Mrs W was in her late fifties when she was diagnosed with right breast carcinoma (breast cancer). Initially she was referred to a consultant at her local NHS hospital who found two breast lumps, both of which were primary grade 3 cancers. The consultant suggested that the best treatment would be to remove the tumour by removing tissue from the breast whilst carrying out a breast reduction – something known as oncoplastic surgery.
“Mr Copeland was very professional and understanding, he reassured me and I felt so confident, safe and secure in his hands"
Mrs W, patient at Spire Cheshire Hospital
However Mrs W was not happy with the treatment option so decided to get a second opinion from Mr Graham Copeland, Consultant Breast Surgeon at Spire Cheshire Hospital.
Mrs W was given an appointment at Spire Cheshire Hospitals ‘One Stop Breast Clinic’. At the consultation Mr Copeland put Mrs W’s mind at ease and discussed the various treatment options with her which were alternatives to the oncoplastic breast reduction treatment initially recommended.
“Mr Copeland was very professional and understanding, he reassured me throughout the whole consultation and I felt so confident, safe and secure in his hands”
Mr Copeland then performed a core biopsy on the lumps, which confirmed they were grade 3 cancers and one of them looked like a lymph node that was also infiltrated with cancerous cells. Mr Copeland and Mrs W decided that the best operation would be a right auxiliary clearance – basically cutting out the tumours. Mr Copeland explains:
“Mrs W had two cancerous tumours and I explained that whilst oncoplastic surgery is an option for patients with similar problems it does mean that the patient is essentially having two operations (removal of the tumours and a bilateral breast reduction) when sometimes it’s best for them to concentrate on fighting the cancer and then addressing any differences in breast shape or size once the cancer is beaten. Mrs W agreed and so we decided that a clearance of the cancer in the single breast was the best option.”
Within a week Mrs W was admitted to Spire Cheshire Hospital and unfortunately an ultrasound scan showed a third, deeper tumour than the two previously identified. Mr Copeland discussed the findings with Mrs W and as this would make any clearance a much bigger operation, to give Mrs W the best chance of beating the cancer for good, it was decided that a mastectomy (removal) would be performed on her right breast.
The operation went well and after 5 days in hospital Mrs W was discharged. Mr Copeland visited Mrs W each day throughout her stay to check on her progress and post-operatively had referred her to Professor Clark, Consultant Oncologist at Spire Cheshire for chemotherapy which she would have at Spire Cheshire and Dr Shaun Tolan, Consultant Oncologist for radiotherapy which would be undertaken at the Clatterbridge Centre of Excellence for Oncology.
However on the Sunday, six days after her operation and when changing her dressings Mrs W had a large bleed from her wound, she immediately went to her local A and E department and was kept in overnight and given antibiotics. She contacted Spire Cheshire the following day who arranged transport to collect her from Stockport and bring her back to Spire Cheshire where she was admitted. Mr Copeland confirmed that she had a small infected seroma. A seroma is the most frequent postoperative complication after breast cancer surgery. It is caused by the fact that the mastectomy operation leaves a lot of "empty space" under the skin where the breast tissue used to be. The walls around this empty space are raw and can ooze serous fluid - causing it to gather up in the space beneath the wound.
Mr Copeland packed the wound and prescribed antibiotics for Mrs W, he then saw her again the following day to repack the wound and after a while Mrs W was fit enough to be discharged again.
Mrs W then started her chemotherapy treatment at Spire Cheshire. She was under the expert care of Professor Clark, Consultant Oncologist whose dry sense of humour and no-nonsense approach pleased Mrs W. “Professor Clark is wonderful, a genius. When we first met he asked me what I thought I was here for and as I’m down to earth I said ‘You’re going to give me nasty drugs to kill this cancer’ and he said ‘you’re right. It’s not going to be pleasant though’ and from that moment we really got on. I couldn’t have felt in more expert hands”. At every visit Mrs W was met by Rita the Health Care Assistant who assists Professor Clark. “Rita is like an angel. We were greeted with homemade biscuits and tea. A nice touch but also aimed at keeping my spirits and energy up and my husband and I felt very cared for ” said Mrs W.
Professor Clark made Mrs W aware of the side affects she could get from the chemotherapy drugs she was taking. “He laid it bare and I really appreciated that because he said ‘we’ll do this together’ and I knew he meant it”. Unfortunately at one stage Mrs W experienced what is known as neutropenic fever. This is a very serious complication whereby a patient’s white blood cells (neutrophils) drop so low that the patient becomes susceptible to serious infections. Mrs W was urgently readmitted to Spire Cheshire where Professor Clark and the Resident Medical Officer quickly put her on strong intravenous antibiotics. After many days bed rest and some TLC Mrs W was feeling much better “I truly felt terrible, worse than I’d ever felt but those few days when I was feeling my worst it was so reassuring to see familiar faces who I’d got to know well. Even the catering team who knew that I liked Earl Grey Tea were god-sent in giving me little things to look forward to.”
After regaining her strength, fighting off infections and getting back on her feet Mrs W was discharged for a third time and this time for good. Mrs W continued with her Chemotherapy, completed her course of Radiotherapy and is looking forward to the time when she will come back to Spire Cheshire to have her breast asymmetry corrected. “I’ve already been for my first consultation” says Mrs W “I just can’t wait to be comfortable about my body shape again. The Cosmetic Surgeon I met has outlined all the options and I think I’m going to have what’s known as a Pedicle Tram Flap, though I have to wait at least six months as the chemotherapy and radiotherapy can affect how well my body will heal and so I need to wait until it’s out of my system”. A Pedicle Trap Flap is a procedure where the body’s natural fat and tissue from the abdomen is brought up through the body to create a natural breast.
Mrs W has her surgery booked for her Pedicle Tram Flap operation the start of which marks the beginning of the end of her treatment at Spire Cheshire. “I can’t wait, I have total confidence coming back to Spire Cheshire for my operation. I know it’s going to be another long recovery and not everything will go smoothly but all the staff are fantastic and the nurses can’t do enough for you so why wouldn’t I come back? But it’s not just the hospital nurses, it’s the end to end process, they all make a difference”.