Dr Jenny Edge informs us on the running of Tygerberg Hospital Breast Unit.
About Tygerberg Hospital Breast Unit
Tygerberg Hospital (TBH) is situated in Parow, in the northern part of Cape Town. It’s one of two large teaching hospitals in the city. The other being Groote Schuur. TBH is affiliated with Stellenbosch University (SU), so it’s both a clinical facility and teaching hospital.
Tygerberg Breast Unit was one of the first breast clinics to be developed in South Africa. It was set up in the 1980s by Prof van Zyl. He had the vision to create a space dedicated to the management of breast cancer patients. The clinic is still on the 5th floor of the hospital.
The clinic is run on a day-to-day basis by dedicated medical officers who see patients with breast complaints, soft tissue tumours and skin cancers. These patients are from the West Coast, Paarl, Worcester and Khayelitsha.
Unlike many other breast units, patients with breast cancer are also followed up in the breast clinic rather than in the oncology department. About 450 to 500 new patients with breast cancer are seen every year.
As always, the clinic isn’t about the location as much as the staff. The first point of contact is Mrs Roman, the receptionist who makes the bookings. After that, the team of four nurses (led ably by Sr September) interact with the new patients before they are seen by the three medical officers who work either full- or part-time: Dr van Staden, Dr Malan and Dr Otto.
Although the clinic is still in the original location, it has recently been upgraded. The breast clinic is in transition and is gradually transferring to an electronic note system which will be compatible with the hospital programme. This aims to serve a dual function: it will allow more efficient note keeping and collection of data. If we are to improve outcome for breast cancer patients, we must ensure we know how the system is working for them and how they do in the system.
Managing breast cancer requires input from many specialists. In our unit, there are multi-disciplinary meetings: one to discuss diagnosis and another to review treatment. This allows the relevant role players to be together and form the treatment plan, review the images and biopsy results, and discuss the recommended management for the breast cancer patients. The success of the meetings is because of the dedication of the staff involved.
For women with breast cancer, it is often a long and complex journey, requiring spiritual, physical and emotional support. It is often difficult to provide that support in a busy breast clinic. Ideally, there would be many role players in the clinic. In practice, we are gradually building up the capacity to provide support. We have been joined by Elna, a psychologist, who is available for patients to talk to and share their concerns with.
There are many non-profit organisations in the South African breast cancer arena. Tygerberg Breast Unit has had a long association with Reach for Recovery; all the women with breast cancer in the unit are visited by one of their volunteers.
More recently, we have partnered with Pink Flamingo, a project that finances extra theatre lists. Not only do the women on the lists receive their breast cancer surgery earlier, it results in shorter waiting lists for all women with breast cancer.
Training course for nurses
In many other countries in the world, the first healthcare worker seen by a person with a breast problem is a specially trained nursing sister. At present, in South Africa, we don’t have enough trained personnel who are able to fulfil the role. Tygerberg Hospital, along with Stellenbosch University, are hoping to be able to offer a training course which will empower nurses to manage women with breast problems.
MEET OUR EXPERT –Dr Jenny Edge
Dr Jenny Edge is head of the breast and endocrine surgical unit at Tygerberg Hospital. She is the founder of the Breast Course for Nurses.