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.