He points to a 2005 Swiss study that showed that women who had surgery in low volume hospitals had a three-fold risk of drying of breast cancer.
Similar results were reported by the West of Scotland Cancer Surveillance Unit ten years ago when they analysed the revival rates of nearly 4,000 patients and found that the 10-year survival rate for women operated on by specialist surgeons was eight per cent higher.
Another large study of breast cancer cases treated in Yorkshire between 1989 and 1994 showed that women treated by surgeons performing less than ten breast cancer operations a year faced an increased death rate of 15 per cent.
He adds that studies of other surgical procedures, including prostate cancer and operations on the pancreas and oesophagus, have also found significant differences between low and high volume institutions.
"Poor surgical technique has been linked to more complications and deaths" says Professor Fentiman. "This may become apparent immediately after complex surgery on vital organs such as the heart, but for breast cancer patients unnecessary deaths from inadequate procedures can take years to manifest.
"Although workload and hence experience is a major determinant of outcome, it is expertise that it most important. However, there is normally a close correlation between the number of procedures a surgeon carries out and his or her level of expertise.
"Quality assurance in breast cancer surgery will assume even greater importance as new techniques, which could improve patient outcomes and reduce hospital stays, become more widely used" he adds.
"It is essential that these specialist procedures are carried out by surgeons who perform sufficient numbers of breast cancer operations to develop and maintain the level of expertise needed."
Contact: Annette Whibley
Blackwell Publishing Ltd.