The Breast (1997) 6, 310 0 1997 Pearson Professional Ltd
BOOK REVIEWS Ultrasound of Diagnosis of Breast Diseases E. Tohno, D. Cosgrove, editors. 1994 Churchill Livingstone 207 pages ISBN 0443 043876
The stated goal of this atlas is to document the knowledge acquired through wide experience in the field of aesthetic and reconstructive surgery of the breast with the intention of presenting a ‘how-to-do-it’ atlas rather than an encyclopaedic book. It succeeds admirably in the first with all sections containing descriptions of all the salient points in text, illustration and photograph and very nearly succeeds in the second. The only limitation is the varying degree to which the contributors deal with patient and procedure selection, the planning of particular procedures and their complications. Although the need for careful patient selection is emphasized in the single page summary at the end of the book this does not really give an adequate insight into the place of the different procedures described which the authors undoubtedly have and from which the trainee surgeons, at whom this book is aimed, would undoubtedly benefit (as might ,their patients). Lejour’s contribution is clear and gives the reader the full benefit of her experience of vertical scar mammoplasty, including complications and her methods of dealing with and avoiding them. All surgeons involved in breast reconstruction would benefit from reading the contribution by Januszkiewicz and Nahai on microsurgical breast reconstruction which gives an excellent summary of the development of breast reconstruction and more importantly for the trainee some very sound advice on patient and flap selection. The only significant omission is the lack of any description of the perforator flaps developed by Robert Allen whose original article is, however, included in the bibliography on plastic and reconstructive surgery. Overall, this is an excellent contribution to plastic and reconstructive surgery of the breast, not only because of its value as a training aid but also because the results illustrated are goals to which all surgeons reconstructing the breast should aspire.
This is a well-written tome dedicated to the ultrasound appearances of breast diseases. There is something here for everyone. For the novice and beginner, the first three chapters are dedicated to the basic principles and physics of ultrasonography, techniques as well as normal. For the experts and specialists, the rest of the book is dedicated to various benign and malignant processes. What works particularly well in this book is the well laid out and structured chapters. The chapters themselves are tilled with good quality photographs of various pathologies all of which are accompanied by explanatory line diagrams of various appearances. Tables summarizing important points, differential diagnoses or appearances are also used to good effect. Each individual chapter is also well referenced and the whole book itself is extremely readable which is unusual for such an authoritative text. The authors are undoubtedly experts in the field of ultrasonography and they have certainly succeeded in conveying their knowledge and feel of the subject in this atlas. A very minor negative point is the fact that though colour Doppler is discussed within the text, more recent developments in the usage of colour Doppler as well as the new ultrasonic contrast enhancing agents are not covered in this book. This omission is hardly surprising as this is the second reprint of the 1994 edition. However, this does not detract from what is essentially an excellent atlas of breast ultrasonography. It is to the authors’ credit and strength that the book still stands as probably the best ultrasound breast atlas even when compared with more recent books on the same subject. As such it comes with a ‘best buy’ recommendation.
M. HENLEY W. TEH Textbook of Mammography A. K. Tucker. 1993 Churchill Livingstone 338 pages ISBN 0443 04208 X
Plastic and Reconstructive Surgery of the Breast H. Bohmert, C. Gabka. 1996 Thieme 376 pages Price 348DM ISBN 3 13 103571 4
This textbook does not merely cover mammography but a whole range of subjects from cilnical findings, quality assurance, radiological appearances of breast disease as well as the invasive procedures in breast imaging. The chapters on localization of impalpable breast lesions as well as fine needle aspiration are well w&ten and interesting. However, the chapter on breast ultrasound is flawed by the fact that the images used are B-scans rather than real time images. Furthermore, the importance of core biopsy and more recent aspects of invasive diagnostic procedures are not covered in this book. This in part reflects the fact that this is actually a 1995 reprint of a 1993 edition. Overall, this textbook is beginning to feel its age and certainly does not stand up to comparison with more recent similar textbooks which are both more topical and provide a wider breadth of knowledge.
Successful breast reconstruction has different meanings to different people. To the oncologist it is understandably of secondary importance to treating the malignancy and in the current climate is a service to be provided at minimum cost of time and money. The aesthetic plastic surgeon may pursue the goal of producing an anatomically normal breast to the extent of exposing the patient to significant physical risk. To the patient it means feeling normal again. The extent of reconstruction required to make a woman feel more at ease with herself varies widely between individuals and accurately identifying the most appropriate method is probably the greatest challenge in reconstructive breast surgery. Aesthetic breast surgery also has different meanings to different people but here profit motive may lead to the exploitation of vulnerable women whose breast dimensions lie outside the parameters which society deems normal.