Matthew Stephenson

MBBS MSc FRCS (Gen Surg)
Consultant General and Oncoplastic Breast Surgeon

Breast Surgery

Breast surgeons are trained as general surgeons, but then develop a subspecialty interest in breast. Mr Stephenson’s subspecialty is breast surgery however he has been trained beyond the usual standard into what is known as oncoplastic breast surgery. This is a relatively new subspecialty which is now becoming the gold standard in the management of breast cancer. Old style general surgeons would traditionally perform a very limited range of operations, which meant care was not as customised to the individual patient.

Mr Stephenson offers the full range of modern breast surgery meaning that he can perform breast reconstructions when mastectomy has been necessary but also more complex surgery to remove cancers but salvage the breast. Prior to late 2013 all breast cancer patients in Jersey needing complex breast surgery needed to travel off island, this is now almost never needed.

Mr Stephenson has a very large range of experience of breast surgery. He is the only breast consultant surgeon in Jersey and there are approximately 90-100 new cancer diagnoses per year, which is enough to keep any surgeon very busy!

Breast Lumps

Every woman worries when she finds a lump in the breast. But in fact the vast majority of breast lumps are not cancerous. The younger you are, the more likely the lump is benign, but a careful assessment is always needed to be sure. Mr Stephenson performs what is known as triple assessment of breast lumps, which means that firstly they are throughly examined, secondly they are imaged using an ultrasound +/- mammogram, and thirdly, where necessary a biopsy is taken.

Breast lumps are a cause of great anxiety for women and Mr Stephenson usually offers a private appointment within 12-24 hours of receiving a GP referral (provided he is on island). That way we can quickly get the diagnosis and either give you the reassurance you need or organise a strategy to deal with whatever we find.

Breast Cancer

Unfortunately breast cancer is very common, affecting about 1 in 8 women (about 1% of breast cancer patients are men). There are about 90 – 100 new breast cancers each year in Jersey alone. Being diagnosed with breast cancer can be a hugely traumatic time for women, however we aim to make each patient’s journey as painless and patient focussed as possible. All patients have access to a specialist breast care nurse and are cared for by a Multi Disciplinary Team of experts.

More available on this soon.

Breast conserving surgery

Traditionally the treatment of breast cancer was mastectomy, removal of the whole of the breast. That is still necessary in some women, but Mr Stephenson specialises in preserving the rest of the breast wherever possible and where the patient prefers it. The gold standard of this kind of care is at the centre of the subspecialty known as Oncoplastic Surgery. This means removing the cancer and at the same time, remodelling the breast to maintain a good shape. There are many ways of doing this, individualised to the patient. You will have a detailed discussion with Mr Stephenson if this is a possible option, to include all aspects such as scar placement and post operative shape changes, as well as the cancer treatment aspect. This sort of surgery is usually performed either as a day case procedure or overnight stay.

Breast reconstruction

Prior to Mr Stephenson’s arrival in Jersey in 2013, patients had to travel to the UK for complex or reconstructive breast surgery. This is now almost always possible on island. There are a variety of types of breast reconstruction, each with its pros and cons. The type of reconstruction needs to be carefully matched to the individual patient based on issues such as body shape and treatment priorities. Lengthy discussions are often needed before making a final plan. Reconstruction can either be performed at the time of mastectomy or delayed, to allow all the rest of the cancer treatment to be completed first.

Mastectomy

Sometimes it’s not possible, or sensible, to try and save the breast. This is usually because the cancer is too large relative to the breast. In these cases a mastectomy can be performed either with or without reconstruction of the breast. There many pros and cons of reconstructing the breast at the same time, and again these are highly individualised amongst patients.

Family history and genetics

Many women are concerned about their risk of breast cancer because one or more of their relatives are affected by breast cancer. Contrary to popular perception, only 5-10% of breast cancers are caused by an inherited genetic mutation. Deciding who might benefit from having a genetic test for an inherited mutation is a complex decision and Jersey has a contract with the Guys Genetics Unit who are specialists in this area. If you would like an initial consultation with Mr Stephenson to discuss possible family history risk, this can be arranged, but do be aware that most insurers will not cover this.

Lymph Node Surgery

When a cancer develops within the breast, there is a risk that it will spread, and the first place it tends to go is the lymph nodes (glands) in the armpit. Historically, all patients had to have all of their lymph nodes removed but only a quarter of them ever had cancer within them, meaning three quarters of patients were being over treated. Nowadays, we inject some blue dye into the breast during the same operation to remove the cancer in the breast. The dye will travel to the closest lymph node(s) to the breast and make it go blue and easily recognisable during the operation. The dye will travel to the same lymph node that any cancer cells would have travelled to, so checking to see if these lymph nodes have cancer in them, allows us to tell whether it would be sensible to remove all the rest of the lymph nodes. This procedure is called a sentinel node biopsy. If we have confirmed that there is cancer in the lymph nodes, the operation we perform is an axillary node clearance.

Other breast symptoms

Breast pain, nipple discharge and perceived change in the texture or shape of the breast are all common symptoms. Often they cause significant anxiety although they are not usually associated with cancer. Again, careful expert assessment is needed to determine the cause. Because of the extra anxiety involved with these symptoms, Mr Stephenson usually offers an appointment within 12-24 hours of receiving a GP referral (provided he is on island).

Memberships and Associations