The Tayside Breast Service provides a 'symptomatic' one stop clinic in Ninewells Hospital and PRI for patients in Tayside, North East Fife and Angus (approximately 5000 patients/year). The East of Scotland Screening Unit provides routine 3 yearly screening through a static site in Ninewells and mobile vans for the same catchment area as above (approximately 20 000 patients/year). Family history services (Clinical Genetics) are provided on the Ninewells site. Oncology services provide chemotherapy treatment on both Ninewells and PRI site. Radiotherapy is only provided on the Ninewells site.
Routine review clinics are provided in Ninewells and PRI. Patients under the age of 50 at diagnosis are reviewed annually and have annual mammogram until 50 then discharged to routine breast screening. Patients over the age of 50 at diagnosis are reviewed one year after surgery and have annual mammography for 3 years then discharged to routine breast screening. All Surgery is based in PRI although some reconstructive surgery is performed in Ninewells.
Breast Disease
CONTENT UNDER REVIEW
Who we are
How to refer
Emergency referrals should be made through the acute surgical receiving unit (ASRU). Elective referrals should be made through through SCI Gateway Breast Service proforma (General Surgery - Breast – Breast Service) .All referrals are vetted by a Consultant in line with Healthcare Improvemnt Scotland Scottish Breast Cancer Referral Guidelines (see below).
Contact us
If you need to contact us directly please phone the Breast Unit at Ninewells on ext 33885 Existing patients can contact the Breast Care Nurses on this extension during normal working hours. At all other times referral should be made through ASRU.
Who to refer
Referrals are vetted in line with the Scottish Breast Cancer Referral Guidelines . Please state clearly the presence of any new lumps, any associated features/ skin changes and presence or absence of pain.
Urgent suspected cancer referrals are seen within 2 weeks Urgent referrals within 4 week Routine referrals within 3 months.
Concerns relating to family history of breast (or ovarian) cancer should be directed to Clinical Genetics as per the guidance for patients with a family history or breast or ovarian cancer
Urgent suspected cancer referrals are seen within 2 weeks Urgent referrals within 4 week Routine referrals within 3 months.
Concerns relating to family history of breast (or ovarian) cancer should be directed to Clinical Genetics as per the guidance for patients with a family history or breast or ovarian cancer
Who not to refer
The following patients should NOT be referred to the one stop symptomatic clinic:
Breast screening requests - Refer to Breast Screening Unit.
Ninewells Family history patients - Refer to clinical genetics.
Cosmetic enquiries including implants - Refer to Plastic Surgery Unit.
- Skin lesions (dermatology).
- Mastitis that resolves with single course of antibiotics
- Long standing nipple inversion or transient nipple discharge
- Moderate breast pain with no focal lesion
- Gynaecomastia does not require referral or imaging. Please check hormone profile and testicular tumour markers (AFP, beta HCG)
Breast screening requests - Refer to Breast Screening Unit.
Ninewells Family history patients - Refer to clinical genetics.
Cosmetic enquiries including implants - Refer to Plastic Surgery Unit.
Initial Primary Care management
As per the full Scottish Referral Guideline. There are also links to useful CKS summaries provided below. Referral should be consistent with the Scottish Guidance.
Alternatives to referral
Time sensitive advice can be available by phone as above in the 'contact us' section. Non-urgent referral advice can also be requested via SCI-Gateway advice template.
Useful links
Scottish Referral Guideline These are the guidelines we use for vetting in Tayside.
The following NICE CKS Summaries provide useful education information and case scenarios.
The following are links to useful national patient information leaflets. NHS Inform also link to further information about screening centres and translated formats.
The following NICE CKS Summaries provide useful education information and case scenarios.
- Breast Cancer Recognition and Referral
- Cyclical Breast Pain
- Family History of Breast Cancer
- Breast Screening
The following are links to useful national patient information leaflets. NHS Inform also link to further information about screening centres and translated formats.