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11.4. Consultant Breast Radiographer Case Study 2

I have been a consultant radiographer  since 2007 and am involved with all aspects of patient care with regard to the diagnosis of breast abnormalities and malignancy. I work autonomously running my own symptomatic breast assessment clinics and also work in collaboration with radiologists in breast clinic sessions. 

As a consultant radiographer I have progressed and gained in knowledge and experience and this role has given me great job satisfaction and fulfilment. I advocate fully this fourth tier of the radiography profession which gives autonomous working, flexibility and greater responsibility to those motivated and enthusiastic radiographers who wish to progress to this level.

My role within my department is structured, varied and very rewarding. I enjoy working collaboratively with radiologists and other members of the breast MDT.

Developing a network of fellow consultant breast radiographers has helped to inform my knowledge of all aspects of breast diagnostic imaging. This had enabled us all to develop best practice at a National level. My involvement with professional activities such as Symposium Mammographicum and the National Imaging Board has provided stimulating and exchange of ideas and knowledge has helped to further my development as a consultant breast radiographer.

Good communication and passing on my own knowledge and experience is a vital aspect of my work. Also the promotion and encouragement for advanced practitioners of all specialities in Wales has made my role interesting, fulfilling and a joy to perform.

Clinical Expertise:

My clinical practice encompasses:

  • Stereo-tactic and ultrasound guided core biopsies
  • Stereotactic and ultrasound guided wire localizations.
  • Film reading, interpretation and reporting.
  • Reporting of surveillance and family history mammograms.
  • Present my own cases at multidisciplinary team meetings (MDT).
  • Clinical Breast examination & Communication

Further development and skills

My post graduate qualifications include:

  • Certificate of competency in mammography - 1997
  • Film reading & interpretation - 2004
  • Interventional techniques - 2005
  • Clinical breast examination & client communication - 2006
  • Breast ultrasound - 2008
  • Research methods - 2008
  • Breast cancer treatment management & care - 2009
  • Competencies in Genetics counselling - 2009
  • MSc  in Medical Imaging - 2013

I gained my MSc in 2013, my dissertation was entitled ‘Consultant radiographers – an evaluation of the role 8 years on’.

Education, Training & Development

I am team lead for advanced practitioners and mammographers’, identifying training needs within the department. I mentor and teach radiology trainees, mammographers and new breast clinicians. I obtain great satisfaction in seeing others progress, and having helped and mentored them. 

Radiology trainees rotate through my department and I help our radiologists to oversee their clinical practice during their time here. I complete training proformas for them to log their improved skills at biopsy taking, aspirations of cysts and abscesses and general ultrasound techniques and communication with patients. These are read and assessed by their course directors.

Professional Leadership and Consultancy                

It has been a challenging few years with the transition from analogue imaging to digital picture archiving systems and I initiated and lead a team from members of my department to develop process. As a team we had input into structural changes and equipment. It has been an interesting and educational few years with the advent of digital breast imaging.

During my time as a consultant radiographer in Dorset I was invited to be part of a steering group with Exeter University, helping to develop an MSc mammography module for the training of mammographers. 

Also in Dorset, I was approached by the Primary Care Trust (PCT) to establish a family history counselling and assessment clinic for women with familial risk of breast cancer. This clinic was to be a brand new development within the Dorset screening service.  I was answerable to the PCT for the progress and outcomes of this new clinic, meeting the PCT to discuss any problems and issues that had arisen. In the first year of running this clinic 7 breast cancers were diagnosed in women of moderate risk who were under the National Breast Screening Programme age of 50.

Since moving to Cardiff in 2011 to take up the first official consultant radiographer post in Wales I have been heavily involved with promoting the role of advanced practitioners and consultant radiographers in Wales.  I have  been involved with the Welsh National Imaging Board to improve career progression for advanced practitioners in Wales.   In 2010 I was invited to be an organising committee member of Symposium Mammographicum, one of the largest international breast cancer conferences in the UK. This involves programme planning, venue, costs and exhibitors including bursaries and awards. 

Health Inspectorate Wales supports consultant practitioners and has developed a Welsh Consultant Nurse, Midwives and Allied Health Professionals (CNMAHP) forum and support group. This meets twice a year and I have just attended a leadership challenge two day event where we meet, undertake leadership challenges and lectures. 

Service Planning and Development

Within the unit there have been various issues which I have highlighted to management as part of my leadership and involvement with service planning and development. Usually I get involved when I feel there are problems or issues that impact on patient safety. Examples include better rotation off radiography staff through the department, better administrative staff training where there is cover when staff are absent, re-banding of an excellent radiography helper whose work was undervalued and who needed recognition for the extra service, training and efficient care that she provided to both patients and staff. This re-banding by KSF criteria, rewriting of the job description and references, was acknowledged and granted.

Research

I have been involved in collaborative research within my department on Tomosynthesis and 4D ultrasound tissue volume measurements. The Tomosynthesis research is to be presented at Royal College of Radiologists Conference in September 2013.

Research was also undertaken for my 2013 MSc dissertation on an evaluation of the current role of the consultant role 8 years on. A survey of 24 UK consultant radiographers and the dynamics of their role were undertaken.

I am currently involved with a survey and article comparing Welsh breast imaging services with England, to see if better integration between screening and symptomatic breast services provides better use of staff, resources and equipment.

Zebby Rees  DCR MSc
Consultant Breast Radiographer & Vice chair of Symposium Mammographicum
The Breast Centre
University Hospital Llandough
Vale of Glamorgan

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