The management of breast disease is becoming a recognized sub-speciali
ty of general surgery. This paper describes the results of a survey un
dertaken in order to identify consultant general surgeons who would be
willing to act as trainers of surgeons who may wish to declare an int
erest in breast disease. The survey has also given an insight into the
workload of surgeons who are involved in the management of both sympt
omatic and screen-detected breast disease. The questionnaire was sent
to all surgeons in England and Wales and to selected surgeons in Scotl
and and Northern ireland. The response rate was 51%. The mean number o
f new cases of breast cancer seen per year by each surgeon was 66 with
a range of 2-400. Half the surgeons were involved in the National Bre
ast Screening Programme. The mean number of screening cases referred f
or biopsy per year was 46 for those involved in the screening programm
e. Approximately half of the surgeons who undertake breast work spend
less than 20% of their time in the subject. The majority (97%) also ta
ke emergency admissions in general surgery. Twenty-five per cent carry
out breast reconstructions themselves. The breast screening programme
has not resulted in an excessive workload but this study has failed t
o show that the management of breast cancer is in the hands of those w
ith a special interest in the subject.