Breast Cancer

Breast cancer is the most common form of cancer in women in the UK. Each year, we see over 4,000 new patients and diagnose 450 new breast cancers. This makes the Breast Unit at the Linda McCartney Centre one of the most experienced in the UK.

We provide patient-focused care in a clean and pleasant environment. If you come to the Linda McCartney Centre at the Royal you can expect:

• Specialists from different medical areas meet weekly. This is called a multi-disciplinary team meeting (MDT) and is central to the way we work. The MDT advise, support and create treatment plans that are personalised for every patient.
• You’ll be assigned a specialist breast cancer nurse who stays with you for the treatment journey. The nurse is your key-worker and is there to help you with any problems or questions you may have.
• The rapid diagnosis clinic allows us to perform tests for breast cancer in one single visit. Most patients benefit from a final diagnosis before leaving.
• We’re committed to giving the best treatment in the UK. That’s why we use the latest techniques - like Oncoplastic surgery and sentinel node biopsies, and intra-operative lymph node assessment - to give our patients the best possible outcomes.
• We are one of only a small number of Centres in the UK to offer Intra-Operative Lymph Node assessment. In addition we offer access to a wide clinical trials programme, which makes new treatments available to patients – often giving them a better outcome. We aim to have a trial option open to patients at each step of the treatment path.
• As a university hospital, we lead research into breast cancer diagnosis, treatment and prevention. We regularly publish research papers that help in the fight against cancer.
• All patients are screened for MRSA before entering the ward.
• The Macmillan Information Centre is near to the Breast Unit. Here you and your family can get information and advice from two highly experienced cancer nurses.
• Our clinical psychology team are there to reduce patient distress and promote psychological wellbeing.

Screening for breast cancer

We run the National health Service Breast Screening Programme for women between the ages of 47-73 years old. You will be invited for breast screening via your GP practice. Regular screening is important. Patients who have had breast cancer or who are high-risk of developing the disease are put on a mammographic surveillance program at the Linda McCartney Centre.

Find out more about the breast screening programme here

Breast Cancer treatment

Your test results are discussed by the multi-disciplinary team (MDT). This is a group of cancer experts who provide support, advice and help you decide the best treatment path if cancer is discovered. Members of the MDT include: breast cancer surgeons; specialist breast cancer nurses; clinical and medical oncologists (specialists in the treatment of cancer using radiotherapy and chemotherapy); pathologists (tissue specialists); radiologists (who will undertake and report on x-rays and scans); palliative care experts (skilled in caring for patients with advanced disease).

Treatment types

• Surgery is usually the first way of stopping the cancer. There are two different operations: removal of the lump and the tissue around it (lumpectomy) or removal of all the breast tissue (mastectomy). Often breast reconstruction and breast correction surgery are performed at the same time. We also perform a procedure called ‘sentinel lymph node biopsy’ to see if the cancer has spread to the armpits.
• Hormonal therapy is used for cancer types that are affected by female hormones.
• Chemotherapy uses different drugs to kill cancer cells.
• Radiotherapy uses x-rays to destroy cancer cells.
• Targeted therapies (Herceptin): Herceptin is generally less likely than chemotherapy to harm normal healthy cells. All patients are tested to see if they could benefit from the treatment.
• Palliative care is the support of patients with incurable disease. We have an excellent palliative care unit at the hospital.

Breast reconstruction

This is surgery to rebuild the breast mound to match the remaining natural breast. It’s an option to consider if you undergo mastectomy or lumpectomy. Many women choose to use a false breast (prosthesis) instead. We can perform the procedure at the time of the initial operation, or at a later date. Types of breast reconstruction include:

• TRAM uses skin and fat from the stomach to provide a natural and warm-feeling new breast. TRAM stands for: transverse rectus abdominis myocutaneous flap reconstruction.
• LD uses skin and muscle from the back to recreate a new breast. It is often combined with an implant dependent on the breast size. LD stands for latissimus dorsi flap reconstruction.
• Implant reconstruction is when a tissue expander and implant is placed under the skin and muscle of the chest wall to provide a new breast.

