Specialist Surgeon | Female Health Care | Cape Town Mediclinic
Assessment and Diagnosis
Most breast lumps are benign, but any new lump or change in the breast should be assessed promptly.
At the first consultation Dr. Loots takes a history, examines both breasts and the regional lymph nodes, and reviews any mammogram or ultrasound. Where a tissue diagnosis is needed, Dr. Loots arranges a needle biopsy. Histology confirms whether a lesion is benign or malignant and, if malignant, its type and receptor status.
If you have found a lump or noticed a change, please arrange a consultation with Dr. Loots. Appointments can be booked online or made by calling the practice on 021 224 0077. A referral from your GP or gynaecologist is welcome but not required.
Treatment Planning
Treatment commonly combines surgery with chemotherapy, radiotherapy or endocrine therapy. In some cases chemotherapy is given before surgery (neoadjuvant treatment). Each case is discussed with the oncologists and, where reconstruction is planned, the reconstructive surgeon, before a plan is agreed with you.
Consultations allow time for questions, and you are welcome to bring a partner or family member.
Surgical Options
- Lumpectomy (wide local excision): removal of the tumour with a margin of healthy tissue, conserving the breast. It is usually followed by radiotherapy. For women suitable for either operation, it works as well as mastectomy in curing the cancer.
- Mastectomy: removal of the whole breast. A simple mastectomy removes the breast tissue, nipple and areola. Skin-sparing and nipple-sparing techniques preserve the skin envelope when immediate reconstruction is planned with a reconstructive surgeon.
- Risk-reducing mastectomy: for women at high inherited risk, such as BRCA mutation carriers, removal of one or both breasts reduces the likelihood of breast cancer developing.
The choice depends on tumour size and position, breast size, tumour biology, whether disease is present in more than one area of the breast, and your preference.
Axillary Surgery
- Sentinel lymph node biopsy: a blue dye and a low-dose radioactive tracer identify the first draining lymph nodes, which are removed through a small incision in the axilla for pathology. If they are clear, further axillary surgery is usually unnecessary.
- Axillary clearance: removal of a larger number of axillary lymph nodes when the sentinel nodes contain cancer or nodal disease is already established.
Limiting axillary surgery reduces the likelihood of arm swelling (lymphoedema), arm discomfort and shoulder stiffness.
Chemotherapy Port Placement
Where chemotherapy is planned, Dr. Loots can insert a port: a small reservoir beneath the skin of the upper chest that provides reliable venous access for the course of treatment. It is removed once treatment is complete.
Admission and Recovery
- Surgery is performed under general anaesthetic at Mediclinic Cape Town.
- The length of the hospital stay depends on the operation and on your recovery.
- A wound drain may be placed; the nursing staff will explain its care.
- Arm and shoulder exercises begin early to preserve mobility.
- Dr. Loots reviews you after surgery to assess the wound and discuss the histology, after which the next stage of treatment is confirmed.
General guidance on medication, fasting and admission is on the Patient Information page.
Medical Aid, Referral and Private Patients
Breast cancer is a Prescribed Minimum Benefit condition, and medical schemes cover its treatment, generally through their oncology programmes and subject to pre-authorisation. The practice will assist with this.
Patients without South African medical aid, including those living abroad, are welcome.
Frequently Asked Questions
Is mastectomy always necessary?
No. Many women are suitable for breast-conserving surgery. Where mastectomy is needed or preferred, reconstruction may be possible at the same time or later.
How soon after diagnosis is surgery performed?
Surgery is scheduled once the diagnosis is confirmed and the treatment plan agreed, unless chemotherapy is given first. Dr. Loots will discuss the timing with you.
Will I need chemotherapy or radiotherapy?
This depends on the tumour type and stage and on the surgery performed. It is decided with the oncology team once histology is available.
May I bring someone with me?
Yes. A partner or family member is welcome at any appointment.
Getting to the Practice
Suite A115, Mediclinic Cape Town Hospital, 21 Hof Street, Oranjezicht. Surgery is performed in the same hospital.
- City Bowl: Gardens, Tamboerskloof, Vredehoek, Oranjezicht and the CBD.
- Atlantic Seaboard: Green Point, Sea Point, Camps Bay and Clifton, via Kloof Nek or the city.
- Southern Suburbs: Observatory, Rondebosch, Newlands, Claremont and Constantia, via the M3.
- Northern Suburbs: Milnerton, Parow, Bellville and Durbanville, via the N1.
About Dr. Loots
Dr. Loots is a specialist general surgeon at Cape Town Mediclinic with a special interest in breast and thyroid surgery and endoscopy. MBChB (University of the Free State, 2004); MMed Surgery (Stellenbosch University, 2015); FCS SA.
Related Reading
Book a Consultation
At the first consultation Dr. Loots examines you, reviews your imaging and outlines the next steps. New patients should select "First consultation - new patient".
Our Details
Practice Location:
Suite A115, Cape Town Mediclinic,
21 Hof Street, Oranjezicht,
Cape Town, 8001
Get directions
Phone: 021 224 0077
Email: admin@doctorloots.com
Operating Hours: Monday - Friday, 9:00 AM - 4:00 PM