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Early Breast Cancer: Histopathology, Diagnosis and Treatment
212
BOOK REVIEWS
Overall, all chapters are extremely well written, providing a good balance between the present and potential future for management of breast cancer. A critical review of this nature is very timely and should act as a stimulus to all involved in breast cancer research and it would be a welcome addition to Departmental libraries, despite its expense. John A . Levi
Early Breast Cancer: Histopathology, Diagnosis and Treatment. Ed. J. ZANDERAND J. BALTZER. Springer-Verlag, Berlin, 1984. 321 pp., 217 illustrations, 154 tables, subject index. ISBN 0-387-15059-5. This volume contains specially prepared versions of papers presented to a Symposium on Advances in Early Detection and Treatment of Breast Cancer, held in Miinchen, Germany in March 1983. The opinions and work reported represent a cross section of well-known pathologists, gynaecologists, radiologists and surgeons from the United Kingdom, the Continent and the United States. The book is so wide ranging in its application to the problem of breast cancer, and so outstanding in its attention to scientific results, it is difficult to pin-point a chapter of particular merit. The first 9 chapters on histopathology should be read by all pathologists who report on biopsy or mastectomy specimens. This group includes an excellent report on whole-organ studies by Stephen Gallagher, and a description of what is early breast cancer by Edwin R. Fisher. The relationship between in-situ disease and invasive cancer is discussed by Tulasan et al., and autopsy findings in the female breast reported by Andersen et al., from Denmark confirm their hypothesis that 25-30% of all women aged from 22 to 89 seem to harbour either in-situ or invasive primary malignant breast lesions. The literature on methods of early detection is thoroughly reviewed by Lissner of Munich, whose findings reflect the generally accepted view in Australia, that ‘film-screen mammography in combination with a grid . . . is the method of choice at present. With this combination, we have a diagnostic accuracy of 92-96% according to tumour size’.
Pathology (1987), 19, April Radiologists will be fascinated by Lanyi’s chapter on the configurations and contours of groups of benign and malignant microcalcifications, whose observations will change the reporting patterns of many mammographers. The chapters on ultrasonography emphasise the complementary role of this test, which, except in the young, should not be used in the absence of recent and adequate mammography. Comparisons between dedicated automated water-path and real-time scanners are made which reflect the experience at the SSDBC. That is that the real-time scanner gives more accurate results in palpable tumours, with the disadvantage that there is limited possibility of delegating the examination. However, in the context of early breast cancer, ultrasonography has no place as a screening technique. Thermography, when practised by dedicated experts, has value as a predictor of future risk, first reported by Agnes Stark of England in 1975, and this is confirmed by Amalric and Spitalier of Marseilles. Thermography is not used in Australia at this time. Again, readers who are pathologists will be interested in the chapters on fine-needle aspiration biopsy, and sterotactically-guided biopsy of impalpable lesions found on mammography. As FNAB is becoming more popular with surgeons and diagnostic centres in Australia, pathologists will be required to develop expertise in this highly specialized field. The final chapters are devoted to a discusson on the recommended treatment for early breast cancer, showing that less than radical surgery (quadrantectomy) gives as good disease-free intervals and survival as mastectomy. Urban of the Memorial, New York, Hermann of Ohio, Hayward of Guys, London and Veronesi et al., of Milan detail their methods and results. The only failing in this volume is the fact that it was published a year before Tabar of Sweden, (Lancet June, 1985), reported a 31% reduction in mortality from breast cancer in women offered mammographic screening, when compared with a control group not offered screening. I strongly recommend this book for easy reading to pathologists, radiologists, surgeons, paramedicals and students as a required text, whether interested in breast disease or not. Joan CroN
BOOK REVIEWS
Overall, all chapters are extremely well written, providing a good balance between the present and potential future for management of breast cancer. A critical review of this nature is very timely and should act as a stimulus to all involved in breast cancer research and it would be a welcome addition to Departmental libraries, despite its expense. John A . Levi
Early Breast Cancer: Histopathology, Diagnosis and Treatment. Ed. J. ZANDERAND J. BALTZER. Springer-Verlag, Berlin, 1984. 321 pp., 217 illustrations, 154 tables, subject index. ISBN 0-387-15059-5. This volume contains specially prepared versions of papers presented to a Symposium on Advances in Early Detection and Treatment of Breast Cancer, held in Miinchen, Germany in March 1983. The opinions and work reported represent a cross section of well-known pathologists, gynaecologists, radiologists and surgeons from the United Kingdom, the Continent and the United States. The book is so wide ranging in its application to the problem of breast cancer, and so outstanding in its attention to scientific results, it is difficult to pin-point a chapter of particular merit. The first 9 chapters on histopathology should be read by all pathologists who report on biopsy or mastectomy specimens. This group includes an excellent report on whole-organ studies by Stephen Gallagher, and a description of what is early breast cancer by Edwin R. Fisher. The relationship between in-situ disease and invasive cancer is discussed by Tulasan et al., and autopsy findings in the female breast reported by Andersen et al., from Denmark confirm their hypothesis that 25-30% of all women aged from 22 to 89 seem to harbour either in-situ or invasive primary malignant breast lesions. The literature on methods of early detection is thoroughly reviewed by Lissner of Munich, whose findings reflect the generally accepted view in Australia, that ‘film-screen mammography in combination with a grid . . . is the method of choice at present. With this combination, we have a diagnostic accuracy of 92-96% according to tumour size’.
Pathology (1987), 19, April Radiologists will be fascinated by Lanyi’s chapter on the configurations and contours of groups of benign and malignant microcalcifications, whose observations will change the reporting patterns of many mammographers. The chapters on ultrasonography emphasise the complementary role of this test, which, except in the young, should not be used in the absence of recent and adequate mammography. Comparisons between dedicated automated water-path and real-time scanners are made which reflect the experience at the SSDBC. That is that the real-time scanner gives more accurate results in palpable tumours, with the disadvantage that there is limited possibility of delegating the examination. However, in the context of early breast cancer, ultrasonography has no place as a screening technique. Thermography, when practised by dedicated experts, has value as a predictor of future risk, first reported by Agnes Stark of England in 1975, and this is confirmed by Amalric and Spitalier of Marseilles. Thermography is not used in Australia at this time. Again, readers who are pathologists will be interested in the chapters on fine-needle aspiration biopsy, and sterotactically-guided biopsy of impalpable lesions found on mammography. As FNAB is becoming more popular with surgeons and diagnostic centres in Australia, pathologists will be required to develop expertise in this highly specialized field. The final chapters are devoted to a discusson on the recommended treatment for early breast cancer, showing that less than radical surgery (quadrantectomy) gives as good disease-free intervals and survival as mastectomy. Urban of the Memorial, New York, Hermann of Ohio, Hayward of Guys, London and Veronesi et al., of Milan detail their methods and results. The only failing in this volume is the fact that it was published a year before Tabar of Sweden, (Lancet June, 1985), reported a 31% reduction in mortality from breast cancer in women offered mammographic screening, when compared with a control group not offered screening. I strongly recommend this book for easy reading to pathologists, radiologists, surgeons, paramedicals and students as a required text, whether interested in breast disease or not. Joan CroN