Ashley Charitable Trust


Burton King is a general surgeon with a special interest in breast cancer management.

The Ashley Charitable Trust was delighted to provide a Fellowship to Burton King, who came to the UK from New Zealand for nine months to work with Michael Greenall, Jane Clarke and Professor Adrian Harris at the Churchill Hospital.

Burton King was looking to further his experience in the management of breast disease in general and breast cancer in particular. He assisted with several areas of research conducted by the Breast Unit including:

  • Breast screening – audit and outcomes;
  • Breast cancer surgery – extent and complications;
  • Molecular markers in breast cancer and gene therapy.

His work involved the assessment of women who had been recalled because of abnormalities seen on their screening films. Women who have undergone screening can be compared to unscreened patients. This latter group (symptomatic women) would be diagnosed only after discovery of a breast lump.

Burton King performed a study comparing these two groups (screened vs symptomatic) and looked at recurrence of breast cancer after breast saving surgery and radiotherapy.

Burton King examined whether interval cancers behave differently in comparison to cancers in unscreened women. Interval cancers are breast tumours that are discovered in between three yearly screening, i.e. the woman discovers a breast lump after she has been told that she has a normal mammogram, but before her next screening. In addition, the research showed that approximately 60% of interval cancers occur within two years following the screening – this suggests that reducing screening intervals from three years to two years may be beneficial.

King also assisted with a study comparing the survival of women after the removal of lymph nodes. Breast cancer surgery involves operating on the glands under the arm on the same side as the affected breast. The national guidelines are to remove at least four lymph nodes. The study compared the survival of women with adequate (>4 nodes) compared to inadequate (<4 nodes). The survival in the latter group was worse than the former. The result validated the national guideline to excise at least four nodes. This report was presented at the British Association of Surgical Oncology and published.

*FRACS is a Fellow of the Royal Australasian College of Surgeons. The distinction is only awarded to specialist surgeons who have completed a minimum of 12 years medical and surgical education, with at least five years of specialist postgraduate training. A specialist plastic surgeon with the letters 'FRACS' appearing after their name is accredited to perform invasive reconstructive and cosmetic plastic surgery.