London Breast Health

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Professor Zoe Winters

PhD (Oxon), FRCS (Edin), FCS (SA) SFHEA (UCL)

Consultant Breast Cancer Surgeon

and

Breast Specialist

Breast Cancer Breast Pain Breast Lumps Lymph Nodes

Women with breast cancer and benign breast problems

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Publications

Click here for Academic Journal Papers on PubMed

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Research Gate

Professor Zoe Wintes academic achievements

Khajuria A, Charles WN, Prokopenko M, Beswick A, Pusic AL, Mosahebi A, Dodwell DJ, Winters ZE. BJS Open. 2020 Apr;4(2):182-196. Immediate and Delayed Autologous Abdominal Microvascular Flap Breast Reconstruction in Patients Receiving Adjuvant, Neoadjuvant or No Radiotherapy: A Meta-Analysis of Clinical and Quality-Of-Life Outcomes

Bjelic-Radisic V, Cardoso F, Cameron D, Brain E, Kuljanic K, da Costa RA, Conroy T, Inwald EC, Serpentini S, Pinto M, Weis J, Morag O, Lindviksmoen Astrup G, Tomaszweksi KA, Pogoda K, Sinai P, Sprangers M, Aaronson N, Velikova G, Greimel E, Arraras J, Bottomley A; EORTC Quality of Life Group and Breast Cancer Group. 2020
An International Update of the EORTC Questionnaire for Assessing Quality of Life in Breast Cancer Patients: EORTC QLQ-BR45

Nava MB, Benson JR, Audretsch W, Blondeel P, Catanuto G, Clemens MW, Cordeiro PG, De Vita R, Hammond DC, Jassem J, Lozza L, Orecchia R, Pusic AL, Rancati A, Rezai M, Scaperrotta G, Spano A, Winters ZE, Rocco N.2019
International Multidisciplinary Expert Panel Consensus on Breast Reconstruction and Radiotherapy

Winters ZE, Bernaudo L. Evaluating the Current Evidence to Support Therapeutic Mammoplasty or Breast-Conserving Surgery as an Alternative to Mastectomy in the Treatment of Multifocal and Multicentric Breast Cancers

Winters ZE, Khajuria A. Quality of Life After Breast Reconstruction-The BRIOS Study 2019 Nov;19(11):e579.

Winters ZE, Benson JR. Can Patients With Multiple Breast Cancers in the Same Breast Avoid Mastectomy by Having Multiple Lumpectomies to Achieve Equivalent Rates of Local Breast Cancer Recurrence? Response to the Preliminary Alliance 11102 Trial Report 2018

Cutress RI, McIntosh SA, Potter S, Goyal A, Kirwan CC, Harvey J, Francis A, Carmichael AR, Vidya R, Vaidya JS, Fairbrother P, Benson JR, Reed MWR; Association of Breast Surgery Surgical Gap Analysis Working Group
October, 2018 Opportunities and Priorities for Breast Surgical Research

Winters ZE, Horsnell J, Elvers KT, Maxwell AJ, Jones LJ, Shaaban AM, Schmid P, Williams NR, Beswick A, Greenwood R, Ingram JC, Saunders C, Vaidya JS, Esserman L, Jatoi I, Brunt AM. Briish J 2018 Systematic Review of the Impact of Breast-Conserving Surgery on Cancer Outcomes of Multiple Ipsilateral Breast Cancers

Oberguggenberger AS, Nagele E, Inwald E.C, Tomaszewski K.A, Lanceley A, Nordin A, Creutzberg C.L., Kuljanic K, Kardamakis D, Schmalz C, Arraras J, Costantini A, Almont TWei-Chu Chie, Dehandschutter S., Winters Z, Greimel E. Phase 1 to 3 of the cross-cultural development of an EORTC questionnaire for the assessment of sexual health in cancer patients: the EORTC SHQ-22. Cancer Medicine 2017.

Winters ZE and Benson J. The surgical treatment of multiple ipsilateral breast cancers (MIBC). British J. Surg. 2018 DOI:1002/bjs.10738. Lead author, idea, trial design and paper writing: 70%

Mercieca-Bebber R, King M, Boxer M, Spillane A, Winters ZE, Butow P, McPherson J, Rutherford C. What quality of life issues do women with ductal carcinoma in situ consider important when making treatment decisions? The Breast, 2017; Feb 28. doi: 10.1007/s12282-017-0765-0.

