Appointments, assessments and patient pathways

If you are referred to the breast clinic, you’ll be sent an appointment to be seen in a new patient clinic by one of the breast team doctors. You may have the investigations done on the same day and be discharged from the clinic, or you may need to return at a later date for the results. Please be aware that you are likely to be at the hospital for approximately 3-4 hours.

Under normal circumstances we welcome and encourage you to bring someone with you. However, due to social distancing being in place for the foreseeable future we ask that you are mindful of this when attending the hospital for the comfort and safety of yourselves, other patients and staff. Please refer to the hospital website for up to date information before attending appointments.

At your appointment you'll meet a doctor and a clinic nurse in the surgical outpatient department.

The doctor will ask you about your symptoms and carry out a breast examination. This will be done in the presence of a chaperone (someone who helps to support patients during intimate investigations).

RD&E Wonford, Barrack Rd, Exeter EX2 5DW

Clinics are held in General Outpatients on Level 1, which is accessible via the RD&E Hospital entrance and opposite our main reception.

Imaging is carried out in the Breast Care Unit: Level 2, Area N

Breast Care Nursing service based in the Breast Care Unit: Level 2, Area N

New Patient (Fast track / Triple Assessment) clinics held daily throughout the working week.

Patients will be seen initially by one of our Breast Consultants or specialist breast doctors:

• Douglas Ferguson, Consultant Oncoplastic Breast Surgeon
• Julie Dunn, Consultant Breast Surgeon
• Sisse Olsen, Consultant Oncoplastic Breast Surgeon
• Rachel Tillett, Consultant Plastic and Breast Surgeon
• Charlotte Ives, Consultant Oncoplastic Breast Surgeon
• Di Cameron, Trust Breast Physician
• Tanvir Ahmad, Trust Breast Specialist Registrar

If the doctor feels that imaging is needed, they will refer patients to the breast care radiology team:

• Russell Davies, Consultant Breast Radiologist
• Rachael Currie, Consultant Breast and General Radiologist
• Simon Ewart ,Consultant Breast Radiologist
• Sarah Knightley, Consultant Breast Radiographer

If you need to see a Breast Care Nurse Specialist – the Breast Care Nursing Service is based at the RD&E:

• Gill Gray, Lead Breast Care Nurse Specialist
• Sue Avery, Breast Reconstruction Nurse Specialist
• Katherine Bonnin, Secondary Breast Clinical Nurse Specialist
• Dawn Peters ,Breast Care Nurse Specialist
• Mary Allen, Breast Care Nurse Specialist
• Sara Green, Breast Care Nurse Specialist
• Amanda Green, Breast Care Nurse Specialist
• Liz Powe, Breast Care Nurse Specialist
• Alice Osigli, Breast Care Nurse Specialist
• Sam Headon, Breast Care Nurse Specialist

The Breast Care Unit is open Monday to Friday, 8am - 5pm. 

To change an out-patient appointment please contact our booking office on:

Telephone: 01392 406992 (stating your NHS number).

If you have an appointment for surgery and need further information about this appointment or need to make changes please contact the secretary of your designated consultant, by calling the hospital switchboard: 01392 411611

Oncology appointment bookings contact number: 01392 406181

You might be asked to attend our breast care unit to have:

Mammogram:

This is a special type of X-ray, used to examine the breast in detail. Both breasts will be examined. The breast is held gently but firmly between two plastic plates. Two X-rays are taken of each breast at different angles. Some patients find the mammogram uncomfortable and occasionally painful but this is usually only for a very short time.

Ultrasound:

An ultrasound scan is a painless test, which takes just a few minutes. A small device called an ultrasound probe is used, which gives off high-frequency sound waves. Special gel is placed on the breast and the probe is moved over the area being investigated. Images are then recorded on the ultrasound machine.
You may feel some pressure because sometimes the probe needs to be pressed firmly against your skin to get a clear picture.

Core biopsy:

During a core biopsy very small samples of tissue are taken from your breast for further examination. Local anaesthetic numbs the area before a needle is used to collect the sample. We aim to keep you as comfortable as possible through the biopsy procedure and you will be supported by the radiographers and radiography assistants. The biopsy can be done using ultrasound or mammogram as a guide. If mammogram guidance is advised you will be given an appointment on another day to have it done. The specimen of breast tissue taken is then sent to our laboratory to be examined. Your breast can bruise and be tender after a core biopsy, but this generally settles within a week.

You will be given an aftercare advice leaflet by our staff before you leave the department.

After your tests, you might be asked to return to the surgical outpatient department to discuss the results of the investigations with the doctor. If a biopsy is taken you will return to the clinic in 1 to 2 weeks' time to discuss the results. Otherwise, you will be contacted by letter with your investigation results.

If further tests or scans are needed and they can't be done on the same day, you may have to return for a further appointment.

Breast MRI

In addition to triple assessment, breast MRI (Magnetic Resonance Imaging) has a useful role in selected cases (young patients and implants) as a problem-solving tool to help diagnose breast cancer or to give further information.

MRI does not involve x-ray irradiation but uses a very strong magnetic field. It requires specially trained radiographers to perform the test and takes 45-60 minutes. All breast MRI examinations are carried out at the Royal Devon & Exeter Hospital and double-read by experienced breast-dedicated radiologists.

It is most often used to give further information following a mammogram and ultrasound. In many cases, an additional breast ultrasound is performed after the MRI to clarify its findings. It is sometimes used to assess the response of a cancer to chemotherapy or hormone treatment prior to surgery.

In addition to its role as a diagnostic tool, breast MRI is useful in screening younger women at a significantly increased risk of breast cancer either as a result of a very strong family history or a mutated breast cancer gene (BRCA1 or BRCA2), or following chest mantle irradiation for Hodgkin’s disease at a young age. MRI is often helpful for these women because it is effective in dense breast tissue and many youn­­­g women have dense breasts.

However, mammography and ultrasound remain the most useful diagnostic breast imaging methods and even where MRI is recommended for women at high risk of the disease, it is used in conjunction with mammography and ultrasound for selected women. Breast MRI is a very specialised technique and the results take longer to process.

If the test has been performed for a suspicious or known breast cancer, you will be given an appointment to return to the clinic to discuss your results with a specialist. Following the Breast MRI examination, many patients are called back for a further ultrasound of the breast as this helps the radiologist to interpret the MRI findings. This is known as a “second look ultrasound”

Treatments will depend on any scan or biopsy findings. Most benign conditions do not need any further investigation or treatment.

For benign conditions we aim to offer any recommended treatment within three months but we must always prioritise patients with cancer. When the demand for cancer surgery increases, waiting times for non-cancer surgery can be up to a year.

We produce a wide range of leaflets which provide information about our services and about the treatment you might receive in our clinics or during your stay in hospital. 

We also produce these in different formats including large print, please contact the department you are visiting for more information.

Find out more

The breast care nursing service provides emotional support, as well as practical help if you have a diagnosis of breast cancer. We can signpost and refer you to other agencies of support, such as counselling available through the Force Cancer Support Centre.  If your needs are more specialised, we have our breast clinical psychologist.

We also have a wealth of written information and internet links to safe and reliable sites, as well as the information available on our Health and Well Being Information and Support Presentation.

We also offer every patient diagnosed with breast cancer (click here to visit our pages) a holistic needs assessment at three points from their diagnosis until the completion of their initial treatment. Click here to visit our Breast Cancer Clinical Nurse Specialist services.