The Royal Marsden

Meet Nicola Roche, Consultant Breast Surgeon

Miss Nicola Roche has developed an ‘oncoplastic’ approach to breast surgery that combines the oncological principles of cancer removal with the plastic surgical techniques of breast reconstruction.
Miss Nicola Roche

About 70% of breast cancer patients who require surgery at The Royal Marsden are suitable for breast conservation surgery followed by radiotherapy, while the remainder have a mastectomy.

“Breast surgery has evolved and is becoming a lot less aggressive,” says Miss Roche, a Consultant Breast Surgeon at The Royal Marsden for the past nine years. “Now, we try to minimise the amount of tissue we remove from the breast and the amount of lymph nodes we take from the armpit, and can offer a reconstruction immediately.”

Miss Roche performs immediate reconstructions on patients who require a breast implant. She also works closely with the Department of Plastic and Reconstructive Surgery when patients require a reconstruction using tissue from elsewhere in their body: “We discuss all options and guide our patients towards what is most suitable for their case. This can depend on physique and the cosmetic result they would like.”

Cancer is an emotive word but breast cancer should no longer be seen as a death sentence

The Royal Marsden’s Rapid Diagnostic and Assessment Centre (RDAC) is one of the most advanced of its kind in the UK. Within the unit, Miss Roche works with the specialist clinic for women suspected of having breast cancer. Diagnostic techniques include mammography, ultrasound, tissue sampling and biopsies. Increasing numbers of women are having a genetic test for the faulty BRCA gene, which increases the risk of developing breast cancer.

Some women with this genetic fault opt for surgery to remove healthy breasts to reduce their risk. Miss Roche says more women are also diagnosed in the early stages of breast cancer, due to an increase in awareness and more accurate screening via a mammogram.

“The survival rate for breast cancer is excellent,” she says. “Cancer is an emotive word but breast cancer should no longer be seen as a death sentence, as the vast majority of women are successfully treated and live beyond their diagnosis.”