How patient-focused models of care are improving breast cancer treatment

17th October 2013

 

Breast cancer remains the most common malignancy for women in the UK and the leading cause of death for women aged 34-54.

Increasingly genetic testing has been used to help determine risk and target women who can be offered treatment prior to the development of breast cancer. Recommendations are available through the recently published NICE guidance

For patients who develop malignancy in one breast, genetic testing can also help to determine risk and target women who can be offered treatment to prevent the chance of another malignancy in the opposite or contralateral breast. Although there was a shift from mastectomy to breast conservation in the 1990s, the rates of mastectomy, especially of the contralateral breast, appear to have increased. The management of the contralateral breast remains controversial. Evidence has recently been published to suggest that a survival advantage does exist for patients who are genetically tested positive for the BRCA 1/2 mutation carriers, who have chosen to undergo contralateral mastectomy.

Patients are increasingly more aware of the advancements in the management of breast cancer and across the UK there remains a need to provide patients with unbiased, evidence based advice on the pros and cons of contralateral mastectomy. The decisions need to be discussed at a multidisciplinary meeting and require the involvement of dedicated breast care nurses and patient support groups. Together a patient focused model of care will allow patients to make important choices in their own management.

Having encouraged patient empowerment and patient focused groups throughout my career, the breast cancer support group ‘Keeping Abreast’ is one example of a successful patient support model. It has enabled a number of my patients, who have helped each other through the reconstructive process, to further develop this patient focused model across cities such as Manchester.

Keeping Abreast was founded in 2007 in Norwich, by three women who recognised the need for peer support for women living with breast cancer. It is crucial for women both newly diagnosed with breast cancer and facing the possibility of mastectomy, as well as those considering reconstructive surgery, to meet and talk with women who have been through similar experiences and view reconstructions first hand. 

For further information on Keeping Abreast visit: www.keepingabreast.org.uk

 

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