Professor Zoe Winters is a Consultant Breast Cancer Surgeon and Breast Specialist
I am delighted and honoured to share my passion and short story and how I got to where I am now in my career. My early passions in medical school related to acquiring as much knowledge as I could where I felt that “ knowledge is power” and can embolden how we present complex cases of breast cancer in the context of a fascinating expansion in the field of understanding different types of breast cancers, what causes breast cancer and how they might have arisen.
In my current full time private practice in London, we talk a lot about gene mutations that occur at the time of the “egg and sperm” recombination to produce what are known as germline mutations. These account for the minority of breast cancer (8-10%), however the ability to test extended gene panels beyond BRCA1 and BRCA2 have changed our abilities to perform young onset breast cancer screening using tests like breast MRI including 3D mammograms and ultrasounds. These include genes like PALB2, CHEK2 and ATM whereby young age commencement of breast screening from 30 years using breast MRI can reduce breast cancer deaths by 56% to 60%.
Let’s look at the genes
On the other hand, we are passionate about talking about how spontaneous breast cancers occur through what we refer to as multiple functional changes in background genes that effectively act like the “body machinery”. We can assess multiple functional changes in 76 or more low risk genes to assess the changes in a “big gene dataset” using a validated personal breast cancer risk test called MammoRisk. This can allow us to predict personal breast cancer risks at 5 years and allows us to recommend the frequency of screening mammograms in all women from 40 years of age and older. This means we can personalise how often we recommend each individual woman’s mammograms with or without synchronous breast ultrasounds depending on their mammogram assessments of breast tissue density.
My passion is trying to deliver “state of the art knowledge” to my patients in a One-Stop rapid diagnosis breast clinic on all aspects of breast health and breast cancer symptoms that allows each individual to understand basic mechanisms that help to explain what we do and why.
Medicine is my passion
“Medicine is my absolute passion and I try to share my excitement and knowledge in each patient interaction”.
“I want women to feel empowered and comfortably reassured that we are working in a multidisciplinary team of experts ranging from Radiologists, to Pathologists and Breast Surgery that also encompasses more complex plastic surgery breast reconstructions and breast reductions and is always supported by clarifying surgery options and explaining the pros and cons of each type of surgery”.
“We share every medical report with each patient and place the patient at the centre of each decision-making step”.
“Breast Surgery has changed dramatically and is now synonymous with targeted personalised approaches based on each patient’s particular breast cancer biology. The aims of modern breast cancer surgery are to de-escalate the extent of surgery by combining the latest medical treatments such as chemotherapy and endocrine treatments (drugs that block the oestrogen and progesterone receptors in breast cancer) only when they are needed based on the cancer genes that can be measured in each cancer”. The patient’s age and cancer biology can also determine whether we give post surgery radiotherapy and how much we give”.
“We offer the latest techniques in localising small cancers using a Magnetic Seed, the size of a grain of rice”. The cancer is then detected using a Magnetic probe during surgery. We perform localisation of the axillary predictor lymph nodes using a liquid containing magnetic iron filings called Magtrace, that also allows us to perform diagnostic excisions of small numbers of sentinel lymph nodes”. The latter represent the key predominant draining lymph nodes that we would like to test diagnostically and determine whether we treat the axilla using axillary lymph node dissection that causes most of the side effects or whether we can treat the axilla using radiotherapy that causes half the numbers of side effects.
“We combine targeted cancer surgery with the latest breast remodelling techniques that are called” Therapeutic Mammoplasty” or “Therapeutic Breast Reduction” that are techniques that allow us to remove one or multiple cancers and optimally save the breast taking cognisance of the overall cosmetic results”.
She’s still one of the very few women leading in this field
“One of the highlights of my career was becoming a Professor of Breast Surgery which took 17 years and unfortunately numbers very few women in the UK. This pinnacle was the culmination of decades of work and dedication, but also pure “sweat and tears” in the context of a climate of patriarchal attitudes and discrimination at all levels of clinical and academic medicine”.
“I have used all of my experiences to power on because no one can snuff out passion and determination, and today I am thrilled to be part of the London Clinical fraternity of breast cancer surgery and breast health”. I truly work with some of the leading and top colleagues in London and Surrey”.
“One of my other passions is mentoring the future generation of surgeons so they can attain their full potential based on each individual’s talents. It was a privilege and honour to be able to do postgraduate research in molecular biology at Oxford University. I found it fascinating and that it underpins major advances in past and future drug developments and in garnering some understanding into mechanisms of breast cancer development and growth”.
Professor Zoe Winters became a Professor of Breast Surgery in 2017 through University College London. She is an experienced, Senior London Consultant Breast Cancer Surgeon and Breast Specialist, specialising in the diagnosis, treatment and management of breast diseases, breast cancer and all benign breast problems. She is a nationally and internationally recognised senior breast surgeon, with clinical excellence awards through iWantGreatCare in 2018, 2019, 2021 and 2022. Zoe also received the London Prestige Health award for Top Breast Surgeon of the year in 2021 and 2022. Professor Winters trained in Johannesburg and Cape Town (South Africa) and completed her Doctor of Philosophy degree at the University of Oxford by receiving the prestigious Oxford Nuffield Senior Research Fellowship.
Professor Winters works closely with Oncologists, Geneticists, Plastic Surgeons and Psychiatrists at the Royal Marsden NHS Foundation Trust. Zoe has received many awards for her clinical research, including the King James IV Professorship for surgery research from the Royal College of Surgeons of Edinburgh. She has also led two world first randomised trials in breast surgery and has validated the first European Patient Reported Quality of Life questionnaire in breast reconstruction after cancer surgery that has been used internationally. Zoe now teaches post-graduate surgeons in the latest aspects of breast cancer and breast cancer surgery, including breast reconstructions.
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You may also enjoy reading Michelle’s breast cancer journey under Professor Winters’ care