Who should run breast clinics, surgeons or radiologists?

Demand management remains a difficult problem to resolve throughout the NHS. Nowhere has this been more so that in symptomatic breast clinics which have witnessed continued increase in referral over many years. These difficulties have been compounded by changes to the role of junior medical staffing, an expectation that the service is consultant based, the demands of the two-week wait' rule and the potential need to see all patients within this time-frame. These two papers provide local evidence that it is possible to run symptomatic breast clinics either by surgeons or, in part, by radiologists. Cretainly, it is an advantage to have available full radiological support in the clinic to aid not only with imaging but also to perform directed biopsy. The key question is whether surgeons can adopt these skills - especially in the presence of a well staffed radiology department keen to maintain this role. Surgeons should be aware that, if they do not embrace these diagnostic techniques, radiology departments may make major inroads into symptomatic breast clinics and that their role in this specialty may become attenuated to that of surgical technicians.