need Assessment clinic to ensure they are well supported to live well and beyond cancer diagnosis and treatment. A virtual MDT to review patients after five years of surgical treatment was also introduced, assessing each patient’s risks and benefit of extended endocrine treatment prior to discharging patient care.

“The breast surgical team has worked hard and will continue to work towards achieving their common goal in delivering a service that is of high quality and individualised.”