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A review of current practices in breast conservation surgery in the UK.

INTRODUCTION
The aim of this study was to assess whether surgeons in the UK were practising wide excision consistent with current guidelines and current evidence.


PATIENTS AND METHODS
Questionnaires were sent to 200 breast surgeons throughout the UK to determine current practices in breast conserving surgery.


RESULTS
When performing a wide excision for invasive cancer, 61% of respondents always remove full thickness of breast tissue and 37% usually do. Of surgeons, 60% rarely use specimen X-ray for palpable lesions. However, 91% always take specimen X-rays in impalpable lesions, but 9% do not always take specimen X-rays for impalpable lesions. In 93% of units, the pathologist always reports the distance to the nearest margin. For both invasive and in situ cancer, there is a wide variation in what is considered an adequate radial margin. There is wide variation in the practice of re-excision. Of surgeons, 50% indicated that they wish wider margins in the presence of an extensive in situ component and 39% wish wider margins in younger women.


CONCLUSIONS
The results show a large variation in practice with many surgeons not treating patients in accordance with current guidelines and evidence.