Breast cancer patients operated on 10 years ago by specialists have done better than those treated by surgeons with fewer breast cancer patients, a Yorkshire study reveals.
Reporting their results in the British Journal of Cancer1, Cancer Research UK scientists found that patients operated on by surgeons with an annual breast cancer caseload of more than 50 patients have a 68 per cent chance of survival after five years.
But the survival rate dropped to 60 per cent among patients whose surgeons performed fewer than 10 breast cancer operations a year. So if a specialist surgeon operates on 100 women, 8 more women will survive at least 5 years than if all 100 of them had been operated on by a less experienced colleague.
The study was carried out by Cancer Research UK using data from the Northern and Yorkshire Cancer Registry Information Service (NYCRIS) and was based on more than 11,000 patients over a five-year period.
It also found that the patients of specialist surgeons were more likely to have chemotherapy.
Dr Jasmina Mikeljevic, who led the study for Cancer Research UK at St James’ Hospital in Leeds, says: “Patients whose surgeons performed more than 30 breast cancer operations a year were less likely to have surgery on its own and more likely to have additional treatment.
“This is because surgeons with higher caseloads usually work in multi-disciplinary teams where they would join a wide range of cancer specialists and so patients would have more comprehensive access to other treatments.
“Our figures for survival were based on patients treated between 1989 and 1994. We believe the situation has steadily improved in Yorkshire since then and future data should bear this out.”
In 1996, the Department of Health recommended that patients should be managed by breast cancer teams, which would include specialist surgeons. Dr Mikeljevic believes the results of the NYCRIS study reinforce the importance of this recommendation.
Dr John Toy, Medical Director at Cancer Research UK, says: “The study indicates that a woman with breast cancer has a better outlook if she is looked after by a team of expert medical staff working together as members of a multi-disciplinary team. Such a team should obviously include a specialist surgeon, who is doing breast cancer operations frequently.
“Wherever a woman with breast cancer is being treated in the NHS, she should expect the best possible care, which means being treated by the appropriate expert multi-disciplinary team.”
- British Journal of Cancer89 (3)