Once a week, I lead a multidisciplinary team meeting in which radiologists, surgeons and clinical nurse specialists discuss the images and biopsy results of patients whose mammograms or ultrasounds are indeterminate. We want to ensure that all the results from examinations, biopsies and imaging fit together to make a firm diagnosis so we can decide the best course of action.
I then head to our clinic in the Rapid Diagnostic and Assessment Centre (RDAC). I’ll see patients who have been referred by their GP with a breast symptom and need to be seen within the recommended two-week period. It’s an anxious time for the patient, so we make it as straightforward as possibleWe usually carry out a ‘triple assessment’, which is an initial clinical examination, followed by a mammogram, if the patient is over 40, and an ultrasound. Then we’ll decide if an interventional biopsy is required.
At this stage, I hope to tell them that they don’t have cancer – but of course, I often have to break the news that they do. This isn’t an easy part of the job, but I try to deliver the news in a way that is manageable, reassuring the patient that we’ve caught the cancer early and that they’re in the right place for treatment. They then wait for the conclusive results from their biopsy, and are seen by a consultant surgeon who will recommend a course of treatment.
During our clinics, we also see patients who are undergoing chemotherapy. They come to us for imaging to find out if the treatment is shrinking the tumour.
I will also see patients who are going into surgery that morning. Because patients are increasingly being diagnosed in the early stages of breast cancer – which is good news – the tumours are often relatively small and can’t be felt by the surgeon. So, using ultrasound or mammography, we insert a small wire into the breast to guide the surgeons to the tumour, so only the cancer is removed, and not the healthy surrounding tissue.
Trialling new techniquesI am also involved in research. In the Magseed trial, for example, we place a tiny marker the size of a grain of rice into the breast instead of a wire prior to surgery. This reduces the number of procedures the patient needs on the day of surgery and will improve efficiency.
Another trial, called KORTUC, involves injecting a drug into tumours immediately before radiotherapy, under ultrasound guidance. We are hoping that this will make the tumour more receptive to this treatment. We are the only centre in the UK to be carrying out this trial, and hope that the results could be good news for patients with incurable breast cancers.
I am also incredibly proud that our department has been accredited under the Imaging Services Accreditation Scheme. This is not easy to achieve and is proof that RDAC imaging provides a top-quality service.
I love my job: it’s varied, I get to meet many wonderful patients and I work with a great team.