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Case study: Poole resident takes part in UK led international breast cancer study

A Poole resident is taking part in an international research study after being diagnosed with breast cancer.

Susan Williams, who is 60 and married with four children, decided to volunteer for the POSNOC study, which is looking at whether it is necessary for breast cancer patients to have an extra surgery to the armpit if the cancer has spread to the lymph nodes. 

The study, which is funded and supported by the National Institute for Health Research (NIHR), will recruit 1,900 women from over 100 hospitals across the UK, including Poole Hospital NHS Foundation Trust. The study is also taking place in 21 hospitals in Australia and New Zealand.  

Mrs Williams was told she had breast cancer following a routine mammogram in April 2019. Further mammograms, ultrasound and biopsies were required to confirm the diagnosis. It was just hours before she and her husband were due to go on a cruise to celebrate their 60th birthdays. 

Following surgery to remove nine tumours which were discovered in her left breast, Mrs Williams was told that the cancer had spread to one of the lymph nodes. 

When cancer has spread to the lymph nodes, patients are offered the choice of further surgery to remove all of the lymph nodes in the armpit and/or radiotherapy to the breast along with drug treatment.

Undergoing surgery to remove all of the lymph nodes in the armpit can have long-term side effects such as swelling of the arm, shoulder stiffness or numbness of the hand. These problems can be upsetting and difficult to cope with. 

Women now have the opportunity to be part of the POSNOC study where they will receive routine radiotherapy to the breast and drug treatment, but will be randomly allocated to undergo further surgery to remove the remaining lymph nodes in the armpit or not. 

Evidence suggests armpit surgery is unnecessary and researchers believe that drugs and radiotherapy to the breast alone can treat the cancer that has spread.

Mrs Williams decided to take part in the POSNOC study after speaking with her consultant and a research nurse at Poole Hospital. Of her decision to take part in research, Mrs Williams said: “Deciding what to do was the most difficult bit. I said to my husband, I think we ought to go for the trial. If I’m in the group that’s got to have the operation, then the decision is made for me. On the other hand, if I’m in the group that’s not having the operation, that’s even better.”

Mrs Williams was allocated to receive radiotherapy and the drug treatment alone: “My research nurse Debbie talked through everything with me. Within an hour, I found out I was in the group that wasn’t going to have the operation. I was really relieved. I didn’t really want to have another operation. I just wanted to end the chapter and move on.”

After three weeks off to recover from the surgery to remove the tumours in her breast, Mrs Williams returned to work on a phased basis. She will now be followed up at regular intervals for five years, seeing both her cancer nurse specialist and her research nurse. During the follow-up care, she will be asked to complete questionnaires focusing on her quality of life, any problems in the arm and hand and any feelings of anxiety she may have. 

Every year, more than 55,000 people are diagnosed with breast cancer in the UK. In breast cancer awareness month, Mrs Williams is looking to raise awareness of the condition and the opportunities for patients to participate in research: “Unless we do research, we won’t know. It’s probably not going to affect me, but it might help someone else in the future. It could potentially change practice, save the NHS money and stop them from doing operations that they don’t have to do.”

On the importance of mammograms, Mrs Williams added, “If I hadn’t gone for mine, I would never have known and this could all be a different story. You just don’t know what’s around the corner. Hopefully this is now the end of this horrendous period and I can count my blessings. On with life.”

Miss Clark, who is a Consultant Oncoplastic Breast and Skin Surgeon and a co-investigator of the POSNOC study at Poole Hospital, said: “Poole Breast Unit has a long history of actively taking part in national trials for new breast cancer treatments. We are very grateful to the patients who take part in clinical trials. We cannot improve breast cancer treatments without people like Mrs Williams.”

Sarah Chessell, Head of Research and Innovation at Poole, added: “We are delighted to be able to provide patients with the opportunity to join this important study. Poole is committed to providing high quality evidence-based care and growing our portfolio of research studies for the benefit of our local patients.”

Mr Amit Goyal, who is leading the study internationally said: “Together we can reduce the unpleasant side effects of breast cancer treatment. The results of this study will benefit future patients globally.”

For more information on the POSNOC trial and how to take part, please visit