The South Eastern Breast Care Service provides specialist care for patients with breast cancer and non-cancerous conditions through a consultant led service.
Services provided are:
- Symptomatic Breast Clinics
- Specialist Breast Surgery
- Integrated Breast Reconstruction Service with Regional Plastic Surgery Unit
- Lymphoedema Service
- Breast Prostheses Service
- Family History
To allow us to provide a high standard of personalised care, a core team of health care professionals are involved in the care of patients with breast problems, these includes:
- Specialist Oncoplastic Breast Consultant Surgeons
- Consultant Radiologists
- Consultant Pathologists
- Consultant Oncologists
- Associate Specialist in Breast
- Breast Care Nurse Specialists
- Radiographers/Advanced Practitioners
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Symptomatic Breast Services
There are symptomatic clinics held in the Breast and Endocrine Centre at the Ulster Hospital, led by Specialist Breast Surgeons with Consultant Radiologists, pathologist and Breast Care Nurse Specialists.
If you have a concern or symptom regarding your breasts, please contact your GP as soon as possible. They may refer you to a Symptomatic Breast Clinic.
Referral guidelines are available on the NICE website.
The symptomatic breast clinic is a one stop triple assessment clinic – this means a clinical examination, X-rays/ultrasound and possible biopsies. Not all patients need all 3 forms of investigation. This appointment may take up to 4 hours depending on what investigations are required.
For more information about attending this clinic and what might happen on the day, please see our leaflet here.
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Specialist Breast Care Nurses
Specialist Breast Care Nurses can provide information, psychological support and practical help for all patients who have or who fear they may have breast cancer. They are based in the Breast and Endocrine Centre and can be contacted on Tel: (028) 9055 0499
Medical Records process referrals and make appointments.
Appointments office direct line is Tel: (028) 9056 4887
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Breast Awareness
It is important to see your GP if you notice any changes to your breasts that are not normal for you. For more information please click here.
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The Northern Ireland Breast Screening Programme
The breast screening service for SEHSCT is delivered in partnership with BHSCT.
The Breast Screening Programme covers the whole of Northern Ireland. It involves staff from GP surgeries, Health Centres and the Breast Screening Units.
How will I get an invite?
The Northern Ireland Breast Screening Programme is a rolling one which calls women from GP practices in turn every 3 years from the age of 50-70. Not every woman will receive an invite as soon as she is 50, but each woman should receive her first invite before the age of 53. If you are registered with a GP and the practice has your correct details, then you will automatically receive an invitation. You don’t need to contact anyone but it is important your GP has your correct details. If you are over the age of 70 you can contact the screening office for an appointment.
The Screening Centre for Belfast and South Eastern Trusts is located at:
Eastern Area Breast Screening Unit
12-22 Linenhall Street
Belfast
BT2 8BSTel: (028) 9033 3700
For further information about Breast Screening, please click here.
The Breast Screening programme has produced a video to show what happens when women attend their appointment for a mammogram. To watch click here.
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The Breast Family History Resources
Hello and welcome to our family history information and support videos.
We are part of a group of health care professionals and patients from across Northern Ireland who have developed information and resources for people who may have a risk of developing breast cancer due to their family history.
The aim of these resources is to give guidance on how you can reduce your risk of developing breast cancer.
They provide all the information and support you need at the touch of a button. They also provide contact details should you have any further questions.
Introducing the Breast Family History Resources
https://vimeo.com/722980532/f3f33c0f3d
Overview of the Breast Family History Clinic
https://vimeo.com/723688093/07e981091b
Further Information
Tamoxifen
Tamoxifen-New-Leaflet.pdf (hscni.net)
Anastrozole
Anastrozole-New-Leaflet.pdf (hscni.net)
Raloxifene
Raloxifene-New-Leaflet.pdf (hscni.net)
Cancer Genetics Service
It is uncommon for breast cancer to be caused by an inherited genetic change (disease causing) in a high-risk cancer gene such as BRCA1 or BRCA2. Genetic testing of these and other genes may be offered to women who may be at risk. The chances of an underlying genetic cause may be raised in a family if there is;
- A young cancer diagnosis,
- Certain types of breast cancer (histology),
- A strong family history of breast or ovarian cancer or
- Other cancers that can be linked together as part of a genetic cause.
Part of the family history clinic assessment is identifying women who may be eligible for genetic testing or may benefit from a further assessment with the cancer genetics service.
