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One Stop / Rapid Testing Breast Clinic 

Our clinics offer one stop facilities with rapid testing. The main aim of my breast clinics is to provide the highest quality of care to patients. Once a referral from the GP is received, we aim to book an appointment within a day or two usually. In the clinics we provide a high standard of both diagnostic assessments as well as surgeries/procedures for all aspects of breast illnesses ranging from benign problems to breast cancer. 

What to expect 

During an initial consultation as an outpatient, you will be seen for a consultation with full breast examinations. It will also be advised whether breast screening/imaging is needed or whether any further investigations are required. In most cases, all results are available on the SAME day/week. 

Diagnostic Procedures 

Mammogram 

A mammography is a specific type of x-ray screening that is used to examine the whole breast area. It is used in the early stages to diagnose breast diseases in women. Mammograms are performed by Consultant Radiologists and last on average about twenty minutes. It is a non-invasive procedure and causes only minimal discomfort. 

Ultrasound 

Ultrasound imaging involves exposing the breast to high frequency sound waves to produce pictures of the inside of the breast. It is a non-invasive technique and provides information to help diagnose a wide range of breast conditions/diseases. Ultrasounds last on average about 30 minutes, and you should experience no discomfort. 

Punch Biopsy 

A Punch Biopsy is used for superficial lesions that are present on the skin or just under the skin. This involves putting some local anaesthetic to numb the area and take a small piece of tissue for histology. 

Screening Mammogram 

Patients should have regular mammograms – either on the NHS or privately. One can detect calcifications within the breast tissue which may be suggestive of cancer. 

Core Biopsy 

A Core biopsy is carried out on a breast lump where a sample of the tissue needs to be taken. It is done under local anaesthetic and a larger needle is passed through an incision made in the lump to obtain the tissue. This tissue specimen is then sent to the Pathologist to be examined under a microscope for abnormalities. A core biopsy is a more invasive procedure which can last up to an hour. It is not generally a painful procedure, but it can cause some discomfort. 

MRI 

A MRI is used to identify sinister lesions when breasts are dense, particularly in young women where the glandular tissue can hinder interpretation of mammogram or ultrasound. You will be passed through a donut-shaped machine. The procedure is relatively safe although can be noisy. Please inform us of any metalwork or pacemakers prior to MRI scans. 

Surgical Procedures 

If surgery is needed; an operation date is usually set between one to two weeks from the appointment if required. Surgery for cancer is usually arranged within a few days. Most operations are day cases; however, some operations may require a one night stay in hospital. All aspects of the operation will be discussed in clinic and on the day of the operation.  
 
Ms Shrotria uses a minimal scar technique during operations. She has pioneered this type of surgery and is one of the first breast surgeon to offer this and carry out operations through subtle scars. She does not use drains after surgery which is a unique feature of her practice. This is done to reduce discomfort and pain after surgery.  She has a very low complication rate and has rarely taken patients back to theatre. 

Breast Surgery 

Cancer Surgery 

Lumpectomy / wide local excision – This is an operation to remove the lump with a rim of normal looking breast tissue around this. It is the preferred option given to women under our care. Ms Shrotria has pioneered the use of axillary scarless breast surgery. Lumps are taken out through making no incision on the breast but by concealing the scars within the armpit area. Through that same scar, Ms Shrotria can also take out lymph nodes or achieve reconstruction. All of these procedures can therefore be achieved through a single scar. Ms Shrotria was the first breast surgeon to describe it. 
 
Magseed Guided Excision of Breast Tissue - This clinic is possibly the only private centre to offer magseed guided surgery for cancers that are deep in the breast and cannot be felt. These do not typically present as a lump. This technique has tremendous advantages. Most patients prefer this technique as they avoid painful wires that are still used in most private and NHS hospitals. Mastectomy – A Mastectomy is an operation to remove the breast. It is usually carried out due to breast cancer involving a larger part of the breast or for inflammatory breast cancer or rarely because there is a strong history of breast cancer. For most patients treated with us breast reconstruction can be carried out immediately at the time of mastectomy. 

Breast Reconstruction 

Women no longer have to suffer deformity after breast removal. We offer immediate breast reconstruction to preserve shape and size of the breast. This can often be done by saving the breast skin and nipple whilst carrying out the mastectomy. 

Innovative Reconstruction Techniques 

Reconstruction is carried out by using tissue – either muscle, fat or skin. We can also use implants that can be put under the skin with good aesthetic outcome. Ms Shrotria has pioneered another technique called ‘fish-tailing’ which prevents over-hanging of skin/tissue in armpit after breast has been removed to achieve good aesthetic outcome. 

