BMJ 1996;312:1156 (4 May)

Letters

Protocols are important

EDITOR,--The results of Charles R Gillis and David J Hole's study are interesting, but I feel their conclusion is extremely misleading.1 While it seems that the survival rate was higher for those patients treated by specialist surgeons, the paper does not answer the more vital question as to why this should be so--it merely postulates the causes of the difference seen.

The conclusion that the future care of patients with breast cancer should be provided through specialist units cannot be supported by the results of the study. What is needed is an understanding of why there was a difference in survival, leading to recommendations in a protocol for treating breast cancer. Other authors have shown that it is protocols that are the most important factor in determining patients' outcome in breast cancer, not the building in which they receive treatment.2

My fear as a lead clinician in cancer services in . . . [Full text of this article]


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Relevant Article

Survival outcome of care by specialist surgeons in breast cancer: a study of 3786 patients in the west of Scotland
Charles R Gillis and David J Hole
BMJ 1996 312: 145-148. [Abstract] [Full Text]

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