This appears to be a successor to the 1987 text titled Breast Diseases; Harris and Hellman have served as editors for both books. In addition to having an inverted title and two additional editors, the new text differs from the old with chapters on biochemistry, molecular epidemiology, oncogenes and suppressor genes, immunology and immunotherapy, molecular pathology, cytokinetics, screening, new imaging techniques, and new therapies. A quick look at texts on the breast available in a university library showed that the most recent ones focus on either benign or malignant breast disease. The only other book equal to this one in scope and size was the third edition of Haagensen's Diseases of the Breast (1986). Thus, there seems to be little alternative for those seeking a current encyclopedic text.

For an expert outside the field, many sections were very informative, such as those on control of angiogenesis, biological considerations in breast cancer, techniques of molecular biology, and the treatment of early-stage breast cancer. However, it was surprising that clinical evaluation of the breast merited only two pages of text that focused on the signs of advanced breast cancer. Photographs could have been used to show subtle signs of neoplasia. No one could improve their examination technique by reading this chapter. It fell to a radiologist in a separate chapter to warn the reader that negative results on mammography should be disregarded in the presence of a suspicious lump. Mondor disease is illustrated and discussed not only in this brief chapter on clinical evaluation but also in the succeeding chapter on mammography. Does it deserve so much attention? Another chapter on the management of abnormalities on the physical examination provides welcome lucidity enhanced by the provision of an algorithm. However, the editorial decision to provide separate and separated chapters on specific techniques and interpretation of the results of those techniques leads to redundancy and lack of continuity.

The topic of risk and the concerned patient is extremely well presented, although the final recommendations for high-risk women younger than 40 years of age are not evidence based. Lippman has a wonderful ability to make his chapters (those on oncogenes and biological therapy) comprehensible to the generally informed reader, but other chapters, those dealing with basic science, are less successful.

Unfortunately, careful reading identifies grammatical errors, misspellings, undefined acronyms, questionable usage, and puzzling phrases (do they really mean "geronic alterations"?). The index is not always helpful; no entries were found for grading, nuclear grading, or histologic grading of tumors. Numbers in the text do not always correspond to numbers in the tables. "Age" is used when "mean age" is meant. Some figures have no legends and are incorrectly referred to in the text. In one chapter, reference citations in the text did not correspond to those in the bibliography, and factual errors were identified. Given the plethora of detail, it was surprising that no reference could be found to prostate-specific antigen and breast cancer. Why no mention of the purported effect of hormone replacement therapy on cognitive function, balance, and sleep quality?

Conceptually, the scope of this text is impressive, but the devil is in the details. Those who care about details might wish to delay purchase until a second edition is available.