Film-screen mammography: An atlas of instructional cases
2
The Breast (1992) 1, 55-56 1 Book reviews High-Risk Breast Cancer: Diagnosis. By J. Ragaz and I. M. Aviel (Eds), pp xi + 383 illustrated. Springer-Verlag (Heidelberg) D M 198,000, 1989. ISBN 3540 19292 1 This is the first of two volumes concerned with factors which can be used to determine breast cancer of high risk i.e. that of aggressive behaviour which is likely to be associated with micrometastatic dissemination. It shows many of the disadvantages of a multi-author text, tending to be repetitive, and lacking coherence. Nor have contributors necessarily addressed the question in hand. The section on mam- mography concerns itself with screening; and does not mention mammographic risk factors; that on molecular genetics gives sparse information on the relationship between oncogenes and prognosis. Nevertheless it does contain useful information, and is worth browsing through. But as it was originally published in the spring of 1989, it is now rather out of date. A.P.M. FORREST Medical management of breast cancer. By T.J. Powles and I.E. Smith, Martin Dunitz, London, pp. 345 ISBN 1 853170755 This book has been edited by two physicians implying that breast cancer is moving into the sphere of a medically managed disease. The palliative effectiveness of cytotoxic drugs and hormone therapy for advanced disease has been established for many years. That a survival benefit is conferred by adjuvant medical therapy has also become clear in more recent years. These observations are contributing to the change of attitude which is seeing systemic therapy as increasingly important in managing the disease at its various stages. Added to this, the exciting developments in cell and molecular biology raise the possibility of using new targets for novel forms of drug treatment as well as defining prognostic groups for standard ajuvant therapy. A textbook written by medical oncologists on breast cancer is therefore timely. It is also in this case successful as in the space of some 350 pages they have managed to maintain a high quality in the writing despite having multiple authorship. It is a rare privilege to open a text book, particularly a specialised one and read the contents with enjoyment as one does with this book. The editing has clearly been very effective and the contributions of each author have been limited to a smallish volume of writing making the book digestible. The up to date references provide easy access to further reading on points of interest. My only areas of criticism are in the balance of the contributions on the endocrine management of breast cancer where too much emphasis has been placed on aromatase inhibitors particularly as some of the sections by Santen and Coombs are literally duplicated. Rather underdiscussed were the issues of managing advanced disease and the problems in monitoring response. There are hints that the use of tumour associated proteins in the serum might be useful markers, There was surely space for discussing this if only to conclude that more data are required to evaluate the relative contribution of such as approaches as adjuncts or alternatives on to the admittedly inadequate radiology that we rely upon so heavily in assessing drug activity. The fact that the medical manage- ment of breast cancer is sandwiched between chapters on biology and supportive care suggests that the book is aimed at a wider readership than just the practising oncologist. I feel they have succeeded in this and can recommend this not only to interested surgeons but also to undergraduates and nurses who should be interested in certain sections. There are few typographical errors in the text and figures. The publishers are to be congratulated on producing a clear text with bold headings and a generally attractive layout. At a cover price of f35 this text book is destined to do better than just sit in medical libraries. R.C.F. LEONARD Film-screen mammography: An atlas of instructional cases. By LW Bassett, R. Jahanshahi, RH Gold and YS Fu. Pp vii + 312, with 258 illustrations Martin Dunitz, London Price: &65 ISBN 1 853 17 020 8 Written by authors well known in the fields of breast imaging and pathology. This book contains 54 pathologically proven cases illustrated by 258 black-and-white radiological and histological images set out in a format designed to test the readers skills in interpreting mammograms and subsequent management decision making. There is a good case mix providing a wide range of diagnostic features and problems, A brief history is provided for each case followed by the relevant mammographic images. Reproduction of mammo- graphic images in books such as this is notoriously difficult but the authors and publishers must be congratulated for the quality and clarity of the images presented in this atlas. The images are reproduced full-size in a surprisingly realistic format. Indeed, like all good mammographers, the authors suggest that the readers should use a magnifying glass to fully appreciate the subtleties of the images. Each set of images is followed by a brief descriptions of the imaging findings. The subsequent discussion of each case includes the relevant pathology details and pertinent analysis of any important points raised. The discussion is backed up by a modest collection of 153 references. Although this book was published in 1991. none of these references are younger than two years old. These case presentations are preceded by an introductory chapter containing very brief and superficial descriptions of mammographic technique. normal anatomy, a precis of breast pathology and a cursory look at theory of mammographic interpretation and additional diagnostic techniques. As such this chapter is out of step with the rest of the book which deals with some complex issues and topics related to breast imaging interpretation and subsequent management decision making. The opening chapter is in most part irrelevant to the 55
Transcript of Film-screen mammography: An atlas of instructional cases
The Breast (1992) 1, 55-56
1 Book reviews
High-Risk Breast Cancer: Diagnosis. By J. Ragaz and
I. M. Aviel (Eds), pp xi + 383 illustrated. Springer-Verlag (Heidelberg) D M 198,000, 1989. ISBN 3540 19292 1
This is the first of two volumes concerned with factors which can be used to determine breast cancer of high risk i.e. that of aggressive behaviour which is likely to be associated with micrometastatic dissemination. It shows many of the disadvantages of a multi-author text, tending to be repetitive, and lacking coherence. Nor have contributors necessarily addressed the question in hand. The section on mam- mography concerns itself with screening; and does not mention mammographic risk factors; that on molecular genetics gives sparse information on the relationship between oncogenes and prognosis. Nevertheless it does contain useful information, and is worth browsing through. But as it was originally published in the spring of 1989, it is now rather out of date.
