Has anyone got any experience of Ms Choy?

Hi BoobyCancer have you tried typing this persons name into  google search as that should bring up any details that you are looking for.

Hi Granny59,

Yes, I've had a look at everything online, but wondering about people's experiences.

We also have a friend-of-a-friend who is a consultant breast cancer surgeon elsewhere in the country, and she hadn't heard of her which I thought was strange, as she knew a lot of other surgeons, including another one at the same hospital.

Cheers,

BC

Hello,

I would suggest like others have, to google, look at places surgeon works from, both private and NHS etc. Find out what treatment will involve.

I stepped outside the box and went private (in London) for combined lumpectomy and radiotherapy all done in one combined operation. This is called TARGET IORT - totally amazing. This treatment is now available on the N.H.S. via a few hospitals - although it seems this treatment doesn’t get routinely offered or even mentioned.

I am wondering ‘how’ you found your surgeon - as going private you should have a choice. whilst doing my research I have heard of a few, but, I can’t recall this name.

Hi WhatHappened,

My wife had asked for a female consultant, and her insurance pointed her here: https://www.breasthealthuk.com/clinics/the-princess-grace-hospital

A friend of mine who is an NHS consultant, but in a totally different field, had previously warned against anyone that wasn't still doing NHS work, but I can't see why that's an issue.

We're a while away from surgery, as she's having neoadjuvant EC-T first, which will last the better part of 6 months, with cycle 2 of the EC this Thursday (dose dense, so every 2 weeks).

The TARGIT looks very interesting, but I'm not sure if she would be a candidate, at 42, with one 2.6cm tumour, one 4mm tumour (same quadrant), and a positive lymph node based on an FNA biopsy. Thankfully the PETCT was clear otherwise.

Not sure if lumpectomy will be an option even if the tumours shrink a lot, as there are multiple focuses. :/

Cheers,

BC

I guess you need to follow through treatment in the clinic your wife is attending. If you are unsure you could look at ther other surgeons there. If they are part of a chain of clinics I'd see if swapping to a different one was an option and check those surgeons too. A lot of surgeons work in the NHS and private (mine works at The Wellington as well as UCHL and the Whittington).  I agree about preferring one who works in both sectors as they are more likely to have kept up to date with research and training. 

If you are interested in TARGIT IORT, the man who invented it also works at the same NHS hospitals...I've often see him when in the waiting room! I believe that he works with HCA in the private sector if that is where your wife is being treated?  I don't know if it would be suitable for multi focal tumours though. I also thought that (with the NHS anyway) a mastectomy is often considered as there can be other things not seen in the scans, like DCIS.

Hi Londonmumof2,

Right now it's just chemo, and thankfully she can have most of this at home with her insurance.

The BCN has made it clear that she can change surgeons at any point, which was nice. She also does a great job of whisking us away from the surgeon, and explaining things in a more simple manner!

Princess Grace is indeed in the HCA group. I wouldn't be surprised if it ends up being a mastectomy, but we're hoping for nipple and skin sparing if possible, with immediate implant and/or omentum reconstruction. The pathology results came back DCIS negative, but obviously that could change with more testing.

We're awaiting results of a 9 panel gene test to see if it's genetic. Her mum had breast cancer in her early 50's, and exactly the same findings (multi-focal, positive lymph nodes, same receptor results). The good news is that her mum is still fit and well 19 years later.

These results might change things obviously, but I don't think that the insurance (AXA) cover risk reducing surgery.

Cheers,

BC

I don't think the TARGET IORT is an option 'if' there is more than one location (don't quote me, however, I am 90% certain of this).

The gentleman Londonmumof2 is referring to is the most kind, caring and gentle gentleman that you could ever wish to meet and is so humble.

In your wife's position, I would suggest looking for a surgeon that works both Private and NHS and in a hospital of your choosing, in case there is anything not covered by your insurance then you are already under the team at your hospital (if this makes sense) this said, all the hospitals Londonmumof2 has referred to in my opinion (not knowing them, just what I have read and my own research) all of these hospitals are good and have very good surgeons - I think a Consultant/Surgeon that works at these hospitals and 'also' the private sector would be a better and safe option for peace of mind.....

The reason I say this, I didn't have insurance so I am not fully up on what insurance would cover and would not cover, so, I would be thinking along the lines of .... if your wife is seeing her surgeon privately, then 'if' reconstruction becomes something not covered by insurance then the surgeon would be able to arrange for you wife to continue treatment within the NHS under the same team and have access to records etc.

These are only my thoughts, you need to do what feels right with your wife and yourself - this is a roller coaster of ride, you will have many ups and downs along the way, just take it one step at a time. 

Hi WhatHappened ,

That makes a lot of sense re. Private/NHS. If the gene test comes back positive, then I think we'll definitely be looking for another surgeon.

Cheers,

BC

Hi again, 

Please don't answer if you don't want to, but can I ask why your wife is havng neo adjuvant dose-dense chemo as generally ER/PR+ is given after surgery?  It's just interesting to see the different treatment routes taken,  for example why some women have 3xEC and 3xT, some 4xEC and 4xT or 6 x EC etc.  Usually EC is given in a 3- weekly cycle based on NICE  guidelines due to the  possible side effects,  which are a bit more pronounced with the dose- dense regime although dose- dense actually has a slightly higher 10- year survival rate.

Hi Londonmumof2,

The oncologist & surgeon want to shrink the tumours, and ensure that any malignant cells that might be circulating are killed off ASAP, as the lymph node that was aspirated contained "adenocarcinoma cells compatible with ductal carcinoma present" (quoted from cytology report).

The oncologist received high praise from our surgeon friend-of-a-friend, so we're happy to go with what she says.

She's having 4 cycles of EC, every 2 weeks if tolerated, but would be switched to 3 weekly if necessary to control side effects, then 12 weekly rounds of T. So far she would have felt fine on the second week after the first cycle, if not for the pain from the surgical clips and powerport being implanted! She also has a GCSF injection 24 hours after the chemo has gone in, to boost her immune system do help with the dose dense treatment. 

I know that in triple negative cancers, sometimes chemo can obtain a pathologically complete response, but it's much less likely in hormone responsive cancers, and those of a lower grade.

Cheers,

BC