Winters ZE, Horsnell J, Elvers KT, Maxwell AJ, Jones LJ, Shaabaan AM, Schmid P, Williams N, Greenwood R, Ingram JC, Saunders C, Vaidya JS, Esserman L, Jatoi I, Brunt AM. Systematic review: What is the impact of breast conserving surgery on cancer outcomes of multiple ipsilateral breast cancers (MIBC)? A case for generating first class evidence and future recommendations. British J. Surg. Open 2018, in press. Responsible for idea, study design and paper writing: 70%.

Winters ZE, Afzal M, Rumpold G, Holzner B, Oberguggenburger A, Vieira RAC, Hartnup S, Filcroft K, Bjelic-Radisic V, Panouilleres M, Rydevik Mani M, King MTand Rutherford C. International validation of the EORTC QLQ-BRECON23 questionnaire assessment for women undergoing breast reconstruction. British J. Surg. 2017: DOI:1002/bjs.10656. Responsible for idea, funding, trial conduct and paper writing: 80%.

Bided N, MacDonald L, Winters ZE, Edwards S, Emson M, Griffin C, Bliss J, Horne R. How informed is declared altruism in clinical trials? A qualitative interview study of patient decision-making about the QUEST trials (Quality of Life after Mastectomy and Breast Reconstruction). Trials; TRLS-D 16-00198R1

Benson JR, Winters ZE. Contralateral prophylactic mastectomy. Editorial for the BJS Jul 28. dos:10.1002/bjs. 10223

Winters ZE, Hornsnell J, Schmid P, Jones JL, Shaaban A, Mazwel AJ, Williams N, Esserman L, Jatoi I, Brunt MA, on behalf of MIAMI (Multiple Ipsilateral breast cancers for breast conserving surgery versus mastectomy) Trial Management Group. Time for a randomised clinical trial evaluating breast conserving surgery compared to mastectomy in ipsilateral multifocal breast cancer (MFBC)? Breast 2016 Apr;26: 149-50. doi: 10.1016/j.breast.2015.12.011

Winters ZE, Maryam A, Vasiliki B, Freeman J, Llewellyn-Bennett R, Rayter Z, Cook J, Greenwood R and King MT on behalf of the Prospective Trial Management Group. Patient Reported Outcomes (PRO's) after immediate latissimus dorsi breast reconstruction and adjuvant treatments, and their predictors at two and three-year follow-up. BJS 2016; 103(5):524-536.

Thomson HJ, Winters ZE* (corresponding), Brandberg Y, Didier F, Blazeby JM, Mills J. The early development phases of a European Organisation for Research and Treatment of Cancer (EORTC) module to assess patient reported outcomes (PROs) in women undergoing breast reconstruction. European J. Cancer 2012, Oct.11. DOI; 10.1016/j.ejca.2012.09.021.

Winters ZE* (corresponding), Haviland J, Balta V, Benson JR, Reece-Smith A, Betambeau N. Intergration of patient-reported outcome measures with key clinical outcomes after immediate latissimus dorsi breast reconstruction and adjuvant treatment. Brit J Surg. 2012; 99(Aug.) DOI: 10.1002/bjs.8959.

Llewellyn-Bennett R, Greenwood R, Benson JR, English R, Turner J, Rayter Z, Winters ZE* (corresponding). Randomized clinical trial on the effect of fibrin sealant on latissimus dorsi donor-site seroma formation after breast reconstruction. Br J Surg. 2012; 99(10): 1381-8.

Bidad N, MacDonald L, Winters ZE, Edwards SJL, Horne R. Views on the right to withdraw from randomised controlled trials assessing quality of life after mastectomy and breast reconstruction (QUEST): findings from the QUEST Perspectives Study (QPS). Research Ethics 2014; 10 (47) doi: 10.1177/1747016114524503. Contribution to paper writing: 50%.

Winters ZE, Emson M, Griffin C, Mills J, Hopwood P, Bidad N, Turton EPL, Horne R, Bliss J: on behalf of the QUEST Trial Management Group. Quality of life following mastectomy and breast reconstruction (QUEST): learning from two feasibility randomised trials (Cancer Research UK (CRUK) /08/027). BJS 2015; 102 (1): 45-56. Responsible for idea, funding, trial conduct and paper writing: 80%.

