Consultant Profile

Dr Zoë Winters

Name:
Dr Zoë Winters MB BCh (Rand), FRCS (Edin), FCS (SA), DPhil (Oxon)
Practicing at:
Spire Bristol Hospital
Specialties:
  • Breast care
    • Benign breast problems
    • Breast cancer
Special clinical interests:

Dr Zoë Winters is a Consultant Breast Cancer Surgeon. She is an experienced, highly regarded, nationally recognised breast surgeon specialising in the diagnosis, management and treatment of breast cancer.

Dr Winters has established a breast cancer surgery clinical practice based on more than 15 years of experience working internationally in Johannesburg, Cape Town, Oxford, and as a Breast Cancer Consultant Surgeon, at the University Hospital Bristol NHS Foundation practice and from 2013, in the newly amalgamated Bristol Breast Care Centre at Southmead Hospital, North Bristol Trust. The Bristol Breast Care Centre, which is now one of the largest patient throughput centres for breast surgery practice in the UK. Dr Winters consults with over 200 women per year in the NHS whilst running her private practice in the evening and on the weekends based at the Spire Hospital.

All patients are given a high quality, individual service. Most of the time, patients are given a diagnoses at their first consultation. 

Dr Winters performs all types of breast cancer surgery and breast reconstuctions using oncoplastic techniques within the remit of breast cancer treatments including the close collaboration with Consultant Plastic surgeons in more complex micro-vascular breast reconstructions. Dr Winters can offer some patients immediate reconstruction, which is performed at the same time as your initial surgery. All options will be fully explored by Dr Winters, to find the best solution for you.

Specialist areas of works are:

  • Breast cancer
  • Oncoplastic reconstrucitve surgery
  • Sentinel lymph node biopsy
  • Breast pain
  • Nipple discharge

 

Family history patients Breast reconstruction procedures include:

  • Implant only (under the pectoral muscle or using an ADM)
  • Back flap and implant
  • Back flap tissue only (your own body tissue)

 

Dr Winters is able to perform cosmetic procedures in the context of achieving optimal symmetry between the breasts after breast conservation or types of breast reconstructions. This applies to breast augmentation, breast reduction and fat filling techniques. Dr Winters will invite the collaborations of the most expert plastic surgeons if required on any of these techniques if they involve more complex cosmetic revision procedures. This also applies to the performance of ‘free flap’ nipple reconstructions.

All patients have their recommended treatments discussed within a strong Multi-disciplinary team, involving pathology, radiology, oncology and radiotherapy as well as involving referrals to specialist services such as physiotherapy, pain clinics, psychologists, lymphoedema nurses, breast care nurses, and other supportive practices. Patients are recommended to undergo MRI together with mammography and ultrasound using these specialised imaging techniques to guide accurate biopsies. Other of the latest imaging techiques are also used to include PET scans.

She is also experienced in the field of preventative breast surgery after childhood radiotherapy and in women who have a high risk family history and require testing of the BRCA1 /BRCA2 gene abnormalities.

Dr Winters has established ‘gold standard’ approaches to detecting the sentinel lymph node and in using techniques to measure the results of the lymph node in theatre, thus avoiding unnecessary second surgical procedures to the axillary lymph nodes. The lastest innovations are used.

Dr Winters provides access to the latest OncoTypeDX genetic testing of breast cancers to help women make personalised decisions on their requirements for chemotherapy after breast cancer surgery. She is a strong advocate of women being given the opportunity to enter all new and available breast cancer clinical trials.

Expert in clinical evidence in breast reconstruction. Nationally recognized in clinical research in the field of breast reconstruction using patient reported outcome measures (PROMS) to assess each individual woman’s quality of life (functioning at all levels: physical. emotional and psychological) after breast surgery. Establishing national requirements for reporting standardized clinical outcomes such as complications after breast reconstruction as well as all types of breast surgery (including cosmetic breast surgery).

Research interests:

Dr Zoë Winters is a clinical academic breast cancer surgeon with an established clinical practice over 11 years.  Dr Winters was the recipient of a prestigious Nuffield Senior research Fellowship from the University of Oxford to complete her post-graduate PhD degree at the Institute of Molecular Medicine in 1999. Dr Winters was also the recipient of the King James IV honorary Professorship from the Royal College of Surgeons of Edinburg in 2001 for her contribution to surgical research.

Dr Winters is focused on establishing high-level clinical evidence to support women and health care professionals in recommending types of breast reconstruction. Her research particularly takes account of women’s quality of life from all perspectives after surgery, radiotherapy and other medical treatments.

