Quicker to go to France?
Quicker to go to France? Hello, my wife has a lump just above her breast since last week. We went to GP who said yes but come back in
6 weeks
to see if it’s changed
if we leave it till then and it does warrant further looking at she will then refer her to a clinic?
This may take between 2 weeks and a ‘few’ weeks. NHS few = how long.
Then if results are worth looking into further we may have to wait a ‘few’ weeks to hear results.
Then a consultation may take place a ‘few’ weeks after that.
Am I correct to say that if we took the first easyjet flight to France and walked into any hospital we could be seen to and test results in a day or so or have I been reading the Daily Mail too much?
Thanks
Andrew
I think it depends on your GP/Primary Care, I know my experience was very good I was 17 days in total from 1st mammogram to being diagnosed.
This is not a one off as my sister-in-law goes back for biopsy results today, (same PC) and she only found the lump over Easter weekend, and she was classed as a non-urgent case.
I would tell you wife to hound the GP.
Good Luck
As you say I think it depends where you live (the old postcode lottery)
I saw my gp, was refered to our one-stop breast clinic the following week and had a mammogram, ultra sound, needle biopsy, core biopsy and diagnosis the same day.
I started chemo the following month.
I believe that is how everyone should be dealt with.
All this waiting around for a ‘few weeks’ or even days is inhuman.
Sorry I don’t know about France, trouble is I expect that if you went there for the initial diagnosis the powers that be would probably decide that you couldn’t get your wife’s treatment on the NHS.
Definately chase the GP again.
Hope everything goes well.
Valerie
Hi Andrew Hi Andrew,
I don’t know about France but I do know that if your wife has found a lump, is aged over 30 and the GP agrees that there is a lump then your wife should be referred urgently and seen within two weeks - not because she should be panicking but because the clinic medics like to see lumps quickly and because it is in all the official referral guidelines.
[If, by any chance, the GP insists there isn’t a lump then ask for your wife to be reviewed just after her next period ends - this is the time in the menstrual cycle when lumps can most easily be felt.]
Assuming that your GP has agreed that your wife has a lump then you need to look up the following guidelines.
Details of guidelines.
If you live in England or Wales it is the NICE guidelines that you need to refer to. Scotland is covered by the SIGN guidelines.
[Other guidelines saying the same thing are - the Royal Society of Radiologist guidelines, the British Association of Surgical Oncology Guidelines and guidelines as far away as America, Canada, India and Australia.]
In Scotland the SIGN guidelines can be found at
sign.ac.uk/pdf/sign84.pdf
Assuming you live in England or Wales, the NICE guidelines on breast cancer can be found at:
nice.org.uk/page.aspx?o=csgbcguidance
The NICE guidelines state:
URGENT REFERRAL (within two weeks):
¢ Patients aged 30 or over (the precise age criterion to be agreed
by each network) with a discrete lump in the breast.
¢ Patients with breast signs or symptoms which are highly
suggestive of cancer. These include:
¢ Ulceration
¢ Skin nodule
¢ Skin distortion
¢ Nipple eczema
¢ Recent nipple retraction or distortion ( 3 months)
¢ Unilateral nipple discharge which stains clothes
CONDITIONS THAT REQUIRE REFERRAL, NOT NECCESSARILY URGENT:
¢ Breast lumps in the following patients, or of the following types:
¢ Discrete lump in a younger woman (age 30 years)
¢ Asymmetrical nodularity that persists at review after
menstruation
¢ Abscess
¢ Persistently refilling or recurrent cyst
¢ Intractable pain which does not respond to simple measures
such as wearing a well-fitting bra and using over-the-counter
analgesics such as paracetamol.
Bilateral discharge sufficient to stain clothes in patients
aged over 50 years.
¢ Bloodstained discharge in patients aged over 50 years (urgent
referral required if discharge is unilateral).
¢ Any nipple discharge in patients over 50 years of age.
There are several things that you can do to ensure that your wife is seen within two weeks. Remember that knowledge is power. If you know what the guidelines say then you are in a position to ensure that they are carried out.
- Print out the guidelines, highlighting the relevant bits.
- Get your wife to contact her GP surgery and arrange to go and see her GP or one of the other GPs. (The surgery should offer you an appointment within 48 hours if you don’t specify a particular doctor.) Take a copy of the guidelines and ask why your wife hasn’t been referred urgently and insist that she is referred urgently. If necessary show the GP the guidelines.
- If this fails contact the Chief Executive of your NHS Trust by telephone. Explain the situation (both you and your GP agree that there is a lump) and say that you wish to be seen at a breast clinic within the designated two weeks and that you will be putting this in writing.
- Write a short follow-up letter to the Chief Executive stating what you have said on the phone and send it with a copy of the guidelines by special delivery so that you know that he/she has received it.
Be aware that doctors and Chief Executives are not used to being challenged and might try to fob you off. The usual argument is to say that guidelines are only guidelines and that it’s all up to the relevant doctor and his/her professional judgement.
