Having the most advanced diagnostic facilities and efficient treatments available is not enough in itself. We have a responsibility to advance the understanding of breast cancer and its treatments. Our unit is involved in several key areas of research.
Gene expression analysis:
Each breast cancer we see is unique, as unique as the person who is unfortunate enough to get it. This means that each breast cancer will respond to treatment differently and needs to be analysed very carefully.
We are involved in a research project with Genomic Health Inc. of San Francisco, USA to asses how gene expression in breast cancers can help to predict more accurately who will benefit from chemotherapy following removal of the breast cancer surgically, and, more importantly, who can safely avoid it.
If you want to see more about this please clink the link below:
Presentation on Oncotype DX (as presented at the Oncotype testing conference in London Sep 2011)
Poster on the impact on chemotherapy prescribing of Oncotype testing in the UK (as presented at the European Breast Care Symposium 2011)
Poster on the economic impact of routine Oncotype testing in the NHS (Embargoed until 12 Dec 11) (to be presented at the world San Antonio Breast Care Symposium Dec 2011)
Intraoperatve sentinel node analysis:
Sentinel node biopsy (just taking the node or a small number of nodes nearest the tumour) from the axilla to check if there is any spread of cancer is normal practice for the treatment of breast cancer. In women with no involvement, no further surgery to this area is then required. Sentinel node biopsy has several advantages over clearing all or most of the lymph nodes, which used to be the standard treatment. The less surgery necessary the quicker a woman recovers with less risk of side effects, particularly stiffness, numbness of the upper arm and most importantly very little chance of developing lymphoedema (swelling of the arm).
The biggest disadvantage for the small number of women whose lymph glands are involved, is that further surgery will be required to remove any remaining nodes as was done in the past. Since it usually takes about 1 week to analyse the glands, this means a second operation.
To try to solve this problem, we are working with 4 other hospitals in the UK to develop a test that can be performed in less than 1 hour to show if a lymph gland is involved with cancer. This will allow us to proceed immediately to clear the remaining glands without need for a second operation.
This test is called Metasin and will be available to our patient as a routine in early 2012.
If you wish to know more about Metasin please follow this link:
Powerpoint presentation on the validation of the Metasin Test (as presented at the All Wales Breast Cancer Meeting, Cardiff Oct 2011).
Digital Breast Tomosythesis (3D mammography).
Our unit was the first in the UK and one of the first in the world to introduce 3D mammography as the standard examination in our routine clinics. We started in Aug 2010 and we have performed 300 examinations up to Nov 2011.
We have been monitoring and comparing its performance against the usual 2D films and we conclude that it is superior.
If you want to know more about our research please follow one of the links below:
What is Digital Breast Tomosythesis?
An initial assessment of digital breast tomosynthesis. (Powerpoint presentation given to the South West Wales Breast Cancer network Feb 2011).
2500 symptomatic and follow up Digital Breast Tomosynthesis image sets reviewed – the pattern of reporting, diagnostic strengths and weaknesses and lessons learned when compared with 2D digital mammography. (Poster presentation given at the All Wales Breast Cancer Conference, Cardiff, Oct 2011).
Patient satisfaction surveys:
We regularly invite our patients to give their candid opinion of our services and we can confirm very high levels of satisfaction.
If you want to see more please follow these links:
Regular review of our performance is very important. Making sure we are doing our job correctly rather than just thinking we are doing it right requires regular medical audit.
If you would like to know what we have looked at recently here are some links:
Vacuum assisted biopsy audit (Powerpoint presentation given Oct 2011 at the Prince Philip Hospital).
Day care unit activity audit. (Powerpoint presentation given Oct 2011 at the Prince Philip Hospital).
CT staging for breast cancer review. (Poster presentation given at the European Breast Cancer Meeting, St Gallen, Switzerland, Mar 2011). (Link to “BSW CT staging.ppt”)