Surgery of the Breast: Principles and Art, Second Edition
Edited by Scott L. Spear, M.D., and associate editors Shawna C. Willey, M.D., Geoffrey L. Robb, M.D., Dennis C. Hammond, M.D., and Maurice Y Nahabedian, M.D. Pp. 1517. Lippincott Williams & Wilkins, Philadelphia, Pa., 2006. Price: $399.
Approximately a decade after publication of the successful first edition, Dr. Spear and his associate editors have again compiled an invaluable, definitive, and virtually encyclopedic scientific reference to the entire spectrum of breast surgery. With five editors and 123 individual contributing experts from nine different countries, one must admire not only the knowledge and effort but also the interpersonal and organizational skills required to assemble and coordinate such an international cast of authors.
The product is a beautiful two-volume set delivered in a large textbook-style format of more than 1500 pages. As with most good science, it is not light reading. Both breadth and depth of coverage are thorough. Plastic surgeons in particular should note that the title, Surgery of the Breast (instead of “Plastic” or “Reconstructive” Surgery of the Breast), provides an important clue to the breadth of content. The first four chapters are nonsurgical, focusing on the epidemiology, diagnosis, and pathology of breast cancer, and chapters 5 through 23 discuss options for treatment of this disease.
The remaining 60 percent of volume 1 (chapters 24 through 68) addresses virtually every conceivable surgical technique for breast reconstruction. Although there is naturally some overlap among the techniques presented, each chapter has its own easily identifiable differences from the others, resulting in a dizzying array of options that nonetheless should be part of the knowledge of any surgeon performing breast reconstruction.
Volume 2 (chapters 69 through 105) addresses reduction mammaplasty, mastopexy, and breast augmentation. In addition to the multiple already-familiar variations within each of these categories, the editors have included such difficult outliers as the irradiated breast, the hypoplastic tuberous breast, thoracic hypoplasia, and gynecomastia.
Throughout the text, one appreciates the high quality of the abundant illustrations and color photographs and the use of pastel shading to highlight the chapter headings and the subunit headings within each chapter. My favorite feature, however, is the short, italicized, independent commentary inserted at the end of each chapter in which a separate authority offers orientation, support, and sometimes even caution about the chapter’s content. In other words, if you become suspicious, while reading a chapter, that a particular author may be overreaching a bit to buttress his or her particular opinions, it is both refreshing and reassuring to find that the independent commentary echoes your own concerns.
Of all the valuable content, I must confess that my personal (and emotional) favorite was chapter 102, “Managing Complications of Augmentation Mammaplasty,” by Neal Handel. This extensive photographic presentation of disastrous complications provided some always-welcome reassurance that I am not the only one to have experienced such difficult problems.
At $399, this text is an absolute bargain. I recommend it without reservation.
Boyd R. Burkhardt, M.D.
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