Being discharged from the Breast Clinic following treatment for Breast Cancer

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1 Being discharged from the Breast Clinic following treatment for Breast Cancer Introduction For many years women with breast cancer were followed up for 10 years. However, recent evidence has shown that this is not the best care we can give. The change in practice has come from extensive research and has involved patient groups and national expert opinion. The recent guidance is that patients should be discharged at five years post treatment, if all is well. As it is now five years since your initial diagnoses and treatment for breast cancer, we are discharging you from routine follow up. Do I still have to have mammograms after I have been discharged from the clinic? Once discharged from the clinic and you are within the screening age range (currently 50 to 70 years of age but shortly extending to 47-73) you will automatically be called for a mammogram every three years. This is arranged by the Breast Screening Unit based at Brighton. If you are over 70 you will need to contact the screening unit on Tel: for an appointment every three years. If you are under the age of 50 we will continue to arrange annual mammograms for you. What changes should I look for in the breasts? Breast awareness is about knowing what is normal for you and recognising any change. Following your treatment the breast that has been treated will look and feel different than before. It is important to get familiar with the new feel and appearance so changes can be reported. You need to be aware of any changes that are new or different to you, such as: A change in size has one breast become noticeably larger or lower? Breast surgery and radiotherapy may make your breast a different shape and size from before and you should get used to this new shape and size. A change in nipple appearance are either of the nipples inverted (pulled in) or pointing in a different direction? Again surgery to the breast can cause the nipple to point in a different direction and radiotherapy can make the nipple thicker. Is there a rash on the nipple or any nipple discharge? A change in skin texture radiotherapy can change the texture and colour of the breast that has been treated. Is there any new puckering or dimpling of the breast? Is there a rash? A new lump or swelling is there a new lump or thickening in your breast, armpit or around your collar bone? What other symptoms should I report? It is important to remember that everyone can get coughs, colds, aches and pains and stomach upsets from time to time and it does not necessarily mean that the cancer has come back. Page 1 of 5

2 If you experience any of the following symptoms, listed below, for a persistent period or if the symptoms are getting worse please report them: Unexplained persistent or irritating cough Breathlessness Persistent new back, limb or neck pain Persistent unexplained pain anywhere in the body Persistent headaches Nausea, abdominal discomfort or loss of appetite Arm swelling (lymphoedema) Any abnormal vaginal bleeding or spotting This list cannot include everything, but we hope is a useful guide. If you experience any of these symptoms, it does not mean that your cancer has returned, but it does mean you should have a medical assessment. Who should I report any symptoms to? If you are worried about any symptoms please see your General Practitioner who can refer you back to the Breast Clinic, if appropraite. Please feel free to contact the Breast Care Nurses for advice. Do I still need to think about the risk of lymphoedema (arm swelling)? If you have had surgery or radiotherapy to your axilla (armpit) as part of your breast cancer treatment, you will have been given advice about arm care and how to reduce your risks of lymphoedema. You need to follow this advice for life. If mislaid this information please ask the Breast Care Nurses for another copy of alternatively you can download it from the Breast Cancer Care website or call them on: free phone: Do I still need to take my Hormonal treatment? The normal length of time for taking hormonal treatment is five years. This will have been discussed with at your last appointment. There are a few circumstances where we suggest taking hormonal treatment for longer but if this is appropriate we will have discussed this with you. If you are taking calcium supplements or another drug to strengthen your bones please speak to your GP before stopping it. How do I get a new breast prosthesis? At Conquest Hospital The Surgical Appliances Department have trained staff who will provide breast prosthesis and give advice on suitable bras. They also stock a small number of bras. A weekly clinic is held on Wednesday afternoons, appointments can be arranged with Ros Kennard or Bronwen Lowy in Surgical Appliances. Tel: (01424) ext You will need to ask your GP to write a letter to the Appliance Office to request a new prosthesis. Page 2 of 5

