The surgeon's role in breast screening.

The early detection of breast cancer by mammographic screening reduces the mortality of the disease. In the United Kingdom, a national screening service is being established for women 50-64 years of age by single mediolateral oblique mammography every 3 years. It is stressed that the basic mammograph is only the first stage in the screening procedure. The multidisciplinary assessment of mammographic abnormalities is a second critical step by which the need for biopsy is determined. The surgeons involved in screening programs must also appreciate the significance of the methods of assessment used. They must also be knowledgeable of the methods for biopsy of impalpable lesions and of the treatment of the noninvasive and small-invasive cancers. Ideally, they should be full members of the multidisciplinary team responsible for the program. These roles are reviewed.