Information for patients who may be eligible for genetic testing, along with information about genes such as BRCA1 and BRCA2, associated cancer risks and management options for women are available on the Genetic Medicine Website.
For families where there is a known inherited genetic change (pathogenic disease causing variant) in a high-risk cancer gene such as BRCA1 or BRCA2, relatives can either request a referral from their GP or self-refer to the Cancer Genetics service to discuss genetic testing. For self-referral, information is available on our website or via genetic.medicine@belfasttrust.hscni.net. Self-referrals are not accepted unless they include the details of affected family member and family reference number. Where women are concerned about cancer symptoms, they should seek advice from their GP or breast clinic in the first instance.
Further support resources
- How to examine your breasts by Dr Liz O’Riordan – YouTube
- ‘Know your breasts: a guide to breast awareness and screening’ booklet (breastcancernow.org)
- Breast screening | HSC Public Health Agency (hscni.net)
- BRCA Link NI Home (brcani.co.uk) – Support groups for individuals who carry a BRCA mutation
- https://www.womens-health-concern.org/ – Information about menopausal symptoms
- Family history, genetics and cancer risk – Macmillan Cancer Support
Video 3: Healthy Eating to help with breast cancer prevention
https://vimeo.com/749229520/9f978187fb
Video 4: The Role of Exercise in Cancer Prevention
https://vimeo.com/722983050/864d7bfa6b
Video 5: Victoria’s story
https://vimeo.com/719800501/4cf9deab60
Thank you for taking the time to watch these videos. If you have any questions or concerns, please do not hesitate to contact your local Macmillan Information & Support Service. Please watch our Macmillan Information & Support Regional video below to see how they could help support you.
Video 5: Macmillan information & Support Service – Northern Ireland
https://vimeo.com/688381356/620c7c2de6
Macmillan Information & Support Service – contact details
South Eastern Health and Social Care Trust
Contact Numbers: 028 9055 3246/028 9598 0028
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FAQ Breast Family History
Is there medication available to reduce the risk? How effective is this and in order to be the most effective, when should I consider starting to take this?
Yes, there are a number of medications which have been shown to reduce breast cancer risk. These will be discussed with you if suitable in your individual circumstances. For further information-links to leaflets here:
https://nican.hscni.net/wp-content/uploads/2019/09/Tamoxifen-New-Leaflet.pdf
https://nican.hscni.net/wp-content/uploads/2019/09/Anastrozole-New-Leaflet.pdf
https://nican.hscni.net/wp-content/uploads/2019/09/Raloxifene-New-Leaflet.pdf
Do hormones have an effect on my risk of developing Breast Cancer? Are there foods, products or medication that I should try to avoid completely in order to minimise my risk? e.g.) is it safe for me to consume soya products?
There may be additional risks for breast cancer with taking HRT but this depends on many things, for example, age, type of HRT and other personal risk factors including family history. Making decisions about taking HRT is a balance. Menopausal symptoms can sometimes affect your quality of life and HRT can improve this. It can also have beneficial effects on bone density and heart disease.
You should therefore discuss the benefits versus the risks of taking hormone replacement with your healthcare professional.
For more information on menopausal symptoms:
https://www.womens-health-concern.org/
There are no foods that you should avoid in particular to reduce your overall risk. It is however important to have a healthy balanced diet and avoid becoming overweight. You should eat a balanced and varied diet rich in fruit, vegetables, pulses and whole grains and low in red and processed meat, fatty and sugary foods.
Can taking the oral contraceptive pill increase my risk?
The older you are, the higher your risk of developing breast cancer. Taking the combined pill (oestrogen and progesterone) adds to your risk a little further, whatever your age.
It is not known whether the mini pill (also known as the progestogen-only pill, or POP) increases the risk of breast cancer. It is also unknown what the effect on breast cancer risk is with contraceptive implants, injections and intra-uterine devices such as the mirena coil. Research is ongoing in these areas.
If you are over 35 and have a family history of breast cancer it is advisable to discuss your method of contraception with your general practitioner and balance your individual risks and benefits.
Is it ever too late to make changes, how significant do these changes have to be to make a difference? Can a small change really make a difference?
It is never too late to make a positive lifestyle choice to improve your health. By making small healthy changes and living well now, you can lower your risk of getting breast cancer and also lower your risk of developing other cancers or heart disease etc.
