Peter Barry

Peter Barry gained his fellowship in general surgery from the Royal Australasian College of Surgeons in 1997. He then undertook clinical fellowships in surgical oncology in Sydney and London at the Royal Marsden Hospital 1998-2001 in sarcoma (rare cancers), melanoma and breast surgery. He practiced as a surgical oncologist, oncoplastic breast and endocrine surgeon in Australia until 2012 when he returned to the Royal Marsden Hospital as a consultant oncoplastic surgeon.

Mr Barry’s expertise is incorporating complex oncoplastic techniques to optimise cancer-related outcomes whilst addressing the patient’s aesthetic needs and minimising risks and complications of treatment.

In his NHS practice at the Royal Marsden Hospital, he commenced and developed the perforator flap service for partial breast volume replacement. He also developed methods for targeted axillary dissection (selective lymph node removal for cancer). He leads trials of new devices for localisation of breast lesions to facilitate complex breast conservation surgery for cancer and innovations in breast implants for immediate reconstruction.

Mr Barry’s focus is on identifying patient priorities. From the first consultation he assesses individual patient aims and in a shared decision-making process, will plan tailored management aligned to patient goals. This is achieved within a multidisciplinary framework ensuring appropriate referrals within a network of experts in the team. He interfaces closely with clinical geneticists, radiologists, medical oncologists and plastic and reconstructive surgeons as well as breast care nurses, physiotherapists, lymphoedema practitioners, liaison psychologists and experts in pain medicine and acupuncture.

Mr Barry is an internationally renowned speaker and tutor on oncoplastic breast surgical techniques and concepts. At the Royal Marsden, he trains international surgical fellows in these oncoplastic techniques. He has an interest in breast cancer biology and tumour evolution as well as liquid biopsy and circulating tumour markers. He is very closely involved in international collaborative research within the breast surgical community and has over 50 peer reviewed publications.

Clinical focus:

Speciality: Benign breast issues, high risk patients, new breast cancer diagnosis, oncoplastic reconstructive surgery and those with complications from prior cancer treatments.

Advanced imaging: As part of his routine clinical practice, Mr Barry utilises 3D MRI for complex breast conservation and hand-held ultrasound for detailed surgical planning and symptom troubleshooting.

Procedures: All aspects of breast related surgical treatment are offered.

· oncoplastic techniques for breast conservation including breast lift and reduction procedures as part of cancer removal

· volume replacement using local perforator flaps and lipomodelling / fat transfer.

In the most challenging situations, he combines these techniques to optimise cancer and cosmetic outcomes for patients.

· ‘conservative’ (skin / nipple-sparing) mastectomy for both risk reduction in high-risk women (such as those who have a germline high risk inherited gene) or those with established breast cancer or pre-cancerous change combined with immediate breast reconstruction (implant-based).

· Matching procedures for the unaffected breast are offered during the same procedure using a buddy system with a trusted colleague

· He collaborates extensively with his plastic surgical colleagues to also offer immediate autologous reconstruction (e.g. DIEP) using patients’ native tissues.

Mr Barry is a strong advocate for simplifying treatment for breast cancer both in the breast and for lymph node surgery. He believes that less aggressive lymph node surgery should be carried out –only removing abnormal lymph nodes where possible to reduce risks such as lymphoedema.

· highly precise procedures such as sentinel node removal is offered as an option where appropriate.

· Targeted axillary dissection

· locally recurrent breast cancer procedures and re-do axillary (armpit) and lower neck lymph node surgery for cancer relapse following prior treatment

· lipo-modelling (fat grafting) for

· breast contour deformities

· other forms of scarring after previous breast cancer treatment

· scars from ports,

· radiotherapy-related problems

· chemotherapy scarring of arm veins.

· use of local flaps for breast deformity following prior cancer surgery.



Key surgical benchmarks:

Implant loss rate <1% (national average 13%)

Breast conservation rate >90%

Margin re-excision rate (2nd surgery) in breast conservation <5% (national target 20%)