BMJ 1994;308:714-715 (12 March)

Letters

Management of breast cancer Refer women to multidisciplinary breast clinics

EDITOR, - In their audit of patients with breast cancer treated in the Thames regions A M Chouillet and colleagues show and comment on wide variations in the treatment delivered in early 1990 to women of the same age and with disease of the same stage.1 Reasons for these variations are not hard to identify. Women are referred to many general surgical clinics, which lack the range of skill required for managing women with breast problems. Multidisciplinary breast clinics achieve a measure of uniformity and quality by working according to agreed protocols, whose implementation can be audited prospectively.

Referral to specialised breast clinics will not eliminate variation in treatment altogether because of differences of opinion between experts. Differences in treatment practices reflecting clinical uncertainty should act as a spur to participation in large randomised trials rather than to pressure for consensus guidelines. Where the adjuvant systemic treatment of early breast . . . [Full text of this article]


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Relevant Article

Management of breast cancer in southeast England
A M Chouuillett, C M J Bell, and J G Hiscox
BMJ 1994 308: 168-171. [Abstract] [Full Text]

This article has been cited by other articles:

  • Moritz, S, Bates, T, Henderson, S M, Humphreys, S, Michell, M J (1997). Variation in management of small invasive breast cancers detected on screening in the former South East Thames region: observational study. BMJ 315: 1266-1272 [Abstract] [Full text]  
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