Current NHS and /or university posts:

Director and Head of the Breast Reconstruction Quality of Life and clinical outcomes research group, University of Bristol.  Lead for Clinical research at the Multidisciplinary meeting at the University Hospitals of Bristol NHS Foundation Trust.

Year of first medical qualification:
1983
Current membership(s) of professional, national and regional bodies:

National committee of the Association of Cancer Surgeons
Chief Investigator of QUEST trials A and B (Cancer Research UK and BUPA Foundation).
Chair elect of the British Breast Group for national research into breast cancer
Chair of the Breast Reconstruction Quality of life subgroup of the European Organization for the Research and Treatment of Cancer (EORTC).
Chief Investigator of the EORTC development of the first European patient reported breast reconstruction questionnaire to assess quality of life after all types of breast reconstruction in the UK and in Europe.
Chief Investigator of the largest patient study on quality of life after types of latissimus dorsi (back flap) breast reconstruction.
Invited European Faculty of Allergan UK
Past scientific committee member for Breast Cancer Campaign grant awarding body.
Founding Trustee of a national charity dedicated to clinical research into breast cancer called Abreast cancer research Abreast is dedicated to research that tries to make an individual difference to women with the disease in terms of all aspects of their quality of life, including the funding of supportive measures that may help women after breast cancer surgery.

 
Contact Details 
Telephone number to make a private appointment:
07763 692496
Private secretary telephone number:
07763 692496
Private secretary email address:
Personal email address:
Availability:
Monday to Fridays
 
Background Information 
Professional profile:

Since 2000, I have established myself as a specialist breast cancer surgeon with a notional 50% split between NHS Direct Clinical Care and University PAs. My current job plan comprises 6.23 NHS sessions and 5.75 University sessions.

I have an all day operating theatre list allowing me to perform and deliver more complex immediate and delayed breast reconstruction procedures. I have developed an extensive practical experience in immediate types of lattismus dorsi (LD) breast reconstructions, both as implant-assisted and including extended autologous procedures.  My experience relating to these procedures, number approximately 200 or more women since 2001. The development of a prospective cohort study has ensured standardised recording of clinical and PROs over the past 5 years. This work has been based on a 6-centre study. My patients have high levels of recruitment into clinical trials of which I am the Chief Investigator (5 year Cohort on immediate LD breast reconstruction; two trials evaluating the reduction in donor site seromas: Tisseel fibrin Glue trial, and the Quilting sutures trial; the QUEST feasibility parallel trials on types and timings of LD breast reconstruction; and the EORTC studies developing a PRO in breast reconstruction).

I have developed a dedicated Breast Reconstruction clinic that ensures consented prospective photographic capture that is linked to the HRQL access database. I have established a 5-year photographic database of my breast reconstruction results.

I have an established practice in diagnostic and screen detected breast cancer clinics, evaluating approximately 630 patients per year and treating approximately 100 patients with breast cancer. My practice has an established tertiary referral base, and I work closely with Consultant Plastic Surgeons in performing combined oncoplastic procedures for multifocal breast cancers or procedures involving complex therapeutic reduction mammoplasties.

My clinical practice in implant only breast reconstruction is based on staged delayed sub-pectoral implant procedures in the context of post-mastectomy radiotherapy, followed by delayed DIEP flaps. I have reviewed the literature in the use of Acellular Dermal Matrix (ADM)-assisted implant breast reconstructions and this has led me to adopt a selective approach regarding the preferred use of the types of ADMs, preferably within clinical trials. I am a recent academic advisor to Lightpoint Medical as an invited co-PI to design a new randomised clinical trial evaluating intra-operative cancer margin positivity. I am also contributing to the design of the patient reported outcome measures to be used (September 2015).

The ‘New-Start’ Sentinel lymph node audit was part of a large UK clinical training programme for surgeons. It aimed to teach the dual localisation detection of sentinel lymph nodes in the axilla. I was instrumental in setting this up at my University Hospital of Bristol Trust. My audit data included 100 women in whom I achieved 95% detection (n=132 patients, mean of 2.8 nodes per procedure and a false negative rate of 4.6%, 2005-2010). This training programme has revolutionised clinical practice in axillary surgery to minimise unnecessary axillary lymph node dissections.

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Dr Zoë Winters

Dr Zoë Winters Breast care Consultant, Bristol, private hospital specialist.

© Spire Healthcare Group plc (2016)