Breast correction surgery

These operations are often combined with breast corrective surgery. This surgery aims to match your new breast as closely as possible to your existing breast. Techniques include:

• Breast reduction can be performed when there is a difference in size following reconstruction; it is also offered for ladies with very large breasts.
• Breast lift (mastopexy) is usually combined with breast reconstruction. It is often performed on patients who have a reconstruction using implants.
• Structural fat grafting is a new technique that improves the size, shape and suppleness of the new breast.
• Nipple reconstruction is usually offered to patients three to four months after breast reconstruction. It’s often followed with a tattoo than puts in the colour of the nipple and areola (the dark circle around the nipple).

Breast screening can detect breast cancer at a very early stage. We diagnose around 300 new cancers each year due to our regular screening programme. See below in the Breast Screening section for more information

Your GP will refer you to the hospital for further investigation if you have any unusual lumps in the breast. We will see you for an appointment within two weeks at the rapid diagnosis clinic.

We perform the tests you need for cancer diagnosis in one clinic visit at the Rapid diagnosis clinic.

Several tests are performed:

• X-ray of the breasts (mammogram): this helps us see into the breast. We can spot lumps or other strange patterns in the tissue.
• Ultrasound: this uses sound waves to make a picture of inside the breasts.
• Fine needle biopsy: a very thin needle is used to get cells for testing. This is a minor and safe procedure.
• Core needle biopsy: a bigger needle is used through a small cut in the skin.

Tissue samples are sent to a tissue expert (pathologist) for examination under a microscope. This is the only way to confirm – without doubt – the presence of cancer.

The majority of our patients get a final diagnosis before leaving - and most do not have breast cancer.

Several treatment paths are open to you if breast cancer is detected. See our breast cancer treatment page for more details.

Treatment starts within 31 days of the cancer being diagnosed. A specialist nurse will stay with you for your treatment journey. The nurse is available to answer any questions you may have along the way.

Am I at Risk of Breast Cancer?

You may be at risk of developing breast cancer if there is a family history of the disease. We have strong links with the regional genetics service. The family history risk assessment clinic has been established for 15 years and is the largest in Merseyside and Cheshire.

You may have increased risk if you have:

• a mother or sister diagnosed with breast cancer before the age of 40
• two close relatives from the same side of the family with breast cancer (at least one must be a mother, sister or daughter)
• three close relatives diagnosed with breast cancer at any age
• a father or brother diagnosed with breast cancer at any age
• a mother or sister with breast cancer in both breasts (the first cancer diagnosed before the age of 50)
• one close relative with ovarian cancer and one with breast cancer (diagnosed at any age; at least one must be a mother, sister or daughter).

Treatment is given in the Linda McCartney Centre at the Royal Liverpool University Hospital and in our inpatient wards.

Radiotherapy is performed at the Clatterbridge Cancer Centre.

Visit the Marie Curie website here

Visit the MacMillan Cancer website here 

Visit the Cancer Research UK website here

Visit the NHS Choices - Cancer website here

The clinic uses evidence-based research in the assessment process. The assessment is a process where family and personal information is gathered.

Visit the National Breast Cancer Screening website which has lots of information including downloadable leaflets and a list of frequently asked questions.

Local support group - The Lily Centre

Mondays, Tuesdays and Wednesdays from 9.30am to 4.30pm and a 24 hour answer phone is available

The Lily Centre is open to all women and men who have experienced breast cancer, as well as their families and friends. They offer welfare benefits advice and other services including therapies such as Reki and Reflexology.The centre is run by women who have had breast cancer.

Clinical Trials

Clinical trials give patients access to new treatments as soon as they become available. Evidence shows that these patients often have a better outcome. 

Find out more by visiting the Clinical Research Unit website here