Workshop Speakers

Please scroll down to view the speakers information for the Sunday Workshop.

Karina Cox

Karina Cox is a Consultant Breast and Oncoplastic Surgeon at Maidstone and Tunbridge Wells NHS Trust and was appointed in 2011. She is a Trustee of the Association of Breast Surgery and Chairs the Clinical Practice and Standards Committee.

Karina graduated from Imperial College School of Medicine at St Mary’s in 1998 and completed her basic surgical training in London. She then spent two years as a clinical research fellow at Imperial College London investigating the function of immune cells in lymph nodes draining breast cancer. Following on from her research, she continued her training as a general surgeon with The London Deanery before sub-specialising in Breast and Oncoplastic surgery. In 2009, she was awarded the TIG National Breast Oncoplastic Fellowship in Manchester. In 2011, she was appointed as a Consultant Breast and Oncoplastic Surgeon at Maidstone and Tunbridge Wells NHS Trust (MTW).

Karina leads the Research and Innovation Department at MTW as well as being part of a group developing new ways to image lymph nodes and breast tumours using contrast enhanced ultrasound. She is the chief investigator of the SENTINUS study and Co-chief investigator of the LiSENUS study with Professor Mengxing Tang of Imperial College, London. As an Honorary Senior Lecturer, Karina works collaboratively with scientists in the School of Biosciences at The University of Kent, Kent and Medway Medical School and co-supervises PhD and MRes students.

As a surgeon, she is trained in breast reconstruction as well as simple and extended breast conservation including volume replacement. She maintains a team-based approach to the diagnosis and treatment of patients with breast cancer and is the current Director of Breast Screening at Maidstone Hospital. She is a Trustee of the Association of Breast Surgery and currently Chairs the Clinical Practice and Standards Committee.

Title: Technological advances and new applications for contrast enhanced ultrasound (CEUS) in axillary management

Over the last 10 years, the use of CEUS to identify and biopsy axillary sentinel lymph nodes has become established practice at Maidstone and Tunbridge Wells Breast Unit. The technique offers enhanced axillary imaging for selected patients to help clinicians and patients make treatment decisions. Although there are limitations, CEUS sentinel lymph node (SLN) core biopsy may also offer an alternative to surgical axillary staging for a large proportion of patients newly diagnosed with breast cancer. The multi-centre SENTINUS study (www.sentinustrial.com) is the first step on the path to investigate whether the procedure can live up to this promise. In parallel, the NIHR funded LiSENUS study is capitalising on technological advancements in CEUS such as super-resolution to improve the imaging of lymph nodes by allowing visualisation of the internal microvasculature. Other potential applications of axillary/ breast imaging using CEUS include monitoring the response to neo-adjuvant chemotherapy and offering tailored axillary solutions to patients having mastectomies for DCIS. Next generation CEUS may finally offer clinicians and patients a robust and reliable test to measure the volume of axillary lymph node metastases and facilitate a personalised approach to axillary treatment.

Professor Peter Gaines

Professor Gaines escaped Wakefield to spend undergraduate years in Manchester, post-graduate years in Guy’s, and a gap year in Hong Kong before taking up a Consultant post in Interventional Vascular Radiology in Sheffield. He was offered a chair at Sheffield Hallam University in 2006. Through that time over 150 peer review publications appeared as well as the now standard surgical text ‘Vascular and Endovascular Surgery’. He was President of the British Society Interventional Radiology, and worked with NICE, MHRA and finally the NHS developing procedure and reimbursement codes.

Title: A Walk on the Dark Side

Devices are used throughout all medical specialities and the industry is huge. With colleagues I have taken 3 novel devices through conception to acquisition, and am now CMO to one start-up and 1 global company.

I have been asked to take you through that journey, and hopefully inform and guide any potential entrepreneurs.

Dr Rosalind Given-Wilson

Dr Rosalind Given-Wilson is a Consultant Radiologist at St Georges Healthcare NHS Foundation Trust where she set up the breast screening service in 1991 and was Director of Screening, then Medical Director until 2015. She is Vice Chair of Moorfields Eye Hospital and Chair of United Church Schools Trust.

Rosalind has research interests in the optimisation of breast screening and decision making having published over 120 papers and abstracts and is Senior Breast Editor of the BJR. She has lectured widely and has held the Royal College of Radiologists Breast Imaging Professorship. She has been involved with work on implementing Duty of Candour in screening in the UK. She is a member of the UK National Screening Committee and chairs its adult reference group.

