Helen Joseph Breast Care Clinic

We hear the postive impact the HJBCC has on the surrounding community.

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The Helen Joseph Breast Care Clinic (HJBCC) was set up in 2005 by specialist surgeon, Prof Carol-Ann Benn. She was joined by specialist surgeon, Prof Sarah Rayne.

Vision

To provide world-class breast care to the people of Johannesburg, delivered in a government hospital setting. Patient care should be excellent but affordable, and allow women (and men) access to all available methods of breast pathology diagnosis and treatment through an integrated, education orientated, multi-disciplinary approach; ensuring high quality patient care and effective service delivery.

Clinics

The HJBCC provides two specialist breast clinics each week. These are open access clinics which enables each patient to be seen within a week of identification of a breast problem.

Tuesday: Open access for all new patients without previous HJBCC attendance.

Thursday: Open access for follow-up patients undergoing investigation and treatment in the HJBCC.

Each clinic is run with:

• at least one specialist surgeon
• one or two training surgeons (registrar/resident)
• one or two interns (junior doctors)

These clinics and the ward care are complemented by a nurse-led dressing clinic run each morning for patients. Our nurses are experts in managing dressings and drains for post-operative patients, as well as explaining and supporting patients in the management of their own wounds and drains.

In addition, the nurses also manage dressings for our locally-advanced T4 patients, a subset of women who have presented late with fungating or ulcerating wounds.

It is important to give these women the local support of their wounds and develop strategies to prevent odour and leakage and to enable women to adequately cleanse and manage their wounds in the community whilst receiving primary chemotherapy.

Who are the patients of HJBCC?

The clinic manages 500-700 patients each month in two weekly specialist clinics. Separate hospital records have been kept since 2008; the clinic has seen and followed-up more than 12,000 patients in that time. In 2017, 327 new breast cancers were diagnosed and treated.

Breast cancer patients

HJBCC has 10-15 new cancer diagnoses each week. Most of the patients present as locally-advanced disease and are referred immediately for primary chemotherapy. A further 2-3 patients will undergo sentinel lymph node biopsy each week, of which two-thirds are positive.

Surgical care

HJBCC has a ward devoted to breast patients next to the clinic, allowing easy access for patients and relatives. We manage three full-day operating lists dedicated to breast cases, with a further general surgery full-day list used for some benign cases. Two lists are assigned to breast surgery, both benign and malignant, each week and one list is for onco-reconstructive cases and breast plastic surgery.

We have a strong reconstructive surgery department working within the unit, with 100 reconstructions carried out each year. Many patients have immediate reconstruction with oncologic surgery and reconstruction carried out by different teams at the same operation.

Multi-disciplinary care

Oncology facilities are centralised offsite five kilometres away and comprise a radiation unit and medical oncology outpatient and inpatient facilities.

There is a multi-disciplinary meeting comprising surgeons, medical and radiation oncologists each week to ensure comprehensive care.

Within the hospital our close partnership with the specialist radiologists and a weekly combined breast meeting ensure that clinical, radiological and histological assessments of each patient correlate.

Radiology

The mammography unit provides full field digital mammography with two digital mammography units, a prone stereotactic unit and two ultrasound machines with high definition linear probes, employing three radiographers and four specialist radiologists with mammography skills.

Up to 30 patients per day receive diagnostic and screening mammography, multiple core biopsies, aspirations, V marker placements and hookwire localisations under stereotactic and ultrasound guidance.

Supportive care

There is a genetic counselling service with clinics held four times a year. This is for women who are at high risk of breast disease due to hereditary factors. This includes testing for BRCA mutations.

Within the hospital referrals are available to our physiotherapy department to aid with lymphoedema care, and general wellness.

The Breast Health Foundation provide more wide-ranging support to the centre. They raise awareness of the clinic through mobile breast units and community education. Their Bosom Buddies support network is invaluable in continuing our patient support in the community.[/vc_column_text][/vc_column][/vc_row]