WHAT EVERY WOMAN NEEDS TO KNOW ABOUT BREAST CANCER SURGERY
The breast cancer surgeon who wants to help women feel empowered when making difficult decisions about their bodies.
Future Dreams is a charity raising funds to support women on their breast cancer journeys and funding research into the disease, particularly secondary breast cancer. Consultant Breast and Oncoplastic Surgeon Joanna Franks, one of the UK’s top breast cancer surgeons and a trustee of this brilliant charity, dedicates her working life to helping women have the best experience they can in extremely scary and emotionally difficult circumstances.
Her priority is to make women feel as empowered as possible when alongside life-saving sur-gery they are faced with making challenging decisions over their bodies. One of a small number of female breast cancer surgeons, she is in a rare position of truly understanding how women feel about the way they look – as well being an expert in her field.
“Women think it is vain to worry about how their breasts will look after they have had surgery but it is not vain, it is imperative and it is up to us as surgeons to empower women to know what choices are available to them. I try to say to women, every cloud has a silver lining. If you have always wanted perkier breasts there is an option to give you that while we are operating on you. We can carry out reconstructions and symmetry surgery, if you want, while you are un-der anaesthetic to remove the cancer.”
“If possible women should feel strengthened by the choices they can make”
Understandably many women respond to the news of their diagnosis with panic and focus solely on wanting the cancer out of their bodies as quickly as possible.
“I want women to know if you get diagnosed with breast cancer, for the vast majority of cases you do not need to be in a hurry to make a decision. Women get in a dreadful panic and don’t take time to think about the longterm consequences of the decisions they are making. It is im-portant to consider that you will have to live for decades with those choices. There are lots of options and techniques and it is about helping the patient find what will work best for them. It is a very personal journey.
“I am not just talking about private treatment, this is true of the NHS too. You should feel con-fident and safe that the team will look after you and that you all share the same goals for your therapy.
“As the patient you may not want to hear the news you are being told but it is important you believe it is the right person telling you. Patients often find it hard to ask the questions they want because they don’t feel they can. The decision must not be made about you it must be made with you.
“There needs to be a connection you feel with your surgeon even if you don’t like what we have to say. Sometimes we have to tell you unpleasant news but if possible women should feel strengthened by the choices they can make.”
Something Joanna feels very strongly about is that many women don’t know they can ask for symmetry surgery (an operation to make their breasts look balanced) on the NHS at any point – when they are first operated on or decades later.
“Some women are stuffing things in their bras for decades thinking there is nothing they can do about it,” she recalls.
As every patient and her body is unique there are many different scenarios.
“Women may not initially want surgeons to operate on the breast that doesn’t have cancer in it but they can change their minds years later. Or to begin with your breasts may be symmetrical after surgery, but over time healthy breasts can change due to weight gain and gravity. A healthy breast will change due to hormones in a way that a breast that has had radiotherapy won’t. Some women go on to get pregnant after breast cancer treatment which will change their healthy breast. Some women’s breasts look great when they are 30 but totally different when they are 45. One day they may want to do something to change the way they look.
“Many women don’t know they can ask for symmetry surgery when they are first operated on or decades later”
“It is important for surgeons to be creative and mindful. I think knowledge is power and women want to know what treatments are available even if they then make the decision that they don’t want any of them. Patients often feel better knowing that they don’t want a procedure they have been told about rather than always thinking ‘what if?’ A choice of surgery is im-portant.”
Patients knowing they have the right to a second opinion is another cause close to her heart.
“If you buy car insurance you get more than one quote. It is crazy that people don’t think they can ask for a second opinion from a surgeon on something as important as breast cancer sur-gery. Just ask your GP. Your original consultant will send any information across. You may want an opinion from someone else on the team or to see somebody else entirely. Patients need to be educated so that they can ask the important questions. You can always get a second opinion privately or on the NHS and you don’t have to be treated in your local hospital.
“Patients are extremely vulnerable from the moment they are told they have breast cancer and feel very grateful to anybody who says they will help them.
“Breast cancer isn’t just one treatment it is a journey and it is vital that patients get time away from the surgeons with the cancer specialist nurse so they can be their advocate and empower them.
“I am just the front face of the team working with patients but we are all working towards the best outcome. The pathologist who analyses the tissue from a biopsy doesn’t get a bottle of champagne to say thank you, but she is the one who makes the all-important diagnosis from what she sees under the microscope. We are a team working with you to give you the best outcome we can.”
Words: Louise Court