Book Review Eur Surg (2008) 40/1: 45 DOI 10.1007/s10353-008-0389-x # Springer-Verlag 2008

Jakesz, R., Frey, M. (Hrsg.): Mammakarzinom. Operative Behandlungskonzepte. 150 Abb., IX, 239 S. Springer, Wien New York, 2007. Geb. EUR 169,95, £119.00.

With ,,Mammakarzinom – operative Behandlungskonzepte‘‘ (‘‘Breast cancer – Surgical treatment concepts’’) by R. Jakesz and M. Frey, the authors and publishers have succeeded in closing a gap in the literature on the surgical treatment of breast cancer. In 17 chapters and 228 pages, all aspects of breast cancer surgery are presented clearly. The first section of the book is on surgical oncology and the second, on reconstruction. From the first chapter on, covering anatomical considerations relative to surgical treatment of breast cancer, the reader is impressed with the clear and comprehensive presentation of the subject matter and most especially its relevance to surgical practice. The quality of the anatomical illustrations deserves mention. The next chapter presents the surgical point of view on the various diagnostic procedures and their role in the choice of treatment. The following chapters discuss state-of-the-art treatment of precancerous lesions and carcinoma in situ as well as indications for breast-conserving surgery and mastectomy. Backed up by the literature, the authors give a clear presentation of the varying definitions of R-0 resection prevailing in different countries. As the title suggests, ample space in the book is given to questions of surgical technique. There are extensive illustrated descriptions of breast-conserving procedures and mastectomy. Attention

is given to the problems posed by central tumors and the multimodal approach to local recurrences. A chapter is devoted to familial breast cancer and prophylactic surgery in high-risk patients. There is detailed discussion of the management of axillary lymph nodes with both conventional dissection and sentinel node biopsy. With the list of current and ongoing studies, the reader can quickly gain in-depth understanding of the sentinel technique. The only disappointment is the small size of the illustrations in the chapter. The first section of the book concludes with information on surgical tactics and techniques after preoperative chemotherapy. The second section of the book considers questions related to breast reconstruction: indications, contraindications and timing. The various oncoplastic procedures are described in detail, with illustrations. Further chapters are devoted to breast reconstruction with breast implants and various flap techniques. Space is also given to aftercare for patients with reconstructed breasts and the problems of local recurrences after breast reconstruction. This book is impressive evidence that highest-level competence in the treatment of breast cancer exists in Austrian surgeons. It can be recommended without reservations for all surgeons and gynecologists who practice breast surgery, along with oncologists, radiologists and radiation therapists who work in this field and who would like to stay abreast of current surgical treatment concepts and their indications with breast cancer. Hubert Hauser, Graz