Breast Surgery: A Companion to Specialist Surgical Practice (3rd edn)

Abstract

The Companion series in specialist surgical practice is designed to meet the needs of surgeons in higher training and to update practising consultants. Does this book achieve its goal? Yes it does: it is superb. The book logically charts the diagnostic and therapeutic pathway of the present-day breast patient. Its structure reflects the multidisciplinary nature of modern practice in this field, with excellent chapters from radiologists and pathologists. There is an intriguing chapter on ductoscopy in breast cancer by William Dooley, hinting at a new approach in diagnosis. The surgery of breast cancer is well addressed, the editor himself considering in chapter 4 the crucial issue of the balance between good local control and cosmesis. This is a fair and up-to-date statement of the current position. There are good chapters on partial breast reconstruction and an excellent chapter by Gareth Evans and Andrew Baildam on the genetics of breast cancer and risk-reducing surgery. The chapter on breast reconstruction by Eva Weiler-Mithoff is a concise summary of modern techniques. Adjuvant therapy and radiotherapy are well covered as one might anticipate. Where the book really scores is in its chapters on ‘difficult’ subjects like ductal carcinoma in situ (DCIS). This is a masterly summary of the present situation in this relatively ill-understood condition. I enjoyed the chapter on uncommon breast cancers, as well as the chapters on psychosocial issues, palliative care and benign breast disease. It is also a salutary reminder of modern surgical breast practice that there is a chapter on litigation. How easy is this book to use? I have a series of talks on different aspects of breast cancer to deliver in the next 6 months. I have consulted it deliberately to test its usefulness and I have found it invaluable. The references are excellent, with key references flagged up with a scalpel motif, and an accompanying summary of the paper. In short, this book has most that the candidate for the Part 3 UK examination needs in preparation. The authors are leaders in their field and give a balanced view on current controversies in breast disease. Previous editions of Companions to Specialist Surgical Practice have combined breast surgery with endocrine surgery. No longer: the overall editors now recognise that breast surgery is an independent specialty that has come of age. This book contains the working detail that breast surgeons need in current practice. The emphasis is on multidisciplinary working producing good local control of disease by selecting the correct operation for the individual patient. Careful selection can achieve very acceptable oncological and aesthetic results. This book is highly commended. Each breast trainee needs their own personal copy and I am certainly not letting anyone borrow mine.