Dr Georgina Williams on supporting patients with breast cancer
Supporting breast cancer patients involves so much more than medical procedures — it’s also about helping women reclaim their sense of self and confidence. To conclude Breast Cancer Awareness Month, we sat down with Dr Georgina Williams, a consultant plastic and reconstructive surgeon, to explore her work alongside the breast reconstruction team at Charing Cross Hospital.
How do you support breast cancer patients?
Alongside the breast reconstructive plastic surgeons at Charing Cross Hospital, I help support women who have had mastectomies for breast cancer by reconstructing their breasts.
Most breast reconstructions are performed using the patient's own tissues, such as the skin and fat from their abdomens (like a tummy tuck), or their inner thighs to provide a soft, warm and natural breast replacement. The reconstructions can happen at the same time as patients have their mastectomy so that when they wake up from surgery, they have never gone “flat” so to speak, or later after the mastectomy.
In the last few years, we have also been supporting the breast surgeons in their work to help prevent lymphoedema (swelling) in the upper limb in patients who require removal of the lymph nodes from their armpit as part of their cancer treatment. This technique was first introduced into the department by Paul Thirachelvam, consultant oncoplastic breast surgeon. As breast microsurgeons, we use a microscope to connect the small lymphatic channels into veins in the armpit, allowing the lymphatic fluid that would otherwise not be draining properly, to bypass the armpit and enter the venous system. The results of this type of surgery are being closely researched and have been, and will continue to be, presented to the surgical community.
Dr Georgina Williams
"It is hugely fulfilling to be able to guide a patient through unsteady waters, to reassure them that we have the experience and ability to care for them and to get them through such an uncertain and fragile time in their lives."
Before surgery, we run a weekly breast reconstruction seminar for patients who have been recommended to have a mastectomy. Patients usually attend this one-hour session ahead of their first consultation with a plastic surgeon. Originally set up by Mr Frank Henry, consultant plastic and reconstructive surgeon, my colleague Vimal Gokani, consultant plastic, reconstructive and lymphatic surgeon, and I now run these seminars. We cover what each operation involves, and which types of patients would be offered what types of surgery. We also go into a lot of detail about what to expect before, during and after surgery.
The seminars are a valuable opportunity for patients and their families to hear everything in a calm environment, without the time pressures of needing to hear it all for the first time in the outpatient clinic setting. This is then followed up with plenty of time for them to be able to ask questions.
What impact does reconstruction have on patients?
Reconstructive surgery can have a huge impact on a person’s quality of life. Studies investigating the effect of breast reconstruction using patient reported outcome measures have proven the psychological benefits of having breast reconstruction surgery following mastectomy.
For breast cancer patients, the removal of one or both breasts can really affect their sense of identity, femininity and self-esteem. Reconstructive surgery can allow these patients to begin to accept their body again and come to terms with a new sense of self. From a practical perspective, our patients are not limited in the clothes and swimwear available to them.
Speaking to our patients in the outpatient clinic setting, we regularly get a feel for how much of a difference breast reconstruction makes to their lives which never fails to warm me.
How do you find the experience of helping these patients?
It is an honour and an incredible privilege to be able to care for our patients. As reconstructive microsurgeons, we mostly see patients who have had a recent diagnosis of cancer, which has invariably come as a huge shock.
It is hugely fulfilling to be able to guide a patient through unsteady waters, to reassure them that we have the experience and ability to care for them and to get them through such an uncertain and fragile time in their lives.
I think the fact that so many patients look back on their reconstructive journeys as a positive is something that is very satisfying as a surgeon.
Dr Georgina Williams
"If you do notice any changes or if you feel a lump, never feel like you are wasting a healthcare professional's time by getting a second opinion. Don’t hesitate to book an appointment and get assessed by an expert. We are here to help."
Are there any particular messages you want to share as Breast Cancer Awareness Month draws to a close?
Breast cancer affects 1 in 6 women.
The main message I want to share is that both women and men should check their breasts or chest on a regular basis. I have had patients without a genetic predisposition who have been diagnosed with breast cancer and had mastectomies as early as their mid-20s. You should examine your breasts or chest multiple times a month – once a month minimum. Women should also examine their breasts at roughly the same time of their menstrual cycle each month.
If you aren’t sure how to examine your breasts or chest, there are plenty of online resources, including videos, and you should also ask your GP the next time you see them. The key is the earlier the diagnosis, the more easily breast cancer can be treated.
If you do notice any changes or if you feel a lump, never feel like you are wasting a healthcare professional's time by getting a second opinion. Don’t hesitate to book an appointment and get assessed by an expert. We are here to help.
