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Clinics in oncology: Breast cancer
538 operative techniques available to the reader in clear perspective. The surgical descriptions are lucid and well illustrated. All fields of hand surgery are covered, although a number of several
challenging conditions are dealt with surprisingly briefly, notably ischaemic contracture in the forearm. The short chapter entitled “Arterial injuries (vascular affections)” deals sketchily with a number of highly important topics, including electrical burns, paint and grease gun injuries, and wringer injuries. Tt.e other small criticism that could be made is that the more striking recent advances have been grafted on to the book instead of infiltrating all relevant areas of text. The separate chapter on microsurgery by Dr Philip Wright is good, though short, and not set out in the same detailed and helpful manner as the rest of the book. This is basically a surgical textbook but although a paragraph on aftercare follows each operative account, more detailed description of the aims, techniques and timing of rehabilitation would be welcome. These are small criticisms. This book is a major contribution to the hand literature, a work of considerable scholarship and of particular value to plastic surgeons because of its orthopaedic bias; for this reason its publication as a volume separate from the parental Campbell is most welcome. At its low price it is excellent value and very highly recommended. DAVID M. EVANS
Clinics in Oncology: Breast Cancer. Pp 308. Guest Editor: Professor Michael Baum, ChM, FRCS. (London: W. B. Saunders Company, 1982.) Price f11.75. Professor Baum has assembled an impressive array of contributions to the 13 chapters of this book. In his foreword he warns us that we shall not find a recipe book for management but a series of new questions. It seems that Professor Baum having disposed of the dogma that “we know” is in danger of replacing it with another; “we know nothing”. Notwithstanding the productive research that this latter approach can generate, we still have to advise today’s patient about treatment. Our patients will not wait, they will not all be suitable for clinical trials and some guidance is required for those clinicians who are not experts. Will they find anything here? I am pleased to say they will find a useful review of the current state of the art. Kalache and Vessey provide a nice review of our current knowledge of risk factors which leads appropriately into Joclyn Chamberlain’s balanced analysis of the problems that beset screening programmes. Siebert and Lippman provide a very thorough and readable treatment of hormone receptors. Gravelle supplies a sensible approach to diagnostic imaging which provides the advice that mammography, when used wisely. should increase the biopsy rate. Blarney and Elston avoid this problem in the next chapter by avoiding mammography, as far as they can, in women with symptomatic breast disease. Maguire assesses the psychological hurdles our patient5 face and even finds room to provide some advice for surgeons. The chapters on treatment are well balanced and emphasise the need for trials to verify the safety of radical radiotherapy as the primary modality in breast cancer. Adjuvant chemotherapy get5 the expected lukewarm response from Professor Baum himself together with his usual careful analysis of the available published data. John Forbes reviews the management of the advanced disease and Nissen-Meyer finisher off with a look at the future.
BRITISH
JOURNAI.
OF PLASTIC
SURGERY
Altogether a balanced review of the current state of know ledge in breast cancer, but one curious omission in a book which is aimed at improving the quality, as well as prolonging, our patients’ lives is not mentioned, even in condemnation, is that of reconstructive procedures after mastectomy. For the interested plastic surgeon this book will be invaluable and deserves to be widely known, but I fear that without the carrot of immediate interest it will remain largely on the library shelf. D. J. T. WEBSTER
Chirurgie Der lnfectionen. Edited by Professor W. Schmitt and Professor S. Kiene. Pp 648 with 561 illustrations in black and white and colour. 2nd revised edition. (Berlin, Heidelberg, New York: SpringerVet-lag, 1982.) Price: DM238 or $110.80. Twenty-two authors from the GDR and two from the United States got together to produce this massive work on the surgery of infections. In the foreword, the editors state that the task the authors have set for themselves was to provide a comprehensive book on thesubject. This has indeed been achieved. All possible infections that may warrant surgical attention have been assiduously listed but it is doubtful whether diseases such a5 ulcerative colitis, Crohn’s disease and diverticulitis should have been included in a book on surgical infections. Many rarities are mentioned and certainly many of the photographs were taken before the advent of antibiotics. Infections like noma, acute dermal gangrene and wound diphtheria are mentioned under the heading “most important surgical infections”. Because the book is so encyclopaedic, it may prove beneficial to thegeneral surgeon or even thegeneral practitioner practising in a third world country. It is doubtful, however, whether it is of much practical value to the specialist. The general chapters on wound healing. wound management, immune re5ponse to infection etc. are of undergraduate textbook level and the special chapter5 are often too brief (six pages on a difficult subject like ano-rectal fistulae). The plastic surgeon interested in the management of burns will find the meagre nine pages rather drsappointing. Most of the modern trend5 of now well-e5tablished principles of diagnosis and treatment in septic surgery are mentioned (for instance the use of gentamycin beads in post-traumatic osteitis and the use of CT-scanners in the diagnosis of abscesses) but again only briefly, so that anyone more deeply interested will have to look for the original paper or specialist textbook. The bibliography is extensive and the most significant worh and papers have been quoted. Most regrettably, plastic surgery was not awarded a chapter although it ha5 so much to offer to this field and the only examples of reconstructive procedures on illustrations are cross-leg flaps and abdominal flaps. The book as a whole i5 very German in it5 general approach: the reader is given rigid instructions rather than personal opinions and experience. Your reviewer was stunned to learn on page 146 that a significant drop in the rate of infection5 at the Restock University Hospital was secured by a very special squad, the “Wundpolirei” (wound police). They truly have ways! A5 usual, the Springer-Vertag has produced thi5 work very well and the price of around f60 seems justified. It is doubtful. however, whether many individual surgeon5 will want to spend so much rnntley on this book, but it would be a useful volume in the lihrarv ~11a general surgery department. REIMER HOFI-MANN
