New breast health clinic the first of its kind in Australia

Author
Melinda Ham
Date
24 October 2018
Faculty
Faculty of Medicine and Health Sciences
Topic

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A new breast health clinic at Macquarie University Hospital is revolutionising the way women can access specialist treatment.

A few months ago, Marian felt unusual lumps and pain under her right arm. The 59-year-old had breast implants but everything had been fine for 20 years. An ultrasound showed her right implant had ruptured and was leaking.

Stark statistic: About 50 women are diagnosed with breast cancer every day in Australia.

“I went to a plastic surgeon and he was like ‘oh I can replace your implants and give you these instead and make you look 18 again’,” Marian says. “I found it really scary because it was all about convincing me to buy something and he seemed totally unconcerned about my health. It made me wary about the whole profession.”

Dissatisfied with the surgeon’s attitude, she did some research and discovered the new Integrated Breast Health Clinic at Macquarie University Hospital - the first of its kind in Australia - where Professor Anand Deva examined her.

“From the beginning, his approach was very calm and about focusing on my health and removing the implants,” she says.

Three weeks ago, Professor Deva performed surgery. “I didn’t have the implants replaced and now I have nothing to worry about,” Marian says. “I was concerned I might have huge scars but my breasts look fantastic. I’m feeling really well.”

Lifetime assessment for women with implants

Marian was one of the inaugural patients at the Integrated Breast Health Clinic - a unique one-stop clinic where women can access GPs, specialists and surgeons under one roof. The clinic will also provide more data for future breast research.

As a vocal advocate for heightened awareness about the dangers of breast implants and links to cancer, Professor Deva says one of the main focuses of the clinic will be providing accessible lifetime assessments for women with implants, such as Marian.

“Having lifetime follow up for people with implants is absolutely crucial,” says Professor Deva, Director of Cosmetic and Plastic Surgery at the Australian School of Advanced Medicine at Macquarie University. “So many things can go wrong that will affect women’s health.”

Pioneering treatment: Professor Anand Deva and clinic staff at Macquarie University Hospital.

An estimated 1.5 to 2 per cent of women in Australia have breast implants. Professor Deva’s research shows that some of these women with highly textured implants are at risk of developing anaplastic large cell lymphoma known as ALCL - a form of non-Hodgkin's lymphoma.

As many as two in five women are also likely to developing hardening of breast tissue (called capsular contracture) within two to five years after the procedure. Implants can also break, crack, leak or flip.

“At the clinic, we are taking a novel approach to breast health,” says Professor Deva. “We are transforming the current fragmented and increasingly costly model of healthcare in Australia into a new integrated model, where the focus is all about providing the most efficient service to the patient.”

Patients able to self-refer themselves

Now a woman won’t have to wait for a referral appointment to a specialist or surgeon because they will already be available at the clinic, with MRI, ultrasound, pathology and other diagnostic services also on site.

“It’s quite a revolution. Patients will be able to self-refer themselves to the clinic,” says Professor Deva.

He emphasises that while many private and public providers already focus on breast cancer, the new Macquarie clinic has a significant point of difference. “We are taking a holistic approach to women’s ongoing breast health in general; breastfeeding, implants and breast disease, as well as cancer.”

Expertise: Professor Deva is one of three plastic and reconstructive surgeons at the new breast health clinic.

To provide this service, Professor Deva has assembled a team of women breast health experts, including three physicians, a surgeon and a McGrath Breast Care Nurse specialising in cancer support. They will work with plastic and reconstructive surgeons, including himself, when needed.

The Integrated Breast Health Clinic will have an unprecedented opportunity to collect data about breast health in Australia. Professor Deva has already received enquiries from health services in Queensland and WA as well as Sweden looking to replicate the model.

Although the clinic is private, under the MQ Health Access Program women most in need can use the services at reduced rates or no cost.

Connie, aged 36, was one of those patients. She’d had breast implants at 19 years-old and was experiencing some pain.

“I discovered that seeing a specialist would cost me more than $1,300 and I really couldn’t afford that,” she says. “I went to the clinic at the Macquarie University Hospital and they saw me for a nominal fee. They gave me peace of mind. The customer service was so friendly and caring, I will go back there every year.”

The health professionals servicing the clinic include the breast surgeon Dr Karen Shaw, physicians Amanda Cuss, Henny Tamboto and Katrina Tiller. Ruth Cho is the McGrath Breast Care Nurse while Professor Anand Deva, Associate Professor Gazi Hussain and Doctors Thomas Lam and Louis Wessels are the clinic’s plastic and reconstructive surgeons.

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