Breast cancer

Dr Fiona Tsang-Wright (GMC 4549831) is a Consultant Oncoplastic and Reconstructive Breast Surgeon, FRCS Gen Surg who leads breast cancer diagnosis, oncoplastic surgery, and treatment planning for patients in London and Buckinghamshire. She sees private patients in London and Buckinghamshire at the Women's Health Centre – Harley Street, Women's Health Centre - King's Road, and The Chiltern Hospital, and holds an NHS Consultant post at Bucks Breast Unit, Buckinghamshire Healthcare NHS Trust. This hub outlines consultation, surgery and reconstruction pathways, and onward links to related services.

Quick answers

Does a referral mean it is definitely cancer?

No — most referrals are not. A majority of urgent breast referrals turn out to be benign. The consultation is to find out, not to confirm.

Will I need a mastectomy?

Not necessarily. Many patients are suitable for breast-conserving surgery. The right operation depends on tumour size, position, and your preferences — that decision is made together.

How quickly will I get a diagnosis?

At a one-stop clinic, often the same day — examination, imaging, and core needle biopsy (if needed) in one appointment. Core biopsy results take a few working days. Imaging often includes mammogram and breast ultrasound where appropriate.

A breast cancer diagnosis — or the fear of one — is one of the most unsettling things a patient can face. The first consultation is designed to answer the most pressing question as clearly and quickly as possible: what is this, what are the options, and what happens next. Where it is clinically safe to do so, examination, imaging, and biopsy are arranged in the same visit so you leave with a clearer picture rather than a string of separate appointments.

Dr Tsang-Wright's practice is built around oncoplastic principles — treating cancer thoroughly while preserving as much normal breast tissue and appearance as possible. She trained at Imperial College NHS Trust and The Royal Marsden Hospital and holds an oncoplastic surgery fellowship. Her NHS work at the Bucks Breast Unit, Buckinghamshire Healthcare NHS Trust means she remains in active, high-volume breast cancer practice; her private work allows the time to explain, answer questions, and plan treatment with you rather than for you.

Where to start

If you have a new symptom or imaging finding and are not sure what comes next, the symptoms and assessment page describes how a one-stop breast clinic visit works. If you have been told you have breast cancer and want an unhurried review of the plan, a second opinion is a routine and useful step. For surgical options, see breast cancer surgery.

Step by step

What happens at a breast cancer consultation

The following describes a typical first consultation. Every patient is different, and the order can vary depending on what you have already had done.

History and symptoms

We talk through what brought you in — when you first noticed the symptom, your breast history, family history of breast or ovarian cancer, and any previous biopsies or imaging. If you have a referral letter or previous scan results, bring them; if you don't, that is fine.

15–20 minutes

Clinical examination

A careful clinical breast examination. A chaperone is routinely offered regardless of your preference for a female or male surgeon — it is standard practice, not something you need to negotiate.

10 minutes

Imaging

Mammogram and ultrasound are arranged in the same visit where clinically appropriate — this is the one-stop clinic format. If you have recent imaging from another centre, it is reviewed rather than repeated.

30–60 minutes

Biopsy (if indicated)

If imaging identifies an area that needs a tissue sample, a core needle biopsy is performed under local anaesthetic in the same appointment. The procedure takes about ten minutes and is uncomfortable rather than painful. Results take a few working days; you will be contacted as soon as they are ready.

10 minutes

MDT review

Once a diagnosis is confirmed, the case is discussed at a multi-disciplinary team (MDT) meeting with oncologists, radiologists, and breast care nurses. This is standard UK practice and means that every treatment plan has been reviewed by the full team before it is presented to you.

Treatment discussion

At a follow-up appointment (or the same day if results are immediate), we discuss what was found, the MDT recommendation, and the treatment options — including the operation, reconstruction choices if relevant, and any adjuvant treatment such as radiotherapy or hormone therapy. You leave with a written summary and a clear next step.

MDT review is not optional. Every new breast cancer case is discussed at the MDT before a treatment plan is finalised. This is UK best practice (NICE NG101) and means the plan you receive has been reviewed by a team — surgeon, oncologist, radiologist, pathologist, and specialist nurse — not just one clinician. Private patients receive the same MDT review as NHS patients.

Treatment options

Surgery, reconstruction, and adjuvant treatment

The right surgical approach depends on the type and stage of cancer, its position within the breast, and your own priorities — including how important breast shape and symmetry are to you. The options discussed will include some or all of the following.

Breast-conserving surgery (lumpectomy / wide local excision)

Removal of the tumour with a margin of normal tissue, leaving the rest of the breast intact. Often combined with radiotherapy. For many early-stage cancers this gives equivalent survival to mastectomy while preserving the breast. Our guide on wide local excision (lumpectomy) explains the term in plain English.

Oncoplastic breast-conserving surgery uses plastic-surgery principles to reshape the remaining breast tissue after a larger excision, reducing cosmetic deformity. The opposite breast is sometimes adjusted for symmetry.

Mastectomy

Removal of the whole breast when conservation is unsafe or when you choose it for peace of mind. Skin-sparing and nipple-sparing variants exist where oncologically appropriate. See our explained guide on mastectomy for the core concepts.

Reconstruction

Reconstruction can be immediate or delayed; options include implant-based and autologous techniques. More detail is on our breast reconstruction service page.

Sentinel node biopsy and axillary surgery

Most invasive breast cancers are staged with a sentinel lymph node biopsy under general anaesthetic at the time of the main operation where appropriate. If nodes are involved, further axillary treatment may be recommended.

Pathology reporting includes receptor status and grade where available — terms such as ductal carcinoma in situ (DCIS), invasive ductal carcinoma, and invasive lobular carcinoma are covered in breast care explained for patients who want to read ahead.

Common questions

The questions patients ask first

Do I need a GP referral to see Dr Tsang-Wright for a suspected breast cancer?

You can book a self-referral directly. However, most health insurers require a GP referral letter before they will authorise cover, so check with your insurer first. If your GP has made an urgent suspected cancer (USC) referral on the NHS pathway, bring that letter.

I have been told I need an urgent suspected cancer referral. Can I go privately instead?

Yes. You can choose to be seen privately on a faster timetable. Your GP's urgent suspected cancer (USC) referral aims for you to be seen quickly; the NHS Faster Diagnosis Standard targets diagnosis or rule-out within 28 days. You do not lose your NHS right by attending a private appointment — if you wish to return to the NHS pathway, your GP can re-refer you. Bring the referral letter and any imaging already arranged.

What type of breast cancer does Dr Tsang-Wright treat?

Dr Tsang-Wright treats the full range of breast cancer presentations: invasive ductal carcinoma, invasive lobular carcinoma, ductal carcinoma in situ (DCIS), locally advanced disease, and recurrent cancer. She also sees patients with a BRCA1/BRCA2 mutation for risk-reduction discussions.

If I am diagnosed, will I be seen by the same surgeon throughout?

Yes. In private practice every consultation — initial assessment, treatment planning, surgery, and follow-up — is with Dr Tsang-Wright personally. You will not be passed to a junior colleague.

Does the practice accept health insurance?

Dr Tsang-Wright is a BUPA Platinum consultant and holds recognised-specialist status with AXA Health, Aviva, Vitality, and most other major UK insurers. Patients funding treatment themselves are also welcome. Contact the practice for a fee guide and to check your specific insurer.

The full structured record — qualifications, appointments, surgical venues, procedures, teaching, society roles, and publications — is at the credentials page. Assessment, surgery, and follow-up are with the same consultant throughout.