3 At Eastbourne District General Hospital There is a fortnightly prosthetic clinic on a Wednesday in a private room in Paget House where trained staff will provide breast prosthesis and advice on appropriate bras. You will need to ask your GP to write a letter to the Breast Care Nurses to request a new prosthesis. Appointments are always required for prosthetic fittings. Each appointment lasts for 30 minutes. Occasionally more than one appointment is necessary to get a correct fitting. Please contact the Breast Care Nurses to make an appointment for you on Tel: ext Where can I find emotional support? There are local support groups available to help provide support and the opportunity to meet other women who have had breast cancer. Your Breast Care Nurse is also available for advice, support and financial advice. Useful Contacts Bosom Buddies (Eastbourne) This is a social self help group with informal meetings held the 1st Friday of the month at various venues. Bosom Buddies is open to people at all stages of breast cancer. If you would like to know more, please contact: Lynda Bonnett Anne Andrews Tracey Humphrey The Tuesday Club (Eastbourne) TheTuesday club is patient led social self help group providing informal support for men and women with a breast cancer diagnosis. Meetings held on the 1 st Tuesday evening each month at various venues. If you would like to know more please contact Janet Pink Hastings and Bexhill Breast Cancer Support Group This local group was set up in 1981 by breast cancer patients who formed an informal social group. Meetings aim to provide support in a social setting and often have guest speakers attending. They cover a wide range of topics including local and national issues around breast cancer. Meetings are held once a month alternating between Hastings and Bexhill. Please visit the website or for further information please contact: Pat: Pam: Gloria: Sussex Cancer Network This website provides access to high quality, up to date information for people in Sussex affected by cancer. National Support Breast Cancer Care - Is a national organisation offering support to those affected by breast cancer. Free confidential services provided by health care professionals and trained volunteers including a helpline, Page 3 of 5

4 publications and practical and emotional support on a one to one or group basis. Breast Cancer Care Helpline: Textphone: Macmillan Cancer Support (incorporating cancerbackup) provides practical, medical, emotional and financial support. For advice about cancer types, treatments or what to expect please call the cancer information nurse specialists on freephone (Monday to Friday 9.00am to 8.00pm). If you are deaf or are hard of hearing you can use textphone or RNID Typetalk You can also a question using the a Nurse at For advice on emotional or practical help please call freephone (Monday to Friday 9.00am to 9.00pm). If you are deaf or are hard of hearing, you can use textphone or RNID typetalk. For financial help and information please call (Mon-Fri 8am-8pm) Or visit the website on How to contact the Macmillan Breast Care Nurses Conquest Hospital Monday to Friday (not Bank holidays) Frances Jones: Telephone: Ext: 8291 or frances.jones@esht.nhs.uk Juliette Twyman: Telephone: Ext: 8063 or juliette.twyman@esht.nhs.uk Eastbourne District General Hospital Monday to Friday (not Bank holidays) 9.00am to 5.00pm Kerry Chidlow - kerrychidlow@ nhs.net Tracey Simms - Tracey. Simms@ nhs.net Telephone: (01323) Ext: 4334 The Breast Care Nurses are not in the office all the time so please leave a message on the answer phone and you will be contacted as soon as possible. The Breast Care Nurses are part of the Breast Team at the Trust. Important information The information in this leaflet is for guidance purposes only and is not provided to replace professional clinical advice from a qualified practitioner. Your comments We are always interested to hear your views about our leaflets. If you have any comments please contact our Patient Advice and Liaison Service (PALS) details below. Page 4 of 5

5 Hand hygiene The trust is committed to maintaining a clean, safe environment. Hand hygiene is very important in controlling infection. Alcohol gel is widely available at the patient bedside for staff use and at the entrance of each clinical area for visitors to clean their hands before and after entering. Other formats This information is available in alternative formats such as large print or electronically on request. Interpreters can also be booked. Please contact the Patient Advice and Liaison Service (PALS) offices, found in the main reception areas: Conquest Hospital palsh@esht.nhs.uk - Telephone: Eastbourne District General Hospital palse@esht.nhs.uk - Telephone: After reading this information are there any questions you would like to ask? Please list below and ask your nurse or doctor. Reference The Conquest and Eastbourne Multidisciplinary Breast Teams and the patient support groups have been consulted and agreed this patient information. Date agreed: February 2012 Review date: February 2015 Responsible clinician/author: Lis Grimsey, Macmillan Consultant Nurse Page 5 of 5