Place and training of the surgeon in breast cancer screening

The screening service needs to function efficiently and fulfil its objectives with the minimum of disturbance to the woman screened; for this to happen the full involvement of specialists with extra expertise in the subject is required. The surgeon should be involved in the interests of the programme, of the women screened and of surgery as a whole; if surgeons do not become involved they could find themselves bypassed by screening units referring to radiation oncologists, which would be to the great detriment of the patients. Local issues as to who should become the involved surgeon and with regard to the general practitioners' standing must be resolved. It would indeed be a damning indictment of medical ethics if these issues of self-interest were to stand in the way of lowering mortality rates due to breast cancer.