Vacuum-assisted biopsy and excision
A larger tissue sample, or the complete removal of some benign lesions, through a single small incision rather than an open operation.
Prime Hospital, Al Garhoud
Breast Care Clinic
A dedicated breast service: assessment, diagnosis, surgery and genetic counselling in one place, under one surgeon, with the multidisciplinary team behind every cancer decision.
Led by Dr. Verushka Mansukhani · Specialist General & Breast Surgeon
Triple assessment and screening
Breast problems are assessed using three strands together, because no single strand is reliable on its own. When all three agree the answer is dependable; when they disagree, the disagreement is investigated rather than explained away.
01
Clinical examination
History and physical examination, by the surgeon who will be responsible for what happens next.
02
Imaging
Ultrasound, mammography or MRI mammography, chosen according to age, breast density and the nature of the problem.
03
Pathology
Core biopsy, fine-needle aspiration cytology (FNAC) or cytology, where a question remains that only tissue can settle.
Image-guided breast biopsy
Taking the sample from exactly the right place matters more than taking a large one. Imaging guides the needle to the target rather than near it.
Stereotactic-guided biopsy
Mammographic guidance for areas that can be seen on imaging but not felt, including microcalcifications.
Ultrasound-guided biopsy
Real-time guidance to a lesion visible on ultrasound, under local anaesthetic, as a day case.
What a biopsy appointment actually involves is set out in the breast biopsy page, including its risks.
What the clinic sees
Listed by name, because that is how people search for them at two in the morning. A condition appearing here is not a diagnosis, and no list can tell you which one applies to you.
Benign breast conditions
Most of what comes through a breast clinic is benign. Several of these are common, several are harmless, and several simply need to be named so they stop being frightening.
- Breast pain (mastalgia)
- Lactation mastitis
- Granulomatous mastitis
- Galactocele
- Fibroadenoma
- Fibroadenosis
- Fibrocystic disease
- Phyllodes tumour
- Duct ectasia
- Nipple discharge
- Accessory breast tissue
- Axillary lumps
Being told a condition is benign is a finding, not a dismissal. It is arrived at through assessment rather than assumed from appearance.
Pre-malignant breast conditions
These are changes that are not cancer but carry a raised risk, and they are the reason screening exists. Finding them early is what allows the smallest intervention.
- DCIS, ductal carcinoma in situ
- LCIS, lobular carcinoma in situ
- Intraductal papilloma
A pre-malignant finding is not a cancer diagnosis. What it changes is the surveillance and, sometimes, the surgical plan.
Breast cancer
Breast cancer is treated by a team rather than by a surgeon alone. Every case is reviewed by the multidisciplinary tumour board, surgeon, medical oncologist, radiologist, pathologist and radiation oncologist, before a plan is put to a patient.
- Diagnosis, core biopsy, tru-cut biopsy, FNAC of axillary nodes
- Tissue markers and clip placement for image-guided localisation
- Staging, CT, MRI and PET-CT
- Tumour markers, CA 15-3, CA 27.29, CA 125
- Breast conservation surgery
- Sentinel lymph node biopsy
- Modified radical mastectomy, with or without reconstruction
- Port-a-cath insertion for systemic chemotherapy
- Coordination of chemotherapy, radiotherapy, targeted drugs and hormone therapy
Surgery is one part of the treatment and rarely the whole of it. Which parts apply, and in which order, is decided by the team rather than by any one specialty.
Genetic counselling
Most women diagnosed with breast cancer have no family history of it, but where a family pattern does exist, it changes the surveillance and sometimes the surgical decision, for the patient and occasionally for her relatives.
BRCA1 and BRCA2 testing
Where personal or family history meets the criteria for genetic risk evaluation.
Gene panel profiling
Broader profiling where a single-gene result would not answer the question.
Counselling before and after
A genetic result affects more than one person. Counselling is part of the test, not an optional addition to it.
Not sure which of these applies to you?
That is what an assessment is for, and the patient guides explain what each step involves before you go.