This is very misleading. Yes, guidelines are only guidelines and yes, at the end of the day it is up to an individual doctor’s professional judgement. However, these guidelines are legally robust and will stand up in court. Doctors have been successfully been sued for medical negligence for failing to follow these guidelines and so a doctor must have an extremely good reason for not following them. Doctors are also advised, for their own protection, that if they have such a reason they must write it down in the patient’s notes. Your wife can ask to see her own notes.
If anyone says that your wife hasn’t been referred urgently because the clinics are full then this is not a valid reason. The guidelines are clear - you MUST be referred urgently and seen within two weeks. If the local breast clinics are full the Trust must send your wife to a different clinic so that she can be seen within two weeks.
Having said all of this the majority of lumps are benign so neither of you should panic but the best way of being sure is to be referred to a breast consultant to have the appropriate tests done. And you are not wasting anyone’s time or queue-jumping. The consultants are just as pleased if a lump is found to be benign as the woman concerned and they won’t be happy if your GP hasn’t referred your wife in a timely fashion.
Let us know how you get on.
With very best wishes and good luck,
Sue
Should not have to You should not have to go to France.
I saw my GP, saw the consultant 2 weeks later, who was able to tell me the result the same afternoon, had a lumpectomy the next week, then mastectomy 3 weeks later. All under the NHS.
I believe that that is what is supposed to be normal under the NHS.
Keep asking your GP to be reffered to the clinic now, it is your wife’s right.
David
Hi Andrew,
I presented at my doctors with a definite lump in my breast and even though he was sure it was innocent, he said that under NICE guidelines I had to be referred as urgent and not to be alarmed. I was seen 8 days later at the breast clinic and again told the same by another doctor, student and consultant, but again, due to the lump I had to be referred for further tests.
The tests all proved to be inconclusive but finally I was given the bad news.
(nearly 10 weeks from initial dr’s appt)
I was so grateful my GP was on the ball from the start.
Debbie
Re: Quicker to go to France Andrew
So sorry to hear that your wife is being given the brush-off by your GP. It simply shouldn’t happen! My experience was totally different and if you like you can take this and show it to your GP as an object lesson in how it should be dealt with!
Friday 5/9/03 - visited my GP
Friday 12/9/03 - appointment at Breast Clinic. In the space of
3 hours had examination, mammogram,
and needle biopsy. I was given a verbal
diagnosis on the spot!
Tuesday 16/9/03 - back to Breast Clinic for confirmation of
diagnosis and to discuss surgery/reconstruction
Perhaps I’m just lucky living where I do as our Breast Institute is a world-renowned centre of excellence. But it ought to be the same wherever you live.
Go back to your GP, make a fuss - and insist on a referral straight away.
I’ll keep an eye out for any news from you. Give my best wishes to your wife and I hope that everything is sorted soon
Cheers GillT
PS My partner has been SO supportive over the last 3 and a half years and I get the impression that you will be the same!
When I found a lump on 16th nov went straight to my GP who made an appointment at the Breast Care clinic.It took me 3 wks of phonecalls and all sorts of excuses from them before I got an appointment for 16th Dec. Had mammo and dx same day.Apparantly it was 1cm tumour and very slow growing - which I found hard to beleave because I examined myself regulary and this thing had appeared out of the blue! I was told my lumpectomy would be on11th Jan because of the surgeon’s Christmas holidays and that going private would only make a difference of a couple of days. I told them I could feel it growing and was told it was an overactive imagination now that I knew it was BC.Had results of op on 16th Jan,a very fast growing,hormone neg 2.4cm,grade3 with spread to my nodes!Was told by the radiographer that I was extremely lucky that it had only spread to one node! The moral of the story is don’t let them fob you off. My two 20 something headstrong nieceswho also happen to be nurses went from finding a lump to having it removed in just over a week.Luckily their lumps were benign.
Hi there
Just wanted to say that as I live in France I can tell you a bit more .
You would still have to go to the hospital or a Dr to be able to get a first appointment . You could try just walking into a hospital but I dont think it would work.
Also you would have the problem of the language - you dont need any extra stress whn you have cancer .
If you need any other help just contact me but I recon its better to bug your own Dr.
Good luck , jANE
In France Hi there, so sorry to hear about your treatment, it is bad for all the family, not just the patient. I lived in UK and went to my doc with a very painful lump. I got the brush off but I persisted. I waited over a week for an appt for a mamogram, and it only came when I chased the clinic up and reminded them I had private medical cover - through my Co. and I was very lucky. I had two tumours and high grades, ended up a month later having a mastectomy and chemo. All this private and quick, but in my same town people were waiting weeks for appts. and then chemo and up to months for rads.
I moved to France and walked into a doctor with all my notes, in a week I’d met my onc. and can phone him any time if I need to. Both operations I’ve had here were when I wanted them…!!
The language isn’t a problem as you will find most “educated” people all speak English and most medical terms are the same.
Every time I go for tests, by the time I’ve dressed the results are waiting for me, blood tests in under 24 hours, and I walk into the next room to see the Onc.
SO, give your GP a kicking, take it further or take it accross the channel. People are stressed enough with this hanging over them, without the need to have to wait.
Good luck and hope all goes as well as it can in these circumstances.
K