A.P.M. FORREST
Medical management of breast cancer. By T.J. Powles and I.E. Smith, Martin Dunitz, London, pp. 345 ISBN 1 853170755
This book has been edited by two physicians implying that breast cancer is moving into the sphere of a medically managed disease. The palliative effectiveness of cytotoxic drugs and hormone therapy for advanced disease has been established for many years. That a survival benefit is conferred by adjuvant medical therapy has also become clear in more recent years. These observations are contributing to the change of attitude which is seeing systemic therapy as increasingly important in managing the disease at its various stages. Added to this, the exciting developments in cell and molecular biology raise the possibility of using new targets for novel forms of drug treatment as well as defining prognostic groups for standard ajuvant therapy.
A textbook written by medical oncologists on breast cancer is therefore timely. It is also in this case successful as in the space of some 350 pages they have managed to maintain a high quality in the writing despite having multiple authorship. It is a rare privilege to open a text book, particularly a specialised one and read the contents with enjoyment as one does with this book. The editing has clearly been very effective and the contributions of each author have been limited to a smallish volume of writing making the book digestible. The up to date references provide easy access to further reading on points of interest. My only areas of criticism are in the balance of the contributions on the endocrine management of breast cancer where too much emphasis has been placed on aromatase inhibitors particularly as some of the sections by Santen and Coombs are literally duplicated. Rather underdiscussed were the issues of managing advanced disease and the problems in monitoring response. There are hints that the use of tumour associated proteins in the serum
might be useful markers, There was surely space for discussing this if only to conclude that more data are required to evaluate the relative contribution of such as approaches as adjuncts or alternatives on to the admittedly inadequate radiology that we rely upon so heavily in assessing drug activity. The fact that the medical manage- ment of breast cancer is sandwiched between chapters on biology and supportive care suggests that the book is aimed at a wider readership than just the practising oncologist. I feel they have succeeded in this and can recommend this not only to interested surgeons but also to undergraduates and nurses who should be interested in certain sections. There are few typographical errors in the text and figures. The publishers are to be congratulated on producing a clear text with bold headings and a generally attractive layout. At a cover price of f35 this text book is destined to do better than just sit in medical libraries.
R.C.F. LEONARD
Film-screen mammography: An atlas of instructional cases. By LW Bassett, R. Jahanshahi, RH Gold and YS Fu. Pp vii + 312, with 258 illustrations Martin Dunitz, London Price: &65 ISBN 1 853 17 020 8
Written by authors well known in the fields of breast imaging and pathology. This book contains 54 pathologically proven cases illustrated by 258 black-and-white radiological and histological images set out in a format designed to test the readers skills in interpreting mammograms and subsequent management decision making. There is a good case mix providing a wide range of diagnostic features and problems,
A brief history is provided for each case followed by the relevant mammographic images. Reproduction of mammo- graphic images in books such as this is notoriously difficult but the authors and publishers must be congratulated for the quality and clarity of the images presented in this atlas. The images are reproduced full-size in a surprisingly realistic format. Indeed, like all good mammographers, the authors suggest that the readers should use a magnifying glass to fully appreciate the subtleties of the images. Each set of images is followed by a brief descriptions of the imaging findings. The subsequent discussion of each case includes the relevant pathology details and pertinent analysis of any important points raised. The discussion is backed up by a modest collection of 153 references. Although this book was published in 1991. none of these references are younger than two years old.
These case presentations are preceded by an introductory chapter containing very brief and superficial descriptions of mammographic technique. normal anatomy, a precis of breast pathology and a cursory look at theory of mammographic interpretation and additional diagnostic techniques. As such this chapter is out of step with the rest of the book which deals with some complex issues and topics related to breast imaging interpretation and subsequent management decision making. The opening chapter is in most part irrelevant to the
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56 The Breast
rest of the book and is unlikely to be read by most individuals. Although this book is described as an atlas providing a new
approach to instruction in the interpretation of mammogram, it does in fact use a well tried format, that of multiple case presentations followed by topical discussion. However, the reproduction of the mammographic images is innovative and of very good quality, the perspectives achieved probably being as near to true-life as is achievable in this type of book. The management approaches described are, not surprisingly, typical of current practice in the USA. There is very little emphasis on the use of additional diagnostic techniques, such as breast ultrasound, and only cursory mention of the use of cytology and needle histology to avoid unnecessary biopsies. As a result some of the approaches described may appear alien to many European clinicians.
This book will be of interest to both the experienced and the trainee radiologist involved in mammographic interpretation.
A.R.M. WILSON
Fourth HM Queen Elizabeth The Queen Mother Fellowship. Breast Cancer: The decision to screen. Sir Patrick Forrest. Pp 233 Publishers: Nuffield Hospitals Trust, London UK Printers: Burgess & Son (Abingdon) Ltd., Oxfordshire, UK Price: 515 ISBN 09 00574 74 7
This slim volume gives the background to the setting up of the National Screening Programme in Britain. It is highly authoritative as it is written by the Chairman of the Working Party that convinced the Government of the case for popu- lation screening by mammography. The background to the problem of breast cancer and the place of mammography are described briefly. The evidence of the early studies of screening such as HIP and the Swedish trials are reviewed with clear diagrams and details. Having described the evidence for the decision to screen, the doubts and trial weaknesses are then explored. Although the reader is expected to make up his/her own mind in weighing up the evidence, I would have liked to have seen a section addressing the specific criticisms of screening which have been repeatedly debated in both the medical press and newspapers by a vociferous lobby of anti-screeners. A discussion of these dissenting viewpoints and the reasons why the author feels they are invalid would have been useful. The author lists the problems in chapter 2 but the counter arguments are scattered within the text without being specifically addressed.
The book is full of information and is well referenced and is required reading for all those working in the breast screening programme and I would certainly recommend it to anyone who wishes to understand the background to the UK Screening Programme.
R.E. MANSEL
