Breast Cancer Care Guide for the UK
Breast cancer is the most common type of cancer affecting women in the UK. About one in eight women will be diagnosed with breast cancer during their lifetime. The UK has a well established system within the health service for providing breast cancer care, and is supported by a strong network of charities. Each foundation provides specific information and support to patients and their families and are an important resource for patients.
Breast Cancer Care UK Waiting Time Guidelines
Breast cancer care in the UK is subject to waiting time guidelines laid down by the government. This is to ensure that patients living in all parts of the UK receive a consistent and acceptable standard of care.
If breast cancer is suspected, your GP should refer you to a hospital specialist. In England, you should wait no longer than two weeks to see a specialist. In Wales, there is no set standard, but the guidance laid out by the Welsh Assembly Government states that patients should be offered an appointment within 10 working days.
To receive the results of your test, you should normally have an appointment within three to five working days. No patients should wait longer than a week.
If breast cancer is diagnosed, patients should wait no longer than 31 days to start receiving treatment.
Follow-up plans differ and are not subject to strict guidelines. This is due to variations in treatment and the fact that post treatment breast cancer support is tailored to individual to patients’ needs.
The Patient Journey
UK government guidelines set out pathways so that patients across the country can receive a consistent standard of care.
Referral and Diagnosis
As soon as you become aware of any signs of breast cancer, you should visit your GP immediately. Your GP will examine you and refer you to a hospital breast unit for diagnostic tests if they feel further assessment is needed. Many hospitals in the UK have a breast unit containing a specialist breast care team and it is recommended that you attend one of these specialist units. The breast care team is multi-disciplinary and is usually made up of consultant surgeons, specialist radiologists, oncologists, pathologists, advanced nurse practitioners and breast care nurse specialists.
Three different tests form the basis of assessment. You will usually have a physical examination of your breasts and armpits, a mammogram and/or ultrasound scan, and a biopsy where a small sample of cells are taken from your breast or armpit via a needle.
Test results will be given to you by a member of your breast care team. You may have a breast care nurse with you for support. You will have an opportunity to ask questions and some breast care teams may offer you a written record of your results.
Following a diagnosis of breast cancer, you will need to undertake some treatment. The type of treatment that you are offered will depend on the type of breast cancer you have. Most people will have more than one treatment and the order may be different for each individual. This depends on the stage the cancer is at.
The main treatments for breast cancer are surgery, chemotherapy, radiotherapy, hormone therapy and biological therapy (targeted therapy).
The first type of treatment will usually be surgery. Then, depending on the type of breast cancer, this is usually followed by chemotherapy or radiotherapy, or in some cases hormone or biological treatments.
Your breast care team will continue performing tests on your cancer. They do this to enable them to plan your treatment in such a way as to maximise the chances of success, whilst minimising any possible adverse side effects. You will also be involved in treatment and care decisions. Your breast care team will take into account your preferences and will be able to inform you about the treatments, risks and any side effects. If there is a range of clinically appropriate treatments available, you will be supported by your breast care team in choosing the right treatment for you.
As part of your care, you should also be offered counselling. Receiving a diagnosis of breast cancer can cause anxiety and symptoms of depression and it is normal to need extra support. Your breast care team or GP will be able to give you more information on counselling and support services available to you.
Following your treatment, your breast care team will formulate a follow-up care plan. This plan will involve seeing you at set intervals and allows them to manage the side effects of treatment, monitor for any recurrence of the cancer, and offer psychological support. Follow up plans differ depending on the type of treatment and follow-up periods also vary. Around five years is common.
Using the Breast Cancer Care Charity Network for Support
The UK has an extensive breast cancer care charity network providing further information and support to people diagnosed with breast cancer. Your GP or the breast cancer care unit at your hospital will be able to signpost you to the relevant organisation depending on the type of support you require. In addition, there is a wealth of information and advice available online.
Charities also provide information and support to patients’ families and friends, helping them to understand what is happening, how they can best support the patient, and how they can look after themselves.
Further Breast Cancer Care and Support
After you have completed your treatment, you will remain in the breast cancer care system to make sure that your health and support needs are met. Your breast care team should make you aware of the side effects of treatment and any new side affects that may occur, so that you can receive further treatment or support if it is required. Women and their families with a history of breast cancer may also be able to access family history services, which includes genetic testing.