Breastcare nurse Anne Staunton recalls dealing with a patient who received a date for her surgery, but it clashed with her youngest daughter starting primary school. "So we deferred it on to the following Wednesday, and we're able to reassure her that it is okay to wait," she says.
Staunton started working in surgical oncology more than 20 years ago. “I was very interested in breastcare, and I was assigned to work in this, much to my delight,” she says.
“As a breastcare nurse, you attend the triple assessment clinics and the routine clinics. So you’re there when the patient comes in, and ideally, when we see the patient in those clinics the aim is to investigate their complaint and ideally discharge them on the same day. Usually, our greater involvement is for patients who are diagnosed with breast cancer.”
She explains that, due to national guidelines, every single patient’s case is discussed at a multi-disciplinary meeting each week. This meeting involves a discussion between radiation oncologists, medical oncologists, radiologists, pathologists, clinical nurse specialists and members of the research team who agree on a treatment plan.
“It’s not just one individual saying, ‘I think this is the right way’. We can have a very frank discussion about what the best thing is. Also, taking into account maybe their social background, what’s going on at home.”
Staunton feels services have greatly improved in recent years. "The efficiency, I think it is very good," she says. According to Staunton, Beaumont Hospital guidelines dictate that women over the age of 35 who have a breast lump should be seen within two weeks of receiving their referral. "That patient will have met a consultant breast surgeon, and they will have their mammogram and ultrasound and a biopsy in that two-week period. Once we've met them with the result of that biopsy, we usually will have operated within three weeks, if surgery is the treatment plan for that patient."
She says the greatest challenge is the emotional aspect of her work. “Our goal with all breast cancer patients is that patients would have breast-conserving surgery so that they are able to keep most of their breast tissue.” But she adds, “not everybody is ideally suited to immediate breast reconstruction and that is difficult for patients. You have to deal with everybody with a huge amount of sensitivity and compassion, and yet you have to be grounded, you have to be able to educate them and support them through the whole cancer challenge.
‘Pregnant’
“I’ve had patients who are pregnant when they’ve been diagnosed with breast cancer, those who are post-partum or those who have been trying to have a baby and next thing they have breast cancer and they have been having IVF, and that’s put on hold.”
She ruminates on the high proportion of late diagnoses which occur. “It surprises me the number of people, say in the over-50 group, who have not gone to BreastCheck for their free mammogram,” she says.
Part of Breast Cancer Ireland's efforts to raise awareness of breast health includes the charity's Avonmore Slimline Milk-backed Great Pink Run, which takes place on Saturday, October 13th, in the Phoenix Park, Dublin, and on Sunday, October 14th, in Kilkenny Castle Park.
The conversation with Staunton shifts towards a rarely discussed area of breast cancer. Male diagnosis. She says that, although rare, it does occur and presents its own difficulties. She says: “I actually had a man very recently and he had breast cancer and that’s a huge challenge for men because they think it is associated with women only. So I suppose there’s extra emotional status attached around that.”
Staunton reflects and says: “What I love is when you see somebody coming out the other end and you meet them when they’re in for their annual review having had their follow-up mammogram. They’re just so happy and they say you were right, it was a small little blip.” Although, she admits, not everyone is this lucky. “It doesn’t happen to everybody – it is disappointing when you see somebody coming back, and they have a recurrence.
"I know breast cancer in Ireland have a huge research team and we would be affiliated here in Beaumont Hospital to them. I see in the clinics all the time patients signing and consenting to having blood tests done when they're being diagnosed, and after they've been diagnosed with the breast cancer. They're happy to participate in this, so we have all this bio-banking going on" she says.
The interpersonal element of her career is significant. “You get to know these patients and I like to see them – I think they kind of like to see me!” she laughs.
“There is always treatment, whatever it is, and there is a huge amount of expertise here in this country, and we do everything in our power to help patients find good outcomes.”
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