P Rosen (Ed)
Published by Lippincott Williams & Wilkins (2001)
ISBN: 0-7817-2379-5. 990 pages plus index.
Professor Rosen is well known to surgical pathologists whether or not they are interested in breast pathology. He has published extensively on the subject and has been a leader in the field for over 20 years. He has written the definitive single author book on breast pathology and this is the revised second edition of that book. As the author describes it in the preface, the book is a “comprehensive, extensively illustrated description of breast pathology in a clinical context”. It is exactly that, and I would add that it is the best text on breast pathology available and is required buying for any pathologist interested in breast pathology. The 990 pages of the book are beautifully illustrated mainly in colour. Unlike many current pathology texts in which the colour reproduction is often of variable quality throughout the work, in this book the colour illustrations are of uniformly high quality.
The 46 chapters commence with a description of breast anatomy and physiology and then progress through all the categories of breast disease from benign through pre-cancerous lesions to in-situ and invasive carcinoma. In each of these chapters there is much more than just a description of the pathology features and differential diagnosis. The clinical significance, appropriate treatment and prognosis of the various pathological conditions are all discussed, and at the end of each chapter there is a complete reference list with citations up to the year 2000.
Immunohistochemistry, ultrastructure and molecular studies are also covered. Current areas of investigation or new techniques such as sentinel lymph node biopsy and conventional and vacuum-assisted core biopsy are discussed in depth both in their own right and also referred to in the context of the interpretation of pathology findings. Conditions that are being increasingly recognised such as “columnar cell change” are well described and beautifully illustrated. I particularly liked the chapters on lobular carcinoma in-situ and atypical lobular hyperplasia, and invasive lobular carcinoma because of their clarity, practical emphasis and discussion of risk factors. The last chapter addresses practical issues such as specimen handling, frozen sections, specimen radiography and the pathological changes in the breast following needle biopsy. Professor Rosen has had a particular interest in the latter and illustrates a number of interpretive problems such as displaced epithelium. Those seeking detailed information and illustrations on the cytology of breast disease may be disappointed as although addressed, the details are less comprehensive that those available in other specific cytology texts.
If you are a pathologist encountering breast pathology on a regular basis and even if you already have the first edition of Rosen’s Breast Pathology, buy the second edition as it is better. The historical section on in-situ disease and the overlong section on slide packaging in the first edition have gone and the information is right up-to-date.
A surgeon or oncologist wishing to have a means of learning more about breast pathology should also consider buying this book. For trainees in all the above disciplines particularly those considering specialising in breast disease, this is the ideal reference for you.