Cancer of the Breast (5th edition)


WL Donegan and JS Spratt
Published by Saunders (2002)
Distributed in Australia by Elsevier
ISBN:  0-7216-8951-5.  1025 pages plus index.
RRP:  A$390.50

This book is an update from the last edition in 1995 and is therefore a considerable advance on the previous text. Previous editions have been an excellent resource, but as always with textbooks, like computers, they quickly become outdated. With the speed of advancement in breast cancer research and treatment, this is especially so for reference texts on the topic of breast cancer.

This book, nevertheless, comprehensively covers just about all aspects of breast cancer and also has an excellent chapter on common benign conditions of the breast.  A preceding chapter by one of the few non-American authors unifies the concept of benign breast disorders, which is pertinent to anyone dealing with the “worried well”.

History never changes, but there is an excellent introductory chapter on the history of breast cancer with following chapters dealing with microscopic and gross anatomy of the breast and physiology. All the usual necessities of a breast cancer textbook are covered, which include clinical aspects around medical, radiation and surgery. Molecular biology, genetics and prevention are also dealt with well in separate chapters and a whole chapter is devoted to growth rates before leading into staging and prognosis. I found the chapter on nutrition and breast diseases quite interesting and informative. The editors of this textbook are surgeons and some of the key chapters eg In situ carcinoma of the breast, Stage IV carcinoma and Local and regional recurrence are authored by surgeons. This leads to a slight surgical bias for what are clearly multidisciplinary conditions. The non-surgeons amongst you however should not be perturbed as the chapters are still quite comprehensive and well-referenced. A large number of contributing authors provide a good coverage of many other aspects of breast cancer research and management not necessarily covered by other smaller textbooks. There are quite a few chapters that deal with aspects of metastatic disease and chapters devoted to some difficult management problems such as pregnancy and occult primary breast cancer. The final chapters deal with statistical methods and a critical analysis of clinical trials.  A whole chapter is devoted to liability issues related to breast cancer, a North American issue of equal significance in Australia.

Overall I would highly recommend this reference textbook for the generalist with a breast interest or even the highly specialised researcher or clinician.  No one knows it all and there will certainly be chapters that will educate, others that will serve as a quick ready reference and others, which the informed will wish to critically evaluate and perhaps even reach alternative conclusions.  There are only a few textbooks on the management of breast cancer that are as encyclopedic as this one and this is the most current.  It is highly recommended.

OA Ung
NSW Breast Cancer Institute
Westmead, NSW

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