Title: Getting a paper published

Research aims to advance science and patient care. For the individual researcher successful peer reviewed publication disseminates their work, brings satisfaction, benefits their career, and gives opportunities for networking in the research community.

When aiming at publication it is useful to consider the point of view of editors and journal staff. They aim to increase a journals reputation and reach. A numerical proxy for reputation is the impact factor ( IF), the mean number of citations of published articles. This is kept up by ensuring high quality submissions and being selective during peer review. Thus the majority of submissions to most journals will be rejected. Increasing the chances of acceptance involves carefully selecting the appropriate journal for the submission, writing a clear paper which shows that the work is significant, original, valid, ethical, citable and relevant to the journal’s readership. In preparing a manuscript well established guidelines for reporting research such as STARD (checklist for diagnostic studies) provide a useful framework. It is also essential to follow the guidance for authors on the journals website. Open access publication will increase accessibility of the work. Beware of scams offering rapid and guaranteed publication for payment of a fee.

Once a paper has been peer reviewed and if likely to be accepted there will almost always be major or minor revisions advised by reviewers. Addressing these carefully will add value to the paper and increase the chances of final acceptance.

Dr Lyn Jones

As a consultant breast radiologist at North Bristol NHS Trust (Bristol Breast Care Centre), Lyn became interested in research into FAST MRI after reading Christiane Kuhl’s seminal paper in 2014. Lyn has since developed a programme of research, focussing on FAST MRI, in Bristol. She has built a team of researchers who together have successfully attracted funding from the National Institute for Health and Care Research (NIHR), the National Breast Imaging Academy (NBIA) and from local charities. Successes have included a local health and care award for Public and Patient Involvement in Research (PPI) and the demonstration through research that multi-professional mammogram readers from 6 sites across Southwest England can achieve diagnostic accuracy benchmarks (set for full protocol breast MRI) when interpreting FAST MRI, after only a single day of standardised small group training.

Passionate about research, breast MRI, breast screening and medical education, Lyn has contributed sessions to the NBIA on “MRI in breast cancer” and “Breast MRI: the written report” and is a Professional Mentor and an Honorary Senior Lecturer at the University of Bristol.

Title: Overview of sources of research funding in breast radiology

This talk aims to give practical tips for how to go about applying for research funding from within breast radiology. It will include:

·         who to go to locally for help and advice,
·         research team building,
· defining and presenting the research question and
·         research funding sources and how to find them.

Dr Gerald Lip

Dr Gerald Lip is the Clinical Director for breast screening in the North East of Scotland and the Chief Investigator in the mammography artificial intelligence project in the Industrial Centre for Artificial Intelligence and Digital Diagnostics in Scotland (iCaird).

He sits on the Royal College of Radiology Informatics committee, on the Advisory Board of the Centre for Doctoral Training for Biomedical AI in Edinburgh University and is a scientific advisor to the National Covid Chest Imaging Database and is part of the Special Interest Group in Artificial Intelligence in the British Institute of Radiology..

A graduate of Trinity College Dublin, along with his medical degree he also qualified with an Msc. in Health Informatics and completed his radiology training in Aberdeen. He is an honorary senior clinical lecturer at the University of Aberdeen. Dr Lip has published and spoken on topics nationally and internationally such as patient engagement, innovation in breast imaging techniques, quality assurance and safety in breast AI. As Chair of the National Breast Screening IT Group, Dr Lip helped develop and introduce the digital changeover of the Scottish Breast Screening Service to a fully digital environment bringing in regional reporting into the screening service.

Title: The iCaird Project - AI in Screening Mammography Trial - Process, Development and Results in a joint NHS, academic and commercial collaboration.

Dr Lip will speak about his research experience as part of the Industrial Centre for Artificial Intelligence and Digital Diagnostics in Scotland (iCaird) Innovate UK funded project which established a centre for AI excellence and research in Aberdeen. This involved several partners including large and small commercial companies, academia and the NHS working together throughout the pandemic establishing a digital research environment, large scale data science analysis, new techniques in artificial intelligence performed at a scale not possible before and the process of moving from face to face to online collaboration.

He will describe the results from the retrospective review of the AI research on the Aberdeen Cohort of over 80000 mammograms covering 4 years of screening activity along with key findings and implications for the future of AI in the UK breast screening services. Just as importantly he will also speak of lessons learnt along the way, other ancillary research , public and patient involvement, and further learning from this project.

