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Atlas of breast surgical techniques
Journal of Plastic, Reconstructive & Aesthetic Surgery (2010) 63, 1579
BOOK REVIEW Atlas of breast surgical techniques, Klimberg V Suzanne, editor, Saunders Elsevier, 2010, p. 456 CD-ROM and online access, $249.
“A picture is worth a thousand words.” The foreword written by Drs. Townsend and Evers, the editors of the new Surgical Techniques Atlas series, summarises this atlas. ‘The Atlas of Breast Surgical Techniques’, edited by V. Suzanne Klimberg, MD, presents state-of-the-art visual guidance on today’s full range of breast surgery techniques. The book provides more than 550 full-colour illustrations and operative photos, biopsy specimens and artists’ renderings of key anatomy. The atlas consisted of six sections with 25 chapters in total. Each chapter is divided into surgical anatomy, preoperative consideration, indication, technique, postoperative care and ends with pearls and pitfalls. The first section, the longest one (10 chapters), summarises the standard approach to breast lesions and tumour from the diagnostic to the ablative aspect. Percutaneous ultrasound-guided and open biopsy techniques have been illustrated. Basic principles of breast conserving therapy (BCT) have been outlined through the choice of markings, incisions, tumour resection and partial mastectomy. Section 2 explained lymph nodes (LN) surgery. The principles of sentinel and full axillary or mediastinal LD mapping and dissection have been illustrated. I found the chapter on axillary reverse mapping extremely interesting. Using this technique, the axilla LNs that drain the breast can be distinguished from these, which drain the arm so that the arm lymphatics are severed and lymphoedema is prevented. Section 3 described mastectomy techniques. Different incisions and approaches have been presented. An aesthetic outcome and the combination with reconstructive procedure were considered.
doi:10.1016/j.bjps.2010.04.004
Section 4, which dealt with reconstructive breast surgery, presented a wide overview of what is available in oncoplastic and flap surgery. The described techniques varied from the basic level, which should be mastered by any breast surgeon to improve the aesthetic outcome of lumpectomies, to the more refined techniques, which were mainly performed to avoid post-quadrantectomy deformity. The so-called ‘therapeutic mammaplasty’ techniques that were based on glandular pedicles were usually used to integrate the tumour resection within a breast reduction pattern in addition to a contralateral breast remodelling to achieve breasts symmetry. In addition, several chapters illustrated the choice of techniques for postmastectomy immediate or delayed reconstruction using expander/implant or flaps. The state-of-the-art in Alloderm/implant reconstruction and also perforator flaps were colourfully illustrated with comprehensive descriptions of the surgical techniques. Surgical resection beyond the breast borders was described in section 5. Thoracic wall resection and forequarter amputation were demonstrated using also options for reconstruction, if needed. Finally, advances in intra-operative and other types of brachiotherapy were outlined in section 6. The aim of these techniques was to reduce the need for postoperative irradiation and to be more selective to target-specific zones to reduce the post-radiotherapy morbidity. In general, the entire group of authors is to be congratulated to cover the most popular topics in breast surgery, including new ablative and reconstructive procedures. The power of this book is the abundance t of colour surgical photos and the online access, which allows consulting the book from any computer and watching surgical videos demonstrating how to execute key aspects of many procedures. I strongly encourage our colleagues to consult such a work. Moustapha Hamdi Gent University Hospital, Plastic and Reconstructive Surgery, UZG e DePintelaan 185, B-9000 Gent, Belgium
BOOK REVIEW Atlas of breast surgical techniques, Klimberg V Suzanne, editor, Saunders Elsevier, 2010, p. 456 CD-ROM and online access, $249.
“A picture is worth a thousand words.” The foreword written by Drs. Townsend and Evers, the editors of the new Surgical Techniques Atlas series, summarises this atlas. ‘The Atlas of Breast Surgical Techniques’, edited by V. Suzanne Klimberg, MD, presents state-of-the-art visual guidance on today’s full range of breast surgery techniques. The book provides more than 550 full-colour illustrations and operative photos, biopsy specimens and artists’ renderings of key anatomy. The atlas consisted of six sections with 25 chapters in total. Each chapter is divided into surgical anatomy, preoperative consideration, indication, technique, postoperative care and ends with pearls and pitfalls. The first section, the longest one (10 chapters), summarises the standard approach to breast lesions and tumour from the diagnostic to the ablative aspect. Percutaneous ultrasound-guided and open biopsy techniques have been illustrated. Basic principles of breast conserving therapy (BCT) have been outlined through the choice of markings, incisions, tumour resection and partial mastectomy. Section 2 explained lymph nodes (LN) surgery. The principles of sentinel and full axillary or mediastinal LD mapping and dissection have been illustrated. I found the chapter on axillary reverse mapping extremely interesting. Using this technique, the axilla LNs that drain the breast can be distinguished from these, which drain the arm so that the arm lymphatics are severed and lymphoedema is prevented. Section 3 described mastectomy techniques. Different incisions and approaches have been presented. An aesthetic outcome and the combination with reconstructive procedure were considered.
doi:10.1016/j.bjps.2010.04.004
Section 4, which dealt with reconstructive breast surgery, presented a wide overview of what is available in oncoplastic and flap surgery. The described techniques varied from the basic level, which should be mastered by any breast surgeon to improve the aesthetic outcome of lumpectomies, to the more refined techniques, which were mainly performed to avoid post-quadrantectomy deformity. The so-called ‘therapeutic mammaplasty’ techniques that were based on glandular pedicles were usually used to integrate the tumour resection within a breast reduction pattern in addition to a contralateral breast remodelling to achieve breasts symmetry. In addition, several chapters illustrated the choice of techniques for postmastectomy immediate or delayed reconstruction using expander/implant or flaps. The state-of-the-art in Alloderm/implant reconstruction and also perforator flaps were colourfully illustrated with comprehensive descriptions of the surgical techniques. Surgical resection beyond the breast borders was described in section 5. Thoracic wall resection and forequarter amputation were demonstrated using also options for reconstruction, if needed. Finally, advances in intra-operative and other types of brachiotherapy were outlined in section 6. The aim of these techniques was to reduce the need for postoperative irradiation and to be more selective to target-specific zones to reduce the post-radiotherapy morbidity. In general, the entire group of authors is to be congratulated to cover the most popular topics in breast surgery, including new ablative and reconstructive procedures. The power of this book is the abundance t of colour surgical photos and the online access, which allows consulting the book from any computer and watching surgical videos demonstrating how to execute key aspects of many procedures. I strongly encourage our colleagues to consult such a work. Moustapha Hamdi Gent University Hospital, Plastic and Reconstructive Surgery, UZG e DePintelaan 185, B-9000 Gent, Belgium