Galway Clinic Breast Service
The Galway Clinic has been providing breast cancer services over the last ten years encompassing radiology, triple assessment, surgery, chemotherapy administration and radiotherapy services. This has been done in conjunction with the symptomatic breast service at Galway University Hospital (GUH).
What is triple assessment?
Triple assessment means you will have the following:
- Clinical examination by a breast surgeon
- Have a digital mammogram and/or breast ultrasound
- Have a core biopsy or fine needle aspiration
However, not all patients who attend symptomatic breast clinic require triple assessment.
This service is delivered in accordance with the guidelines of the National Quality Assurance Standards for Symptomatic Breast Disease Services and the HIQA standards.
Your Doctor has referred you to our breast clinic. This may be because you require screening, have a breast lump, or another symptom such as discomfort, discharge, or have a strong family history of breast disease.
The Specialised Breast Centre
The centre offers state of the art screening and diagnostic services including digital mammography, ultrasound, Computed Tomography (CT) Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET).
Triple Assessment Clinic
The Triple Assessment Clinic is a new service which offers a quick, high quality service aiming to detect early breast disease and to provide a personalised plan of care for each individual patient. We have a highly qualified Breast Care Team including breast surgeon consultants, a consultant radiologist, a radiographer and a breast care nurse and you will meet with each member on your visit to the Galway Clinic.
Digital mammography is a simple procedure that generates an xray of a women’s breast. The radiographer will position you correctly before compressing the breast to take a digital image that will appear on the monitor in seconds. Mammogram can save lives by detecting small tumours that cannot be felt under clinical examination.
High Resolution ultrasound scanning is used to take clear images of breast tissue. It provides better definition of normal and abnormal features of the breast. It is a painless procedure and can take 10 – 30 minutes to perform.
A core biopsy is performed when your consultant requires more information on a lump or lesion found in the breast tissue. Under local anaesthetic, a sterile needle is placed into the breast tissue. Cores of tissue from the breast lump or lesion are cut away with the biopsy needle and sent to the laboratory for examination.
Frequently Asked Questions:
What is Breast Cancer?
Breast cancer is one of the most common cancers among women in Ireland. About one in 9 women will develop breast cancer in their lifetime. Breast cancer cannot be prevented so the aim is to detect it as early as possible. Early detection of breast cancer and appropriate treatment gives the best outcome.
What you need to know
The diagnosis and management of breast disease has become a complex and highly specialised field. Patients treated at the Galway Clinic have benefited from the experience of internationally trained consultants in breast radiology, surgery and pathology. This multidisciplinary approach, referred to as triple assessment, is the key to safe and effective practice.
Changes You Should Look and Feel for:
- Any lumps or thickening in your breast
- Skin – dimpling, puckering, or redness
- Nipple – pulled in or flattened
- Around the nipple – rash, flaky or crusted skin
- A change in the shape or size of your breast
- Swelling in your armpit or around your collarbone
- Constant pain in one part of your breast or armpit
- Nipple Discharge.
How long will I be at the clinic?
We allocate appointment times and aim to see all patients promptly. Sometimes, there may be unavoidable delays particularly if you require a number of tests. It is possible that you may need to spend a number of hours the hospital and you should make allowances for this.
What should I bring with me?
It is important to bring any previous mammograms or x-rays taken of your breast, please arrange to bring these with you. You will need to contact the hospital or clinic where you had these tests carried out and arrange to get copies of the films to bring with you. If you have difficulty in getting your previous films, please contact the breast secretary in the Breast Clinic in advance of your appointment.
It is also advisable to bring along something to read while you wait.
Can I bring a relative or friend to the clinic?
Yes. Everyone in the clinic is aware that coming to a breast clinic can be a worrying time. You are welcome to bring a relative or friend with you.
We would recommend that you don’t bring children with you, for your own comfort and that of your child. However, if this isn’t possible, we suggest you bring a friend or relative to mind them while you are being seen. There may be areas where accompanying persons are not permitted.
If you are returning to the clinic for your results we would recommend you bring a relative or friend.
What happens when I arrive at the Breast Clinic?
When you check in you will be asked by the receptionist to confirm your personal and contact details. You will meet the Breast surgeon who will ask you details about your symptoms and will carry out an examination.
After examination, the doctor may decide you need some tests, such as a mammogram, ultrasound or breast biopsy. If possible these tests will be done on the same day as your clinic appointment. A breast care nurse is available at the clinic to provide information and support.
What tests might I have?
Depending on your age and symptoms you may have a mammogram or a breast ultrasound scan. Some people will have both tests.
After a mammogram or ultrasound the doctor may decide to take a sample form the lump, either by a core biopsy or fine needle aspiration. These tests are explained later in this booklet.
When will I get the result of my biopsy?
If you proceed to biopsy, you will be brought back to the results clinic. Results can take up to 2 weeks to be processed. We understand that this time can be a very anxious and worrying period. The Breast Care Nurse is there to answer any questions or concerns you might have. We aim to keep you updated at each step of your journey.
The provision of symptomatic breast cancer services requires multidisciplinary high quality, high volume, audited clinical care - meeting the requirements of the national guidelines.
An integral part of the provision of this clinical activity is participation in a multidisciplinary meeting (MDM) on a weekly basis. The MDM meeting at GUH provides the volume and critical mass necessary for this activity. It is anticipated that as a supraregional centre this meeting will receive referrals from across HSE West region. Clinicians working in the private sector will need to ensure their practice meets the national quality assurance guidelines and those who work in the public and private sector will need to ensure standards are met in both locations.
The MDM process is an essential prerequisite to provision of a symptomatic service. All patients who receive triple assessment or have clinical, radiological or histological abnormalities need to be reviewed at this meeting. In light of this and the nature of the tertiary service provided by this hospital the group have identified a need to provide a support network across the region for symptomatic breast cancer services. It is anticipated that patients who have any component of their diagnosis or treatment in the private sector will be discussed at this forum. In order for there to be transparency around this process a seamless system will need to be in place such that all facets of the patients’ clinical, radiological and histological assessment will need to be available to the meeting.
Referrals to the Breast Centre
Patients presenting with a symptom of breast disease which is considered to be urgent may include one of the following:
· A discrete lump
· Ulceration of the skin
· Skin distortion
· Unilateral nipple eczema
· Recent nipple retraction or distortion
· Nipple discharge
· Patients with an acute breast abscess
· Pt GPs deem likely to have a cancer at any age
(As per the HIQA guidelines for Symptomatic Breast Disease)
Acting fast can save lives. We aim to see patients within 24-48 hours of receiving the GP referral.