Dr Lip will then speak of the benefits of the process and the current new prospective research that has sprung from this process.

Amit Goyal

Amit Goyal is a Consultant Oncoplastic Breast Surgeon & Associate Professor at University Hospitals of Derby & Burton NHS Foundation Trust. His research is focussed on axillary management in breast cancer and breast reconstruction. He is the Breast Cancer Research lead for East Midlands. His research as a part of the ALMANAC trial and NEW START training program, has helped to understand and refine the sentinel node biopsy technique. He is the Chief Investigator of the UK’s largest breast cancer surgical trials addressing the role of axillary treatment – POSNOC and ATNEC. He is the Chief Investigator of the BIOSYM randomised breast reconstruction trial that compares synthetic with biological matrices.

Goyal A, Puri S et al. A multicentre prospective feasibility study of carbon dye tattooing of biopsied axillary node and surgical localisation in breast cancer patients.

Breast Cancer Res Treat. 2021 Jan;185(2):433-440

Title: ATNEC randomised trial - de-escalation of axillary surgery post neoadjuvant chemotherapy.

ATNEC is a NIHR funded phase 3 multicentre, randomised trial. It specifically addresses axillary management following neoadjuvant chemotherapy (NACT), in patients with proven axillary node metastases at presentation on needle biopsy. The research question to be answered is:

Can local axillary therapy be safely omitted, post-surgery, in T1-3N1M0 breast cancer patients who have a complete nodal tumour response (ypN0) following NACT?

Patients whose sentinel nodes have converted to benign (ypN0) on sentinel node biopsy (SNB) will be randomised to receive either axillary treatment (nodal radiotherapy or axillary nodal clearance) versus no axillary treatment. The primary outcomes are disease free survival (DFS), and the risk of lymphoedema at five years. The study offers the opportunity to adopt node marking in a standardised way and will prospectively collect data on node marking to enable comparisons between different techniques. The study has collaboration agreements in place with industry to offer Magseed, Savi Scout and Sirius markers free of cost to mark the involved node for ATNEC trial participants.

The trial is recruiting and open to new sites. 52 NHS Trusts are open to recruitment and 152 patients have been enrolled. If your site is interested in joining the study, you can contact the trial team – atnec@warwick.ac.uk.

Dr Sarah Vinnicombe

Dr Sarah Vinnicombe is currently Lead Breast Radiologist and Deputy Director of Screening in the Thirlestaine Breast Centre, Gloucestershire NHS Foundation Trust, Cheltenham. Until 2011, she was lead Breast Radiologist and Director of Breast Screening at Barts Health, then moved to the University of Dundee to take up a Senior Lectureship in Cancer Imaging, a post she held till 2018. She is currently President of the British Society of Breast Radiology, a Trustee of Symposium Mammographicum and Vice Chair of it’s Conference Organising Committee.

In Cheltenham she leads on breast imaging research and is PI, co-investigator and CI on many national and local studies. Her main research interests are in breast density, risk adapted screening, imaging of response to neoadjuvant therapy with MRI and novel breast imaging techniques. She is a fellow of the International Cancer Imaging Society, a member of the NHS BSP Research Advisory Committee and of the NHS BSP Clinical Advisory Group, and serves on the RSNA regional committee for Europe and Educational Exhibit Award panel.

Throughout her career she has been passionate about teaching and is a regular faculty member for ECR, ESOR and RSNA. She sits on the advisory board of the National Breast Imaging Academy and is editor of the breast MRI modules.

Title: COMPULSE: Overview and Update

Dr Patsy Whelehan

Patsy Whelehan is a radiographer-consultant in NHS Tayside and an honorary senior lecturer in the University of Dundee School of Medicine. She has worked in various roles in breast screening and imaging over many years, in both England and Scotland. Patsy has been a co-investigator on a number of breast radiology studies and is the current Chief Investigator on the CONTEST study – the subject of her talk today. However, radiography research remains close to her heart and - alongside heavy current NHS responsibilities - she holds a research grant to investigate AI evaluation of clinical image quality in mammography. In June 2022, she was awarded a PhD from the University of St Andrews for work on patient experience in mammography.

Title: Contrast Enhanced Spectral Mammography with Tomosynthesis: an update on the CONTEST study