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Yazan Masannat, MBBS, MRCSI, MRCSEd, DBRM, FEBS, FRCS, MD

Expert Surgeon

FAQs

Frequently asked questions

Breast cancer can present with a lump, breast changes, skin changes or nipple symptoms. So any change in your breast needs to be checked especially if you have

A new breast lump or thickening
Changes in breast shape, contour, or skin (dimpling, redness, “peau d’orange”)
Nipple inversion or discharge, especially blood-stained
Anything you noticed new in the breast

Answered by Mr Yazan Masannat, Consultant Oncoplastic Breast Surgeon (London, UK) and founder of iBreastBook.

Any new change in your breast especially if that lasts longer than one menstrual cycle should be assessed.

A lump or persistent area of thickening
Nipple changes, discharge, or skin changes
Any other changes that you feel is unusual like change in the skin, tecture of the breast contour etc...

Also you should see a specialist if you have

Strong family history or high-risk findings
Abnormal imaging needing further evaluation

Answered by Mr Yazan Masannat, Consultant Oncoplastic Breast Surgeon (London, UK) and founder of iBreastBook.

A triple assessment combines clinical examination, imaging and Tissue sampling with a biopsy if needed to diagnose breast symptoms.

It is the gold standard for breast diagnosis
Increases accuracy and reduces false results
Usually involves a mammogram for all patients 40+ and/or ultrasound and if there is any abnormality then a biopsy is done.
Sometimes the breast surgeon will arrange other tests if needed

Answered by Mr Yazan Masannat, Consultant Oncoplastic Breast Surgeon (London, UK) and founder of iBreastBook.

Short answer: The best test depends on your age, breast density and symptoms.

Usually all patients 40+ will have a mammogram and usually an ultrasound scan is done after.
Ultrasound is useful for younger women or cysts
Mammograms are ideal for screening and calcifications
MRI is reserved for high-risk cases or complex findings or in some ladies that have very dense breast
There is new imaging modalities like contrast enhanced mammograms that are also being used now more frequently

Answered by Mr Yazan Masannat, Consultant Oncoplastic Breast Surgeon (London, UK) and founder of iBreastBook.

A core biopsy takes a small tissue sample under local anaesthetic taken under the guidance o imaging usually. It may feel uncomfortable but is usually well-tolerated.

Performed with a needle using ultrasound or mammogram to confirm the needle is going through the lesion.
Provides a definitive diagnosis
Bruising or mild discomfort can occur for a few days
Many times the radiologist will. insert a little marker clip in the breast to mark the area biopsied.

Answered by Mr Yazan Masannat, Consultant Oncoplastic Breast Surgeon (London, UK) and founder of iBreastBook.

Mammograms are excellent screening tools especially in women over 50 but the will not pick all breast abnormalities

Sensitivity increases with age as breast tissue becomes less dense, so they are not as accurate in young ladies or ladies with dense breast tissue
its a good screening tool in detecting calcifications and breast abnormalities
Often combined with ultrasound for higher accuracy
There are some tumours that are not easily seen on mammograms especially lobular cancer, so tripe assessment is essential in any patient that comes to the clinic with symptoms
The new mammograms are more accurate especially the 3D mammograms, and there are new contrast enhanced mammograms that increase diagnostic accuracy

Answered by Mr Yazan Masannat, Consultant Oncoplastic Breast Surgeon (London, UK) and founder of iBreastBook.

Surgery for breast cancer includes breast-conserving surgery (lumpectomy) and mastectomy. Lumpectomy removes the tumour while preserving most of the breast, often with excellent cosmetic results thanks to oncoplastic techniques. Mastectomy involves removing all breast tissue, with options for immediate or delayed reconstruction using implants or your own tissue. Lymph node surgery may also be necessary. Answered by Mr Yazan Masannat, Consultant Oncoplastic Breast Surgeon (London, UK) and founder of iBreastBook.

A lumpectomy removes the tumour and a margin of healthy tissue while preserving most of the breast. It is usually followed by radiotherapy and offers similar survival rates to mastectomy for suitable cases. Recent data suggests that patients undergoing breast-conserving surgery may have better outcomes. Oncoplastic techniques enhance cosmetic results. Answered by Mr Yazan Masannat, Consultant Oncoplastic Breast Surgeon (London, UK) and founder of iBreastBook.

A mastectomy is the total removal of the breast, while we aim to remove all, in reality we remover 90-95% of the breast tissue.

Mastectomy is recommended when breast-conserving surgery is not suitable and also in High risk patients with abnormal genes like the BRCA.
The actual size of tumor in not the absolute indication it is the ratio of tumour size to breast size.
In cases of recurrent cancer, in many patients mastectomy is recommended though breast conservation can be an option for some
Can be combined with immediate reconstruction
Nipple-sparing options may be possible in selected patients

Answered by Mr Yazan Masannat, Consultant Oncoplastic Breast Surgeon (London, UK) and founder of iBreastBook.

It identifies and removes the first lymph node or nodes that drain the breast to check for cancer spread.

This is done using a radioactive tracer +/- Blue dye, though other tracers are being used like Magtrace and ICG.
Helps avoid full lymph node clearance when nodes are negative
Even if positive full axillary dissection can be omitted in many patients
Lower risk of lymphoedema and other complicatios than full clearance

Answered by Mr Yazan Masannat, Consultant Oncoplastic Breast Surgeon (London, UK) and founder of iBreastBook.

Yes, many women can have breast reconstruction either at the same time as their mastectomy (Immediate Reconstruction) or at a later stage (Delayed Reconstruction). Options include implants, expanders, and flap-based surgery using tissue from your tummy (DIEP) or thigh (TUG). The choice depends on your body shape, preferences, and other treatments. Not all patients are suitable for reconstruction, so a consultation with the surgical team is necessary. Answered by Mr Yazan Masannat, Consultant Oncoplastic Breast Surgeon (London, UK) and founder of iBreastBook.

Lipofilling, also called fat transfer or lipomodelling, uses your own fat to improve breast shape or correct defects after surgery.

Fat is taken by liposuction usually from the abdomen, flanks or thighs and injected into the breast
Often used after lumpectomy to improve the shape of the breast and correct defects
May require repeat sessions for best results

Answered by Mr Yazan Masannat, Consultant Oncoplastic Breast Surgeon (London, UK) and founder of iBreastBook.

To book an appointment with Mr. Masannat, visit our website and use the online booking form. Alternatively, you can call our office at +44 (0) 20 8194 8609 or email masannat.admin@lips.org.uk for appointments at The London Clinic, LYCA Health, Battersea Power Station, or Springfield Hospital. For 108 Harley Street, call +44 (0) 20 7563 1234 or email frontoffice@108harleystreet.co.uk. Answered by Mr Yazan Masannat, Consultant Oncoplastic Breast Surgeon (London, UK) and founder of iBreastBook.

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