Quality control in breast cancer treatment: what information can the surgeon provide?

In terms of quality control, the surgeon carries responsibility for the accurate measurement and recording of clinical signs at the time of first presentation. Furthermore, the surgeon has to obtain efficiently a histopathological specimen of the primary tumour and also to formulate a plan for the most effective treatment of the primary tumour and axillary lymph nodes. As part of quality control in management of infiltrating carcinomas, axillary clearance should be intrinsic to the primary treatment whether this is mastectomy or a breast conservation technique. Failure to clear the axilla can result in under-staging so that adjuvant systemic therapy may not be given to patients who might benefit from such treatment. There is need for close cooperation between radiotherapists and surgeons in the management and follow up of patients with early breast cancer.