Workload of surgeons involved in the treatment of breast cancer

The management of breast disease is becoming a recognized sub-speciality of general surgery. This paper describes the results of a survey undertaken in order to identify consultant general surgeons who would be willing to act as trainers of surgeons who may wish to declare an interest in breast disease. The survey has also given an insight into the workload of surgeons who are involved in the management of both symptomatic and screen-detected breast disease. The questionnaire was sent to all surgeons in England and Wales and to selected surgeons in Scotland and Northern Ireland. The response rate was 51%. The mean number of new cases of breast cancer seen per year by each surgeon was 66 with a range of 2-400. Half the surgeons were involved in the National Breast Screening Programme. The mean number of screening cases referred for biopsy per year was 46 for those involved in the screening programme. Approximately half of the surgeons who undertake breast work spend less than 20% of their time in the subject. The majority (97%) also take emergency admissions in general surgery. Twenty-five per cent carry out breast reconstructions themselves. The breast screening programme has not resulted in an excessive workload but this study has failed to show that the management of breast cancer is in the hands of those with a special interest in the subject.