If I have the BRCA1/BRCA2 gene mutation how likely is it that I will pass this on to my children? Is there anything I can do to prevent passing the gene on and also to reduce my child’s future risk of developing cancer?
If you carry the BRCA1/BRCA2 gene mutation your children will have a 50% chance of inheriting the same mutation. You cannot do anything to prevent passing it on to your children.
Pre-Implantation Genetic Diagnosis is available in certain circumstances. You can explore this further by contacting the genetics service.
How much does having the breast cancer gene mutation increase my likelihood of developing cancer, are there other genes that may influence this?
Cancer risks for women who carry BRCA1/2
BRCA1 BRCA2 Breast Cancer 60-90% lifetime risk 45-85% lifetime risk Breast cancer in other breast for gene carriers diagnosed with a breast cancer Up to 50% lifetime risk Up to 50% lifetime risk Ovarian Cancer 40-60% lifetime risk 10-30% lifetime risk Cancer risks for men who carry BRCA1/2
BRCA1 BRCA2 Male breast cancer 0.1-1% lifetime 5-10% Prostate cancer Lifetime risk similar to general population Up to 25% Pancreatic cancer No evidence of increased risk Up to 3% depending on Family history There are other high risk gene mutations:
TP53, A-T homozygotes, PALB2, PTEN, STK11 or CDH1
If you are identified as carrying one of these genetic mutations, you will be contacted by a genetics counsellor who will advise you regarding your need for screening and risk-reducing surgery. If a family member has been diagnosed as a carrier of one of these genetic mutations they are likely to encourage you to get in contact with the genetics service to arrange testing.
What research is being carried out into how we can suppress the genes that cause cancer and into treatment to further reduce risk of developing cancer or passing on the genes?
Research studies are ongoing to better advise and screen women at increased risk from breast cancer. On occasions, you may be offered to be part of a study exploring some of these factors.
Prevent Breast Cancer is a charity specifically set up to provide information and to undertake research in this area.
How to I perform a breast self-examination and how often should I do this?
Please watch this video for a demonstration and further advice :
https://www.youtube.com/watch?v=Lib0q4zdutk
What happens when I attend for my first appointment?
The first appointment will be offered after your questionnaire has been returned and your level of risk assessed. This may be a face-to-face or virtual consultation.
Your risk will be discussed as well as breast screening recommendations, breast awareness and ways of reducing your individual risk.
You will not normally have your first breast mammogram at this appointment.
Who am I seen/assessed by?
Depending on the trust you are referred to, this may be a doctor or nurse practitioner with a special interest in patients with a family history of breast cancer.
Should I bring family or a friend with me?
If it is a face-to-face consultation, you are welcome to bring someone with you. If the appointment is virtual people can listen along. You will receive a letter, a few weeks later, summarising what was discussed during either consultation.
How long will my appointment take?
Your first consultation may last up to 30 minutes.
Is a mammogram painful?
Most people find they can tolerate a mammogram. Occasionally having a mammogram can be uncomfortable and some women find it painful. Usually, any pain passes quickly.
What should I wear?
You will be required to take off your top clothing and bra so therefore a top rather than a dress is usually more suitable.
How long until I receive the results of my mammogram and how do I receive them ie post or clinic or GP surgery?
You will receive a results letter within 2-3 weeks of your appointment. A copy of these results will also be sent to your GP.
What happens if something is discovered in my mammogram?
In general population breast screening, approximately 4 out of every 100 women screened will be called back for more tests. Out of the 4, 1 will be found to have cancer and the rest will not.
If you are recalled, you may have a breast examination, more mammograms and/or ultrasound scans. You may also have a biopsy, which is when a small sample is taken from your breast with a needle and checked under a microscope. The results of this are usually available within 1-2 weeks.
Is the Family Clinic part of the main Breast Cancer Clinic?
The Family History services are run by the breast units in each of the five trusts. They often run in parallel with the breast cancer clinics involving many of the same staff.
How often will I attend appointments?
This will be determined after your risk has been assessed and discussed with you at your initial consultation as it may vary from trust to trust.
I have daughters – do I need to get them assessed and if so at what age?
If you remain well and do not develop cancer, your children are less likely to be at risk. They can be referred for assessment however when they are older, ideally in their 30s.
- Useful links
Contact Details
Breast Care Nurses
Breast & Endocrine Centre
Ulster Hospital
Monday – Friday 9.00am – 5.00pm
(028) 9055 0499