Therapeutic Mammoplasty  

Reconstruction after wide excision/lumpectomy can be carried out by innovative techniques to reshape the breast and to fill in the defect. This is called a therapeutic mammoplasty. This is suitable for women with ample breast tissue. Though we can use this technique with modest sized breasts. 
 
Ms Shrotria pioneered the use of the peri-areolar incision to access breast lumps through a small incision. Post-operatively the scar is hidden between the pigmented and non-pigmented skin of the areola. This produces an excellent cosmetic outcome. 

Axillary/Lymph Node Surgery 

Sentinel Lymph Node Biopsy 

This is where a radioactive dye is injected into the breast; this is done to highlight the sentinel lymph nodes. The surgeon then uses a device to detect the sentinel lymph nodes. Once the sentinel lymph node has been detected the surgeon will make a small incision so that the node can be removed. The sentinel node is then examined for the presence of cancer cells. 

Axillary Node Clearance/Dissection 

This is done when cancer has spread from the breast to the lymph nodes. This procedure helps to prevent cancer spreading into the armpit and involving the important nerves and blood vessels. It also helps to prevent spread to other areas of the body. 

Other Breast Conditions 

Benign Breast Lumps 

Sometimes benign lumps like fibroadenomas, cysts, phylloides tumours, papillomas can cause irritation, discomfort and pain. Although these are not cancerous lumps, they may need removal to get a full diagnosis or relief of symptoms. Most can be done as day cases and patients can go home within a few hours of surgery. 

Nipple Discharge Surgery 

When patients experience troublesome nipple discharge, it can affect their confidence, day-to-day activities, socialising and ability to wear certain outfits. This can be distressing for patients. We treat this condition very effectively by offering duct surgery or by offering medication. We may conduct some diagnostic tests to confirm the cause of the discharge. If discharge is blood-stained, it could suggest cancer. 

Breast Abscess Surgery (Incision and Drainage) 

Some women may develop painful infective breast changes during breastfeeding. Older women may still get abscesses due to chronic infections, ruptured cysts or systemic illnesses. Once we have established the diagnosis, we may initially give antibiotics. However, some women may need surgery to drain the pus to provide relief and treat the infection. 

Gender Reassignment Surgery 

We offer surgical techniques to help with the male to female and female to male transitions. In both cases, careful preparation with full psychological assessment and counselling is advised before surgery is contemplated. We offer mastectomy for male to female or breast enlargement for female to male transitions. 

Non-Surgical Conditions 

Mastitis 

Mastitis is when the breasts become engorged with overlying skin redness, swelling, hotness and pain. This can occur immediately post-delivery when mothers are breastfeeding. This can also occur after radiotherapy for cancer.  
 
This condition can worry women as it appears to be similar to inflammatory breast cancer changes. We treat this with appropriate medication. 

Skin Disease (Eczema, Dermatitis) 

Breast skin disease can affect women with allergies and low immunity. It may be as a result of reaction to medication. Additionally, desmodex mites may enter through the nipple and cause irritation. It is important not to forget that this can be similar in appearance to a pre-cancerous condition called Paget’s Disease.  
 
Thus it is important to distinguish between these with good examination. If patients have these symptoms, we would like patients to come to the clinic for assessment as soon as they notice these changes. We may offer medications and creams for this. 

Nipple Disease 

The nipple may become swollen, ulcerated, inverted or flattened. We aim to deliver a quick assessment and treat the underlying condition. 

Genetic Testing (BRCA1/BRCA2 Mutations) 

We offer a comprehensive genetic testing service for women who have family history of breast cancer. Women who have relatives with breast cancer may live in constant fear of developing breast cancer themselves. We can test for the known genes so that decisions on management are facilitated. This may have an impact on siblings/children of women/men affected. We take a careful history of relatives and their relationships in particular if they have developed ovarian, colorectal or prostate cancer. 

HRT/Menopause Advice 

We offer advice on women going through menopause who have symptoms of hot flushes, vaginal dryness, mood swings, heavy periods, irregular/sudden periods. We tailor a careful follow-up programme with mammography and ultrasound for women who go on HRT to alleviate menopausal symptoms. 

Male Breast Procedures 

Gynaecomastia 

Breast enlargement in men is called gynaecomastia. This may be as a result of puberty, hormones and medications. We at, Windsor Breast Clinic, understand the devastating psychological impact this can have on men. We offer surgery to address this and remove breast tissue through minimal scars. This can be life changing allowing men to enjoy activities like sport, swimming, gymming and going to the beach. 

Male Breast Cancer Surgery (Mastectomy +/- Reconstruction) 

Men also develop breast cancer. They will undergo breast cancer surgery as needed. This may be accompanied by medication use. Additionally we offer reconstruction options which not many clinics do for men. Ms Shrotria has pioneered this reconstructive approach for men. 
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