Browsing by Author "Edge, Jenny"

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    Alternative modalities being promoted for breast screening
    (Health & Medical Publishing Group, 2018) Edge, Jenny; Roodt, Liana
    ENGLISH ABSTRACT: is a political issue as much as a medical one, and although there is an enormous amount of literature looking at the benefits of the standard modalities, there is no consensus about the efficacy of screening. South Africa (SA) does not have a national mammographic breast screening programme. There are both economic and logistical reasons for this. The absence of a policy has resulted in alternative modalities being promoted as plausible substitutes. If a new modality is to be used for screening/symptomatic evaluation of the breasts, it should be compared with any of the established and well-researched existing modalities. This editorial serves to highlight some of the problems with the three commonest modalities being promoted in this country at present.
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    Metastatic screening for patients with newly diagnosed breast cancer : who and how?
    (AOSIS, 2020-04-06) Edge, Jenny; Budge, Melissa; Webner, Adiel; Doruyter, Alexander; Cilliers, Glen; Malherbe, Francois
    Background: Staging for breast cancer patients, as defined by the American Joint Committee on Cancer (AJCC), has historically been limited to anatomical staging. However, the eighth version of the AJCC guidelines has been altered to include tumour biology. Anatomical staging still has a place especially in low-middle income countries where the majority of patients present with locally advanced or metastatic disease. Aim: This review article considers which newly diagnosed breast cancer patients should be referred for anatomical staging and the pros and cons of the different modalities available in South Africa. Method: The different modalities available were reviewed with respect to metastatic screening for asymptomatic women. The usefulness of the modalities were considered with reference to organ-specific disease rather than the stage of the patient. Results: Any person with newly diagnosed breast cancer and symptoms suggestive of systemic involvement should be investigated. All symptomatic women who present with a tumour larger than 5 cm, radiological or clinical evidence of nodal disease, triple negative or HER2+ve tumours should have metastatic screening. This gives information about the primary as well as the metastatic status. Conclusion: However, increasingly, the major determinant of treatment is the biology of the cancer and not the anatomical stage. In future, this trend is likely to increase with anatomical staging becoming less important.
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    Reflections on undergraduate teaching
    (Health & Medical Publishing Group, 2019) Edge, Jenny
    Introduction: After 18 years of largely being out of undergraduate teaching of medical students, I am once again immersed. It is the same as it was, but it is also very different. In trying to make sense of this difference, I reflect on what I have experienced since returning to the clinical learning environment. I trained in a large impersonal teaching hospital in London in the 1980s. All consultants were treated like gods. Professors were above them. Matrons were just below them and, working down the chain, medical students were to be seen but rarely heard, spoke only when spoken to, and were used for tasks on the wards that the student nurses felt were beneath them. The ward rounds were staged, dramatic and to be feared. As students, we were expected to be smart and presentable – I was chastised for wearing trousers. I arrived in South Africa (SA) in 1994 and joined Stellenbosch University (SU)’s surgical department as a registrar. I found the medical students to be polite and slightly old fashioned compared with their European counterparts. Then I moved to private practice and for the last 18 years have had minimal involvement with undergraduates. Now I am fortunate enough to have been given the opportunity to return to a teaching position and find myself once again engaging with medical students in the wards. So, what has changed?