Since the initial publication of Dr. Susan Love's Breast Book
5 years ago, every oncologist has seen this guide in the arms
of many patients. When I read the cover to the second edition,
stating that the book was "fully revised," I could not
imagine how the universally excellent first edition could have
been improved. The original text, in fact, remains essentially
unchanged in the second edition. What has changed is the addition
of some 138 pages addressing recent developments or expanding
on various issues.
The New York Times calls this book "a down to earth
guide... the bible of women with breast cancer." And yet,
it is much more than that. Of the 515 pages (followed by 100 pages
of appendices), only half are devoted to the diagnosis, treatment,
and aftermath of breast cancer. The book begins with matters concerning
the healthy breast, including a useful chapter on breast- feeding.
The chapter, including a diagram and brand-name reference, describes
a device used to simulate breast-feeding in women who have not
been pregnant, which could be useful for an adoptive mother. This
is but one example of information with which even the seasoned
practitioner may be unfamiliar.
In her chapter on cosmetic breast surgery, Love describes the
techniques used and indications for the typical aesthetic operations,
and concludes with a philosophical approach to decision-making
about plastic surgery. It is the next section, "Common Problems
of the Breast," however, that is the gem of medical explanation.
Breast pain/sensitivity/discomfort is the bane of many oncologists'
professional existence, as it is common and so distressing to
women with a breast cancer history. Using the concepts and terminology
in this section, the oncologist could lend greater accuracy and
reassurance to the discussion of breast pain with patients. Since
research and factual data on breast pain are so sparse, the chapter
addresses the totality of scientific knowledge in this area.
The chapter on lumps and lumpiness is reliable, comforting, and
highly informational. As Love states in the introduction, "The
most frightening thing about breast problems really is not the
possibility of cancer. The most frightening thing is not knowing,
not understanding what is happening to one's own body...knowledge
is power. With this book, I hope to give readers some of that
power." Love succeeds in her mission to impart knowledge
with a scientific, amusing, and readable style.
The book also contains a thorough review of all the imaging tests
used to diagnose breast cancer, both clinically and experimentally.
As usual, Love is able to simplify complicated ideas, terminology,
and multistep procedures.
The 100 pages of appendices include information on chemotherapeutic
drugs, extra resources for additional reading, regional support
organizations for cancer in general and breast cancer in particular,
the comprehensive cancer centers in the United States, the charter
divisions of the American Cancer Society, the list of references
footnoted in the text for each chapter, and a glossary of common
terms used by physicians. It is to Love's credit that she generally
avoids such words or otherwise briefly explains them each time
they are mentioned. Finally, a thorough index makes the lengthy
work serviceable to the average reader with specific problems.
Love also is to be congratulated for the large, well-written section
on randomized trials, which discusses the value of previous completed
trials to modern breast cancer treatment and the benefits of entering
randomized clinical trials for recently diagnosed patients. Love
makes such a convincing case that readers previously unfamiliar
with "randomized clinical trials" will be encouraged
to bring up the issue with their clinicians. The future of breast
cancer research will, thus, benefit.
Although it might be of limited interest to the breast cancer
patient, I was personally taken by the new, last chapter, "The
Politics of Breast Cancer," wherein Love discusses the "new
money" sources for breast cancer research during the past
5 years and the behind-the-headlines workings of the committed
women and their groups who deserve much of the credit for obtaining
Not a day passes when, in explaining various issues to my own
patients, I am not mindful of the turn of phrases found in Dr.
Susan Love's Breast Book.