As a patient at one of the world’s top three cancer centres, you will benefit from our state-of-the-art facilities, the most experienced and respected cancer consultants, and some of the world’s most innovative technology.
Miss Fiona MacNeill, Consultant Breast Surgeon
Her focus is on achieving the best outcomes in both cancer surgery and breast appearance, enabling women to maintain their breast shape and body image after surgery. Working with colleagues hospital-wide, she uses new treatment innovations to preserve the breast through less radical surgery.
As an oncoplastic surgeon, Miss MacNeill has particular expertise in treating women with complex cancer needs, including managing fertility issues, pregnancy, and risk reducing surgery for women who carry a cancer gene. Highlights of her impressive career include receiving the Querci della Rovere Prize for Excellence in Cancer Surgery, and being elected President of the Association of Breast Surgery from 2015 to 2017.
Miss MacNeill has a notable interest in education and training. As Breast Tutor at the Royal College of Surgeons of England, she established the first educational courses in oncoplastic breast surgery and won the prestigious Silver Scalpel award for the UK’s leading surgical trainer, for which she was nominated by her trainees.
Career highlights
The Breast Unit provides diagnosis and treatment. We offer a rapid diagnostic service for anyone with worries about a breast problem, whether or not they think they have cancer. Most people who come for diagnosis get reassurance that they have healthy breasts. I’m an oncoplastic surgeon, which combines the best of cancer and plastic surgery. With modern surgical techniques, many women can be cured of breast cancer and also achieve a good aesthetic outcome, which is an important part of longer-term survivorship. We provide a very personalised service at The Royal Marsden. I’m passionate about involving our patients in treatment decisions to get the best out of evidence-based care.
I started my career as a general surgeon. When I did my MD thesis at the Trust, it was one of the few places that had specialists. You could see immediately the difference in the quality of care. Working here is very stimulating, because you’re part of a team of world-class experts who are always questioning and challenging, trying to drive treatment in new and better ways. There’s been a big shift in recent years away from mastectomy towards breast-conserving surgery. To deliver that safely and successfully, you need to work with the whole team of oncologists, pathologists and radiologists. That’s where it becomes so important, bringing together all that brainpower, skills, knowledge and expertise to benefit the patient.
I think that, in future, we are going to see more individualised care based on the biology and stage of an individual woman’s cancer. The sequencing of treatments will also change. I am currently collaborating on a study into using radiotherapy before surgery, and I think, increasingly, the role of surgery will be to ‘mop up’ what’s left after drugs or radiotherapy. More women may also be able to avoid having surgery altogether. I am involved in research exploring different options for women who are ‘exceptional responders’, who could fall into this group. Additionally, those with very small cancers that are picked up in breast screening may be able to have their tumours removed under anaesthetic by an ultrasound machine.
Surgical training is like an apprenticeship. It’s vital for trainees to be able to start as consultants with a high level of expertise. You have a duty to pass on knowledge and skills to improve patient care for the future. But it is a two-way process. Being challenged by the next generation helps to keep me on my toes and also keep my own practice refreshed.
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