Breast Surgery

If an operation is recommended, it can usually be arranged within a reasonable timescale in keeping with the patient’s personal arrangements. Cancer operations can usually be performed within one or two weeks. It is feasible to carry out many breast operations, including cancer procedures, as day cases. Each operation is described to the patient in detail in the clinic and again on the day of surgery.
 
Sentinel Node Biopsy & OSNA
Mr. Cunnick has particular interest in this technique which is the new ‘gold standard’ in breast cancer surgery. He was the first Surgeon to introduce the operation to Buckinghamshire and has presented important sentinel node research internationally. He was been approved as a 'trainer' in the technique by the Royal College of Surgeons of England. More recently, he has introduced intra-operative analysis of sentinel nodes using molecular techniques (OSNA).  This means that the surgeon knows whether the node is positive or negative during surgery.  If positive, further nodes are removed under the same anaesthetic, thus avoiding the need for a second operation and anaesthetic.  He has presented work on OSNA in the UK, Europe and America.
For invasive breast cancer, most women are offered breast conservation surgery with sentinel node biopsy, providing they do not have clinically abnormal lymph glands. Instead of removing the majority of armpit lymph glands, only typically one or two glands are normally removed. This means that the patient has far fewer potential side-effects from surgery and typically goes home the same day! It requires a special scan before the operation and an injection of blue dye into the breast during the operation.
 
Mastectomy
If a mastectomy is deemed necessary, breast reconstruction will be offered where appropriate. If not, then the patient will undergo removal of the breast and usually some lymph nodes. Wound drains are required. A local anaesthetic block is given during the operation to reduce postoperative pain. Most ladies go home within 24 hours, thanks to the modern approaches used.

Breast Reconstruction
If possible, immediate breast reconstruction is offered. Mr Cunnick will often carry out a 'skin sparing' masectomy whereby most of the breast skin is preserved to produce a good cosmetic outcome. All types of reconstruction are offered (implant reconstruction, latissimus flap reconstruction and D.I.E.P. flap reconstruction). These options are discussed in detail in the outpatient clinic.

Benign Breast Lumps
Sometimes these require removal. Most operations are perfomed as day-cases via cosmetic incisions.

Cosmetic Surgery
Mr. Cunnick also offers breast augmentation and breast reduction surgery. He also has experience in revisional surgery for those patients with implant-related problems, such as capsule formation and silicone leaks.

Sutures
Dissolvable stitches are used routinely in each patient which avoids the need for subsequent stitch removal. Many Surgeons believe that it also leaves a tidier, cosmetic scar.

In-Patient Care
Patients requiring admission overnight will be looked after by dedicated ward nurses and Breast Care Nurses, and be seen regularly by Mr. Cunnick post-operatively. An out-patient appointment will be made prior to discharge.