Winters ZE, Griffin C, Horne R, Bidad N, McCulloch P. Barriers to accrue to clinical trials and possible solutions. Invited editorial submitted to British J. of Cancer, 24th June 2014 doi: 10.1038/bjc.2014.318. Conceived idea, contribution to paper writing, 70%.

Turner EJH, Benson JR, Winters ZE. Techniques in the prevention and management of seromas after breast surgery. Future Oncology 2014 May; 10 (6): 1049-63. Responsible for idea, supervision and paper writing: 60%.

Winters ZE and Colwell AS. The role of Acellular Dermal Matrix (ADM) assisted implant breast reconstruction in current practice. BJS 2014; 101; 444-445. Responsible for idea and paper writing: 80%.

Winters ZE, Balta V, Thomson HJ, Brandberg Y, Oberguggenberger A, Sinove Y, Unukovych D, Nava M, Sandelin K, and Johansson H, on behalf of the EORTC Quality of Life (QL) Group. Phase III development of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) module for women undergoing breast reconstruction: The EORTC QLQ-BRR26. BJS 2014 Mar; 101 (4): 371-82. Responsible for idea, funding, grant and paper writing: 70%.

Chaudhry A, Williams S, Cook J, Jenkins M, Mohammed S, Calder C, Winters ZE, Rayter Z. The real-time intra-operative evaluations of sentinel lymph nodes in breast cancer patients using One Step Nucleic Acid Amplification (OSNA) and implications for clinical decision-making. European J Surgical Oncology 2014 Feb; 40 (2): 150-7. Responsible for patient recruitment, and paper writing: 60%.

Douek M, Klaase J, Monypenny I, Kothari A, Zechmeister K, Brown D, Wyld L, Drew P, Garmo H, Agbaje O, Pankhurst Q, Anninga B, Grootendorst M, Ten Haken B, Hall-Craggs MA, Purushotham A, Pinder S; SentiMAG Trialists Group. Ann Surg Oncol. 2014 Apr; 21(4): 1237-45. doi: 10.1245/s10434-013-3379-6. Epub 2013 Dec 10. Invited member of Trial Data Steering Monitoring Committee.

English R, Metcalf C, Day J, Rayter Z, Blazeby JM; breast cancer multi-disciplinary team. A prospective analysis of implementation of multi-disciplinary team decisions in breast cancer. Breast J. 2012; 18(5): 459-63.

Winters ZE* (corresponding) and Thomson HJ. Assessing the clinical effectiveness of breast reconstruction through patient reported outcome measures (PROMs), the new metric to complement clinical outcomes in future treatment. BJS 2011; 98:323-325.

McIntosh J, Dennison G, Holly JMP, Jarrett C, Frankow A, Foulstone EJ, Winters ZE* (corresponding author), Perks CM. IGFBP-3 can either inhibit or enhance EGF-mediated growth of breast epithelial cells dependent upon the presence of fibronectin. Journal of Biological Chemistry 2010; 285(50): 38788-800.

Zeng L, Biernacka KM, Holly JMP, Morrison A, Morgan A, Winters ZE, Foulstone, EJ, Shield JP, Perks, CM. Hyperglycemia confers resistance to chemotherapy on breast cancer cells: the role of fatty acid synthase. Endocrine-related Cancer 2010; 17(2): 539-51.

Winters ZE* (corresponding), Benson J, Pusic AL. A systematic review of the clinical evidence to guide treatment recommendations in breast reconstruction based on patient- reported outcome measures and health-related quality of life. Annals of Surgery 2010; 252(6): 929-42.

Kenemans P, Bundred NJ, Foidart JM, Kubista E, von Schoultz B, Sismondi P, Vassilopoulou-Selin R, Yip CH, Egberts J, Mil-Arts M, Mulder R, van Os S, Beckman MW; LIBERATE Study Group. Safety and efficacy of tibolone in breast cancer patients with vasomotor symptoms: a double blind, randomised, non-inferiority trial. Lancet Oncology 2009; 10(2): 135-46.

Potter S, Thomson HJ, Greenwood RJ, Hopwood P, Winters ZE* (corresponding). Health-related quality of life assessment after breast reconstruction BJS 2009; 96:613-620.

Thomson HJ, Potter S, Greenwood RJ, Bahl A, Barker J, Cawthorn SJ, Winters ZE. A prospective longitudinal study of cosmetic outcome in immediate Latissimus Dorsi breast reconstruction and the influence of radiotherapy. Annals of Surgical Oncology 2008; 15 (4): 1081-91.

