Surgery images

Photographs by Jacquie Moran

Warning: some people may find these images distressing

Hookwire localization

In breast-conserving surgery, a hookwire localized wide local excision is used to locate which part of the breast to remove. Under local anaesthetic, a thin sterilized wire is placed into the breast using x-ray or ultrasound guidance. This is usually performed by a radiologist, on the day prior or morning of the operation. The surgeon is then able to use the wire as a guide to remove the cancer



Is a very useful tool in treating cancer and has been used for over 100 years. Modern radiotherapy utilizes exquisitely accurate technology to target the areas treated and so minimizes side-effects on normal tissues. However, the treatment is still to the whole breast, 'mopping' up any microscopic cancer cells in the remaining breast tissue. Used as breast-conserving therapy; when and for whom it is used will vary between patients.


Implant reconstruction

Breast reconstruction can be a crucial step on the path to recovery. Implants are the simplest form of reconstruction and can look very good with some body shapes. Generally performed in two stages, a tissue expander is first placed under the skin and muscle of the chest. This is gradually filled with saline to stretch the muscle and skin over the weeks following the operation. The expander is then replaced with a definitive implant. At this time, a nipple and areola reconstruction can also be performed.


TRAM flap reconstruction

When suitable, a trans-rectus abdominis muscle (TRAM) flap reconstruction provides enough tissue to make a good-sized breast without need for an implant. Skin and fat from the tummy is transferred along with muscle to create the new breast.


Latissimus dorsi reconstruction

Here the latissismus dorsi (LD) muscle is brought forward from the back of the woman’s body to recreate the new breast. This is usually used together with an implant to achieve the correct size match; giving a realistic shape and feel for many women.


Lymphoedema treatment 

Some women may experience lymphoedema after breast cancer. This may require compression sleeves, applied by a physiotherapist or occupational therapist. Fortunately, with new developments in imaging breast cancer, complications such as lymphoedema are being reduced.


At the Breast Clinic

As with other members of the multi-disciplinary treating team, breast nurses bring an area of expertise to cancer care designed to make treatment and its aftermath easier.



During treatment for breast cancer many women report that it is the fight to survive that is paramount. This survivor attitude has implications for all of us, to maximise quality of life by striving for optimal health in mind and body.