Breast Unit Guidelines
The requirements of a specialist breast unit
5.1. Critical mass
A Unit must be of sufficient size to have more than 150, newly
diagnosed cases of primary breast cancer (at all ages and stages) coming under
its care each year.
Note: these are newly diagnosed breast cancers. They may have been
diagnosed elsewhere but if they have received any prior treatment and have been
transferred, for example, to receive radiotherapy, they should not be counted.
All primary treatment must be carried out under the direction of
the Unit (operation must be in the unit, adjuvant therapies must be directed by
the unit but may have been received in other settings e.g. RT and
chemotherapy). Follow up should be under the control of the Unit.
The reason for recommending a minimum number is to ensure a
caseload sufficient to maintain expertise for each team member and to ensure
cost-effective working of the Breast Unit: the establishment of a clinic
staffed by experts is expensive and must have a high through-put of patients.
A number of Units will be recognised as teaching centres,
nationally or internationally. They may be recognised for teaching overall
breast cancer management or special aspects (e.g.) screening, reconstruction,