Daltrey I, Thomson H, Hussein M, Rayter Z, Winters ZE* (corresponding). A randomised trial of the effect of quilting latissimus dorsi flap donor site on seroma formation. Br J of Surg 2006: 93 (7): 825-830.

McGurk R, Fallowfield L, Winters ZE* (corresponding). Information provision for patients by breast cancer teams about the side effects of hormone treatments. Europ J Ca 2006; 42(12): 1760-1767.

Burrows C, Holly JM, Laurence NJ, Vernon EG, Carter JV, Clark MA, McIntosh J, McCaig C, Winters ZE, Perks CM. Insulin-like growth factor binding protein 3 has opposing actions on malignant and non-malignant breast epithelial cells that are each reversible and dependent upon cholesterol-stabilized integrin receptor complexes. Endocrinology 2006; 147(7): 3484-500.

Clark MA, Perks CM, Winters ZE* (corresponding author), JMP Holly. DNA-damage uncouples the mitogenic response to IGF-I in MCF-7 malignant breast cancer cells by switching the roles of PI3-kinase and p21WAF1/Cip1. Int J Cancer 2005; 116:506-513.

Vestey SB, Perks CM, Sen C, Calder CJ, Holly JMP, Winters ZE* (corresponding). Immuno-histochemical expression of insulin-like growth factor-binding protein-3 in invasive breast cancers and DCIS - implications for clinicopathology and patient outcome. Breast Cancer Research 2005; 7(1): R119-29.

Vestey SB, Sen C, Calder CJ, Perks CM, Pignatelli M, Winters ZE* (corresponding). Activated Akt expression in breast cancer - relationships to p53, Hdm2 and patient outcome. Europ J Cancer 2005; 41:1017-1025.

Vestey SB, Sen C, Calder C, Perks C, Pignatelli M, Winters ZE* (corresponding). P14ARF Expression in invasive breast cancers and DCIS - relationships to p53 and Hdm2. Breast Cancer Res 2004; 6(5): R 571-85.

Perks CM, Keith AJ, Goodhew K, Savage PB, Winters & Holly JMP. Prolactin acts as a potent survival factor for human breast cancer cell lines. Br J Cancer 2004; 91: 305-11.

Winters ZE* (corresponding), Leek RD, Bradburn MJ, Norbury CJ, Harris AL. Cytoplasmic p21WAF1/CIP1 expression is correlated with HER-2/neu in breast cancer and is an independent predictor of prognosis. Breast Cancer Res 2003; 5(6): R242-9.

Winters ZE* (corresponding), Hunt NC, Bradburn MJ, Royds JA, Turley H, Harris AL, Norbury CJ. Subcellular localisation of cyclin B, Cdc2 and p21WAF1/CIP1 in breast cancer: association with prognosis. Eur J Cancer 2001; 37(18): 2405-2412.

Winters ZE* (corresponding). p53 pathways involving G2 checkpoint regulators and the role of their subcellular localisation. Journal of the Royal College of Surgeons of Edinburgh 2002; 47 (4): 591-598.

Winters ZE. Prognosis and treatment of patients with breast tumours of 1cm or less and negative axillary lymph nodes. Edit Rev in CME Breast 2002; 1 (3): 77-78. First and corresponding author.

Winters ZE* (first author), Ongkeko RM, Harris AL, Norbury CJ. p53 regulates Cdc2 independently of inhibitory phosphorylation to promote G2 arrest after exposure of human cells to ionising radiation. Oncogene 1998; 17: 673-684.

Winters ZE (first and corresponding author), Rowland G, Lombard C, Arendse H, Tyler M, Hickman R. The changes in circulating Hepatocyte Growth Factor after partial hepatectomy in the baboon. South African Journal of Surgery, 1998; 37 (2): 31-37.

Winters ZE* (first and corresponding author), Mohube P, Gray C, Teare J, Lange M, Mannell A, Myburgh JA. Tumour kinetics in breast cancer. South African Journal of Surgery 1994; 32(4): 135-140.

Winters ZE* (first and corresponding aurthor), Gray C, Wright C, Mannell A. Flow Cytometry and tumour aggression in breast cancer. Research in Surgery 1993; 5(2): 127-131.

