Breast Cancer Awareness Month: prevention and treatment

Q&A - 22ND OCTOBER 2021

Miss Jennifer Rusby, consultant oncoplastic breast surgeon at The Royal Marsden Private Care, on breast cancer prevention and improving cosmetic outcomes

Breast cancer is the UK’s most common cancer, accounting for 15% of all new cases. As part of Breast Cancer Awareness Month, Miss Jennifer Rusby, consultant oncoplastic breast surgeon at The Royal Marsden Private Care on Cavendish Square, talks about breast cancer prevention and improving cosmetic outcomes.

What is your specialty and which areas are you particularly focused upon?
As a breast surgeon, I am involved in the whole process of diagnosing and treating women with breast problems, from the initial consultation to the diagnostic tests, and then working in a multidisciplinary team to coordinate treatment. After training in general surgery, I specialised in oncoplastic surgery, which involves combining cancer removal with techniques in plastic surgery to minimise the impact of surgery on quality of life.

What can you tell us about breast cancer risk factors?
One of my main research interests is in breast cancer prevention. While many of the risk factors are beyond our control – our genes and age when periods start and finish, for example – there are also some risk factors that we can change, such as weight, alcohol intake and limited physical activity. I am leading a pilot study, co-designed with patients, that empowers women to change their lifestyle not only by informing them of their own future breast cancer risk, but also by supporting them to identify a relevant health goal they might want to reach. Over time, we hope to scale this up to a much larger study that can make a real difference to women’s lives.

What services do you provide for patients at Cavendish Square?
The breast unit is set up as a one-stop clinic. This means that women with a breast concern can have a clinical examination and the necessary tests in the same visit – mammography, ultrasound, CT and x-ray. The majority will have changes that occur as part of normal life, or benign problems that do not require treatment. However, should they be diagnosed with breast cancer, the clinic has a minor procedure suite and a medical day unit to receive chemotherapy.

The Royal Marsden is very much a research-led cancer centre. What are some of the research projects you are involved with?
One of my key passions as a breast cancer specialist is improving cosmetic outcomes for my patients. As a clinician, disease control is always my absolute priority, but the psychological recovery of the patient is important too. Maintaining or improving the cosmetic outcome is key to this, because it has a significant impact on a woman’s confidence and helps her to get back to a near-normal life.

Over the past seven years, I have been working on research to develop 3D surface imaging of women’s breasts, using either infrared scanners or multiple, simultaneous cameras producing images to be ‘knitted’ together. One of our recent research studies revealed that women are much more confident going into a lumpectomy operation if they have seen a simulation of how they might look after surgery, rather than being guided by photographs of other women who have had a similar operation. Ideally, we will be able to show women simulations of different reconstruction techniques to help them decide whether they want reconstructive surgery after mastectomy and, if so, what type.