challenging conditions are dealt with surprisingly briefly, notably ischaemic contracture in the forearm. The short chapter entitled “Arterial injuries (vascular affections)” deals sketchily with a number of highly important topics, including electrical burns, paint and grease gun injuries, and wringer injuries. Tt.e other small criticism that could be made is that the more striking recent advances have been grafted on to the book instead of infiltrating all relevant areas of text. The separate chapter on microsurgery by Dr Philip Wright is good, though short, and not set out in the same detailed and helpful manner as the rest of the book. This is basically a surgical textbook but although a paragraph on aftercare follows each operative account, more detailed description of the aims, techniques and timing of rehabilitation would be welcome. These are small criticisms. This book is a major contribution to the hand literature, a work of considerable scholarship and of particular value to plastic surgeons because of its orthopaedic bias; for this reason its publication as a volume separate from the parental Campbell is most welcome. At its low price it is excellent value and very highly recommended. DAVID M. EVANS
Clinics in Oncology: Breast Cancer. Pp 308. Guest Editor: Professor Michael Baum, ChM, FRCS. (London: W. B. Saunders Company, 1982.) Price f11.75. Professor Baum has assembled an impressive array of contributions to the 13 chapters of this book. In his foreword he warns us that we shall not find a recipe book for management but a series of new questions. It seems that Professor Baum having disposed of the dogma that “we know” is in danger of replacing it with another; “we know nothing”. Notwithstanding the productive research that this latter approach can generate, we still have to advise today’s patient about treatment. Our patients will not wait, they will not all be suitable for clinical trials and some guidance is required for those clinicians who are not experts. Will they find anything here? I am pleased to say they will find a useful review of the current state of the art. Kalache and Vessey provide a nice review of our current knowledge of risk factors which leads appropriately into Joclyn Chamberlain’s balanced analysis of the problems that beset screening programmes. Siebert and Lippman provide a very thorough and readable treatment of hormone receptors. Gravelle supplies a sensible approach to diagnostic imaging which provides the advice that mammography, when used wisely. should increase the biopsy rate. Blarney and Elston avoid this problem in the next chapter by avoiding mammography, as far as they can, in women with symptomatic breast disease. Maguire assesses the psychological hurdles our patient5 face and even finds room to provide some advice for surgeons. The chapters on treatment are well balanced and emphasise the need for trials to verify the safety of radical radiotherapy as the primary modality in breast cancer. Adjuvant chemotherapy get5 the expected lukewarm response from Professor Baum himself together with his usual careful analysis of the available published data. John Forbes reviews the management of the advanced disease and Nissen-Meyer finisher off with a look at the future.
BRITISH
JOURNAI.
OF PLASTIC
SURGERY
Altogether a balanced review of the current state of know ledge in breast cancer, but one curious omission in a book which is aimed at improving the quality, as well as prolonging, our patients’ lives is not mentioned, even in condemnation, is that of reconstructive procedures after mastectomy. For the interested plastic surgeon this book will be invaluable and deserves to be widely known, but I fear that without the carrot of immediate interest it will remain largely on the library shelf. D. J. T. WEBSTER
Chirurgie Der lnfectionen. Edited by Professor W. Schmitt and Professor S. Kiene. Pp 648 with 561 illustrations in black and white and colour. 2nd revised edition. (Berlin, Heidelberg, New York: SpringerVet-lag, 1982.) Price: DM238 or $110.80. Twenty-two authors from the GDR and two from the United States got together to produce this massive work on the surgery of infections. In the foreword, the editors state that the task the authors have set for themselves was to provide a comprehensive book on thesubject. This has indeed been achieved. All possible infections that may warrant surgical attention have been assiduously listed but it is doubtful whether diseases such a5 ulcerative colitis, Crohn’s disease and diverticulitis should have been included in a book on surgical infections. Many rarities are mentioned and certainly many of the photographs were taken before the advent of antibiotics. Infections like noma, acute dermal gangrene and wound diphtheria are mentioned under the heading “most important surgical infections”. Because the book is so encyclopaedic, it may prove beneficial to thegeneral surgeon or even thegeneral practitioner practising in a third world country. It is doubtful, however, whether it is of much practical value to the specialist. The general chapters on wound healing. wound management, immune re5ponse to infection etc. are of undergraduate textbook level and the special chapter5 are often too brief (six pages on a difficult subject like ano-rectal fistulae). The plastic surgeon interested in the management of burns will find the meagre nine pages rather drsappointing. Most of the modern trend5 of now well-e5tablished principles of diagnosis and treatment in septic surgery are mentioned (for instance the use of gentamycin beads in post-traumatic osteitis and the use of CT-scanners in the diagnosis of abscesses) but again only briefly, so that anyone more deeply interested will have to look for the original paper or specialist textbook. The bibliography is extensive and the most significant worh and papers have been quoted. Most regrettably, plastic surgery was not awarded a chapter although it ha5 so much to offer to this field and the only examples of reconstructive procedures on illustrations are cross-leg flaps and abdominal flaps. The book as a whole i5 very German in it5 general approach: the reader is given rigid instructions rather than personal opinions and experience. Your reviewer was stunned to learn on page 146 that a significant drop in the rate of infection5 at the Restock University Hospital was secured by a very special squad, the “Wundpolirei” (wound police). They truly have ways! A5 usual, the Springer-Vertag has produced thi5 work very well and the price of around f60 seems justified. It is doubtful. however, whether many individual surgeon5 will want to spend so much rnntley on this book, but it would be a useful volume in the lihrarv ~11a general surgery department. REIMER HOFI-MANN