MONITORING AND ONGOING TREATMENT
In many centres patients have their surgery or radiotherapy and then may see one or two specialists for check-ups. At Macquarie University Hospital, if you’ve just received surgery and radiotherapy, then you will be given alternate appointments between your surgeon and radiation oncologist. If you have seen our three treating partners – a surgeon, radiation oncology and medical oncologist – you will see all of us with alternating appointments perhaps every 3 to 4 months for the first couple of years and then every 6 months.
At each ‘anniversary’ of your treatment you may need to have more tests done. This may will involve further mammography, ultrasound and sometimes MRI scanning. Many patients wonder why we do not perform PET scans or CT scans every year. This is because the international guidelines including the British, US, Canadian and Australian guidelines have shown that such tests cause unnecessary stress associated with false positives and sometimes have extra radiation. It is also proven that having these scans unneccesarily does not improve patient outcomes. Your team will order a scan if there is a need for one.
Lymphoedema Monitoring & Treatment
Before treatment we aim to measure the difference in fluid levels between your arms. This involves a quick and easy technique called bioimpedance spectroscopy, also known as L-Dex. Patients who have lymph node surgery or radiotherapy to lymph nodes may be at risk of developing lymphoedema, which is some swelling in the arm or breast. We recommend that these patients, along with those who have had therapies called ‘taxanes’, to see our lymphoedema therapists regularly for ongoing monitoring of your arm. Patients who require lympoedema management are treated through the well-established Lymphoedema Clinical Care and Research Program at Macquarie University Hospital. Early intervention involves the fitting of a compression sleeve to reduce and control the swelling by our specially trained team of lymphoedema management experts. In appropriate cases, lymphoedema that develops after breast cancer surgery can be treated surgically, through the application of liposuction. This surgical technique was first brought to Australia by Dr Helen Mackie, a rehabilitation specialist providing lymphoedema management to cancer patients at Macquarie University Hospital.
Macquarie University is also the coordinating Australian site for a large international research trial, which aims to detect early fluid changes in the arm by comparing tape measurements to L-Dex measurements.