Handbook of Breast Surgery
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* David M. Fleiszer

**HANDBOOK OF BREAST SURGERY.** Adrian Shervington Ball and Peter M. Arnstein. 166 pp. Illust. Arnold, London, UK; Oxford University Press Canada, Toronto. 1999. Can$56. ISBN 0-340-74161-9

This concise, clearly written handbook is useful as an overview of surgical procedures on the breast for the general surgical trainee or as a primer for those planning to specialize in diseases of the breast. It is also a useful reference for general practitioners who wish to discuss intelligently the possibilities their patients may face when referred to a breast specialist.

Topics include preoperative preparation and investigations, and the complete spectrum of standard surgical breast procedures, from fineneedle aspiration to radical mastectomy. All the standard plastic surgery reconstructive procedures are included. Each procedure is described with its indications, required preparation, technical details and potential complications where pertinent.

Mostly the illustrations enhance the text. However, in describing some of the complex reconstructive procedures there is a paucity of diagrams, and the few that are provided are simplified to the point of not being helpful. I find the authors somewhat dogmatic on the subject of “adequate margins,” and they might acknowledge that this is a controversial topic. Minor criticisms include the following: some of the technical terminology is not explained (e.g., cytology — C3, C4); the use of glass slides for cytology as recommended by the authors leads to air drying. I prefer suspending the cells in 50% alcohol; the authors use drains very liberally and perhaps excessively; log sheets are provided throughout the book, but the purpose of these is unclear and the terminology on the sheets is not explained; the authors do not do bone scanning or liver ultrasonography as part of their preoperative work-up, which I think may lead to unnecessary axillary dissections.

In spite of these minor disagreements, I thoroughly enjoyed reading this book. Written with British literary style, the book is clear, concise, comprehensive and very easy to read. Organized in a procedure-by-procedure manner, it is convenient to pick up and put down between doing other things. It was a useful review for me, and I would expect trainees and others to find it an excellent overview or introductory text. I give it two thumbs up!