Specialist surgeons and survival in breast cancer

doi:10.1136/bmj.312.7039.1155

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Breast cancer is a medical, not a surgical, disease

Karol Sikora

Professor of clinical oncology Royal Postgraduate Medical School, Hammersmith Hospital, London W12 ONN

EDITOR,—There have now been several studies of comparative survival of women with breast cancer under the care of different surgeons. Charles R Gillis and David J Hole's unique and revealing analysis in west Scotland is a further indictment of the haphazard organisation of NHS cancer services.1 If the findings of this study are extrapolated nationally, then nearly 11000 women died unnecessarily during the 1980s—surely a major scandal of neglect …