Surgical trainees are poorly trained and do not have the necessary skills to provide an emergency service for upper GI haemorrhage. Emergency endoscopy facilities are severely under resourced.
Aims: To examine the correlation between margin and cavity biopsy status following conservative surgery for invasive breast cancer. Does cavity biopsy increase the detection of residual disease? Methods: In 510 patients who had conservative surgery for invasive breast cancer, four quadrant biopsies of the residual cavity were compared with the margin. Where repeat excision was performed, the presence of residual disease was recorded. Results: The margins were positive in 102 cases and the cavity in 112, but the concordance was only 57/157 cases (36 per cent). Simultaneously, clear margins and cavities were found in 353 cases (69 per cent). Cavity biopsy was the sole evidence of incomplete resection in 40 per cent of ductal and 19 per cent of lobular cancers. Evidence of residual disease after re‐excision was found in 33 per cent of ductal and 52 per cent of lobular cancers. Conclusion: There is poor correlation between margin status and cavity biopsy. Biopsy of the residual cavity after conservative surgery for breast cancer increases the detection of residual disease by 35 per cent.
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