Winters ZE, Mannell A. Parotid haemangioma. A case report. South African Journal of Surgery 1990; 28(3): 105-106.

Mannell A, Winters ZE. Carboplatin in the treatment of oesophageal cancer. South African Medical Journal 1989; 76(5): 213-215.

Winters ZE, Mannell A, Esser J. Breast cancer in black South Africans. South African Journal of Surgery 1988; 26(2): 69-70.

Winters ZE, Mannell A. An unusual cause of haemoperitoneum. A case report. South African Medical Journal 1987; 71(7): 464-465.

Winters ZE, Mannell A. Kaposi Sarcoma of the oral cavity. A case report. South African Medical Journal 1985; 68(5): 330-331.

Ballot N, Delaney N, Erskine P, Langridge P, Smit K, Van Niekerk N, Winters ZE, Wright N. Anorexia Nervosa - prevalence study. South African Medical Journal 1981; 59(27): 992-993.

PUBLISHED LETTERS

Winters ZE, Llewellyn-Bennett R. Authors' reply: Randomized clinical trial on the effect of fibrin sealant on latissimus dorsi donor-site seroma formation after breast reconstruction (BJS 2012; 99: 1381-1388). BJS. 2013 Nov; 100 (12): 1671.
Winters ZE, Llewellyn-Bennett R. Randomised clinical trial on the effect of fibrin sealant on latissimus dorsi donor-site seroma formation after breast reconstruction. BJS 2013; 100; 1671 (l. Senior and corresponding author: 70%.
Winters ZE*. Prophylactic mastectomy and the timing of breast reconstruction. BJS 2009; 96: 823-827.
Winters ZE. Immediate breast reconstruction should be challenged. BMJ 2009 Mar 17; 338: b1067.
Vestey S and Winters ZE*. Immunohistochemical detection of the alternate INK4A-encoded tumour suppressor protein p14ARF in archival human cancers and cell lines using commercial antibodies: correlation with p16INK4A expression. Mod. Pathol. 2002 15: 1106-1107 (letter).

INVITED BOOK CHAPTERS

Heetun A and Winters ZE (corresponding). The management of Multicentric and Multifocal Breast Cancers. Book called Modern Oncoplastic Breast Surgery. Editors Kissin M and Subramanian A. Publishers; Taylor and Francis, invite May 2017.
The management of Multicentric and Multifocal Breast Cancers for: Modern Oncoplastic Breast surgery, Taylor and Francis publishers, UK 2017
Winters ZE (Corresponding), Llewellyn-Bennett R. Clinical Effectiveness of Breast Reconstruction through Patient Reported Outcome Measures. Invited book chapter for Breast Reconstruction, Art, Science and New Clinical Techniques by Professor Melvin A. Shiffmann, MD, California USA, and Springer publishers. In preparation for submission: September /October 2014.
Winters ZE (Corresponding), Llewellyn-Bennett R. Phase 3 development of the European Organisation for research and Treatment of Cancer Quality of Life questionnaire module for women undergoing breast reconstruction. Invited book chapter for Breast Reconstruction, Art, Science and New Clinical Techniques by Professor Melvin A. Shiffmann, MD, California USA, and Springer publishers. In preparation for submission: September /October 2014.
Barker J, Llewellyn-Bennett R, Winters ZE* (corresponding). The evolving role of the Breast Care Nurse in the management of patients with early breast cancer. In: Benson JR, Gui G, Tuttle TM, Editors. Early Breast Cancer: from screening to multidisciplinary management: CRC Press/ Informa Healthcare, Taylor & Francis group Publishers, 2013.
Winters ZE* (corresponding), Chaudry A. Breast Reconstruction: How do we Measure and Define Patient's Quality of Life and Satisfaction. Recent Advances in Surgery 35. London: Jaypee Brothers Medical Publishers, 2012. p. 45-56.
Benson JR, Turner EH, Winters ZE* (corresponding). Breast Cancer: Side effects of tamoxifen and anastrazole. Handbook of Breast Cancer. Editor MA Hayat, Kean University USA. In Methods of cancer diagnosis, therapy and prognosis. Volume 1. Breast Carcinoma, Dr MA Hyat (Ed) Springer. 2008. Chapter 31, pages 433-457.
Potter S and Winters ZE. Quality of Life after breast-conserving surgery. High Beam Research online: Advances in Breast Cancer 2008, March 1st.