Mediclinic Cape Town Breast Clinic is a First
Posted on 16 July 2018
When Mediclinic general surgeons Dr Pieter Coetzee and Dr Yolandi Loots joined forces with Mediclinic plastic surgeon Dr Mark van der Velde earlier this year, it marked a welcome team approach to breast surgery.
As breast cancer patients at Mediclinic Cape Town embark on what is often a two-year journey towards recovery, they can now enjoy the attention and expertise of three committed medical professionals.
“We’re aiming for a centre of excellence,” says general surgeon Dr Yolandi Loots who teamed up with fellow general surgeon Dr Pieter Coetzee and plastic surgeon Dr Mark van der Velde in January this year to offer this group approach.
“Breast cancer surgery brings a lot of anxiety for the patient and it’s an emotional journey,” says Dr Coetzee. “It’s a long process – undergoing surgery, oncology, chemotherapy, radiation, first breast reconstruction, fat grafting and then creating a new nipple or nipples. As a team, we are able to provide the patient with a solid anchor throughout that journey.”
Patients are referred to the breast clinic by their GP, gynaecologist or radiologist (if they’ve had a mammogram) for the surgeons to make a diagnosis and confirm whether a detected breast lump is cancerous. “Once we’ve decided what we can do from an oncological point of view to get rid of the cancer, Dr van der Velde is able to determine what impact that will have cosmetically – whether removing the lump or the whole breast is best – and if the patient needs chemotherapy, should the surgery happen before or afterwards,” Dr Coetzee explains. “In other words, Dr van der Velde determines what will be better for the patient in terms of long-term effects for the cancer and in terms of long-term effects for the cosmesis.”
“Many factors come into play when it comes to deciding the best route to take,” Dr van der Velde says. “For instance, if I need to make a wide local excision in a small breast, it is sometimes better to perform a full mastectomy. There are so many aspects that individualise each case and the psychology behind a patient’s choice is also very important. Some patients decide to delay reconstructive surgery, some opt not to have it at all and others, often younger patients, elect to have a bilateral mastectomy rather than running the risk of the cancer occurring in the second breast.”
As all three doctors explain, no decision is rushed and they are more than willing to have extra consultations with each patient to ensure they feel heard and understood. “Patients appreciate the extra support and the team approach because there is more than one point of contact,” says Dr Loots. “There is always one of us on call to attend to any queries or concerns and we dovetail well because we see the patients together so often.”
“All three of us were used to this team approach when we worked in the state sector but in private practice, it is difficult to find like-minded doctors who are equally passionate about patient care,” Dr Coetzee says. “We realised there was a gap in private, which is why we’ve formed this breast clinic. It’s definitely pioneering for Mediclinic Cape Town.”