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Your rights
What is a specialist breast unit?
Key features of a specialist breast unit
Further information
Your rights
If you are a woman living in Ireland who has symptoms of breast cancer, you have a right to expect that medical care be of good quality. You have a right to expect standards of care are consistently high. You have a right to expect care that is easy, speedy, effective and efficient.
If you go to your GP with a breast change, it is therefore vital that you are referred to a specialist breast unit if you need further investigation. In the majority of cases a breast complaint is not due to cancer, but the possibility of cancer means that highly trained specialists should examine you in an efficient, sympathetic environment. This is very important in order to provide a firm diagnosis of a benign condition without delay and to be in a position to reassure the patient. Equally, if you are diagnosed with breast cancer, the diagnosis and treatment must be carried out in a systematic fashion and in accordance with the highest standards of care.
What is a specialist breast unit?
National and international evidence shows that patients with breast cancer have the best chance of survival if they are treated in specialist breast units where teams of medical professionals work together and treat high numbers of patients. This means that no specialist operates in isolation and the care of all patients is discussed by many specialists working together on the same site.
Weekly conferences attended by all staff allows the diagnosis and future treatment of the patient to be discussed by all team members, a process that increases expertise, facilitates peer review and most importantly, minimises error. This is called multidisciplinary team working.
Multidisciplinary team working allows queries or concerns by individual members of staff to be heard, and this can trigger a decision to re-test or re-examine the patient involved. It is this process that essentially makes it less likely that a woman with breast cancer will be misdiagnosed.
Multidisciplinary team working is also very important for a patient who has been diagnosed with breast cancer. It allows surgeons, radiotherapist and oncologists to decide on the best doses and sequence of treatments for the individual patient.
Key features of a Specialist Breast Unit
- Specialist breast units should serve a population of around 300,000 to 350,000
- Women (and in a very small number of cases, men) who are urgently referred by their GP to the specialist breast unit should be seen within two weeks
- Breast units shall hold at least one triple assessment clinic per week for newly referred patients with symptomatic breast disease. Triple assessment involves a physical examination, a breast X-ray (mammogram) and a fine needle aspiration
- Specialist breast units should care for at least 150 newly diagnosed patients each year
- Each specialist breast unit should be staffed by at least two consultant breast surgeons, two specialist radiologists, two consultant pathologists with an expertise in breast pathology, a medical oncologist and radiation oncologist and a team of specialist nurses.
- Individual consultant surgeons should treat a minimum of 50 new patients with breast cancer each year
- Patients should be diagnosed without a surgical operation in more than 90% of cases. Diagnostic imaging should be used wherever possible to minimise physical and psychological distress
- Radiographers should perform at least 20 breast X-rays (mammograms) per week
- Consultant radiologists should report at least 1000 breast X-rays (mammograms) per year
- The breast unit should have at least one specialist breast care nurse per 50 patients
- Treatment options should be discussed with patients before the operation by the consultant surgeon
- The breast unit should provide clear and accurate information to patients in verbal, written and other appropriate formats, ensuring that special and minority needs are catered for.
- Each specialist breast unit shall have a dedicated purpose-built physical facilities suitable for the care of patients with breast complaints
Further information
Please call the Action Breast Cancer Freefone Helpline on 1800 30 90 40 to find out where your nearest specialist breast unit is located. The helpline is staffed by specialist cancer nurses who can provide advice, information and support to anyone concerned about breast cancer.
A copy of the report National Quality Assurance Standards for Symptomatic Breast Disease Services is available on the Department of Health and Children website www.dohc.ie/publications
On Friday 9th November, the HSE announced that some hospitals* (which includes the 8 centres already designated as centres of excellence) will continue to provide breast cancer diagnosis and treatment services and that some of these regional hospitals will be grouped and networked to one of the 8 designated centres of excellence. Weekly multidicisplinary team meetings to discuss individual cases and plan treatment and care, will take place in the hospitals.
The 8 designated centres are as follows;
- Mater Hospital, Dublin
- St Vincent’s University Hospital, Dublin
- St James’ Hospital, Dublin
- Beaumont Hospital, Dublin
- Waterford Regional Hospital
- Cork University Hospital
- Mid Western Regional Hospital, Limerick
- University College Hospital Galway
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