- BACUP (breast cancer)
BREAST PROBLEMS Patients with worrying symptoms should seek early medical advice.
Breast lumps are often benign but should be seen and assessed by someone able to differentiate benign from malignant conditions. Any uncertain lump is subjected to "Triple Assessment" which includes careful clinical examination, breast imaging (mammogram, ultrasound or MRI scanning) and, if necessary, tissue biopsy.
Breast Pain is usually not associated with cancer, but also requires careful assessment. Cyclical breast pain may be hormonally affected. Many patients with what appears to be breast pain actually suffer from discomfort of the costal cartilages in the chest wall. Topical treatmemnt with non steroidal anti-inflammatory gel and the use of a good supporting (or sports) bra can improve symptoms.
Nipple Changes or discharges are usually as a result of benign changes, but require full assessment to exclude underlying problems.
Symptoms to be concerned about include changes in the appearance of the breast or nipple or the development of a lump. Many tiny cancers are found on Breast Screening before they can be felt. Surgical treatments for cancer include breast conserving surgery or mastectomy when necessary, with or without immediate reconstruction. Where possible, axillary surgery to assess the lymph glands is carried out using sentinel node biopsy rather than full axillary gland clearance. This has fewer potential complications. Modern adjuvant (backup) treatments including hormonal tablets, chemotherapy and radiotherapy, tailored to each patient and their disease, ensure better chances of long term survival after therapy.
Robert Kirby does not deal with cosmetic breast problems, but works closely with plastic surgery colleagues at UHNS and North Staffordshire Nuffield Hospital.
Hernias are caused by the protrusion of intra-abdominal contents (often containing bowel) though defects in the muscular wall of the abdomen. Hernias can look unpleasant and can be uncomfortable, but the greatest concern is that the bowel may obstruct or strangulate. Hernias can vary in size from less than a walnut to large swellings many inches in diameter. The most common type are inguinal hernias in the groin, but hernias can occur in any region of the abdomen. They can also develop after surgical operations (incisional hernias).
Abdominal wall hernias are repaired with a safe open technique using mesh. Inguinal hernias do not always need surgery if they are small and symptom free, but a (Lichtenstein) tension free mesh repair gives good results when surgery is advised. Most people are comfortable and well enough to go home the same day of their surgery.
Groin Pain; "Sports Hernia", otherwise known as "Gilmore Groin" Groin pain is often due to muscular or tendon problems. Where full assessment and physiotherapy has not helped the underlying problem, surgery similar to inguinal hernia repair can often relieve the pain, and allow full return to sporting activities.
Robert Kirby is a member of the colo-rectal team and assesses people with abdominal or gastro-enterolological problems.
Robert Kirby introduced laparoscopic cholecystectomy for gallstones to North Staffordshire in 1991.
Robert Kirby has a regular endoscopy list and offers a colonoscopy service. Unexplained rectal bleeding is often due to haemorrhoids or other completely benign conditions. Sometimes a colonic polyp is the cause, and removal at colonoscopy can prevent this developing into a bowel cancer at some time in the future.
Patients can be seen at the Nuffield Hospital for assessment of abdominal or breast problems for purposes of providing medico-legal reports.(eg sequelae of trauma / accidents).