More about the Breastcare unit

West Herts Breast Care Unit

Breast Oncology

Surgery one of the components of breast cancer treatment. Based on the microscopic examination of the tissue removed at surgery, our oncology team will recommend other treatments that are likely to be of benefit. Sometimes these treatments are given before surgery, or instead of if the patient is not fit for surgery.

Endocrine treatment

The majority of cancers can be treated with a hormonal drug that can block the effects of the female hormone on the breast cancer cells. This is usually in the form of a daily tablet, Tamoxifen. It may be appropriate to offer one of the newer Aromatase Inhibitors (Arimidex, Aromasin or Femara), that are for postmenopausal women.


Chemotherapy is considered in more advanced or more active cancers or where the cancer shows features that indicate it will not respond to endocrine treatment. The treatment is given as an outpatient at Mount Vernon Hospital, usually every three weeks for six cycles.

There are a number of different agents that can be used, as well as many techniques to minimise side effects of the treatment. If the arm veins are difficult to cannulate, a PICC line is generally inserted for chemotherapy treatment but this may not happen until after chemotherapy has commenced and also makes blood taking easier.


Radiotherapy is recommended after a wide local excision (lumpectomy) to reduce the risk of breast cancer recurring. It can also be recommended after a mastectomy if cancer has been found in the lymph nodes or if the cancer is close to the chest muscle. The treatment is given in sessions lasting a few minutes (Monday to Friday, with some choice as to time of day), usually for three and a half weeks, at Mount Vernon Hospital.


Some 20% of breast cancers will show features that predict a response to Herceptin treatment. This is an antibody treatment and given subcutaneously as an outpatient at Mount Vernon Hospital. The course is usually one treatment every three weeks for one year.

Oncology Staff

Dr David Miles, Consultant Medical Oncologist (Breast)

Qualifications: MD MBBS BSc; FRCP

Dr David Miles, Consultant Medical Oncologist (Breast)David Miles trained at University College London with postgraduate training at Kings College, University College and Guys Hospital. Following an ICRF Fellowship in the Guys Breast Unit leading to an MD, he was appointed senior lecturer/consultant to the Guys Breast Unit in 1995. In 2004 he was appointed as Consultant in Medical Oncology at Mount Vernon Hospital, spending two days of the week in the West Herts Breast Care Unit.

His research interests are in the biological treatment of breast cancer and he is National and International Principal Investigator in studies of novel agents in breast cancer. He regularly chairs and presents at national and international meetings.

Dr Nar Thanvi, Consultant Oncologist

Awaiting profile.

Dr Stephanie Sutherland, Breast Physician

Qualifications: MBBS, MRCP, MSC

Picture of Dr Stephanie Sutherland, Breast PhysicianStephanie Sutherland qualified from Newcastle University. She developed an interest in oncology in 2004 and since 2006 has specialized exclusively in breast cancer. She was a Clinical Fellow on the Breast Unit at the Royal Marsden for several years where she was also involved in clinical research and drug trials. She has an MSC in oncology and joined the West Herts Breast Unit from the Royal Marsden in 2012.

Jackie Evans, Research Sister

Qualifications: RGN 2000, Haematoncology diploma/specialist Nurse 2003, Management and care of chemotherapy 2005, Advanced Communication Skills 2007

Picture of Jackie Evans, Research SisterJackie qualified from University of Hertfordshire in 2000 and worked on the haematology ward in Hemel Hempstead General Hospital, progressing to Ward Manager in 2006. She remained in this position until 2009, when she joined the oncology research team based at Mount Vernon and St.Albans Hospital.

As a research nurse Jackie is involved in the recruiting to, screening for, treatment on and following up for clinical trials. She attends the oncology clinic and breast multidisciplinary meeting on the Wednesdays at St Albans City Hospital. The remaining time is based at Mount Vernon Hospital.