Readers will find the following work modest in its scope. It does not encompass the full range of clinical, pathological, and investigational information concerning diseases of the breast in encyclopedic detail, nor does it discuss the entire range of disorders that afflict the mammary gland. Several excellent texts of this type already exist, and I cannot improve upon them. Instead, I have set out three limited objectives. First, I have tried to record in both verbal and photographic format the morphologic characteristics of those mammary lesions commonly encountered in the practice of diagnostic surgical pathology. Second, I have endeavored to conceptualize lesions according to fundamental biologic processes and, in so far as possible, to categorize lesions according to these concepts. Identifying the underlying nature of a pathologic abnormality serves two purposes: it helps the diagnostician to shape the differential diagnosis, and it provides the context required to understand the origin and the significance of the morphologic characteristics. The analysis of these morphologic findings sometimes represents the most challenging element of the diagnostic process; therefore, I have set out a third objective: to offer a few lines of reasoning and points of general advice in the hope that they will assist pathologists when analyzing problematic cases. Drawn from the common wisdom and from personal experience, which includes occasional painful mistakes, these suggestions should serve as generalizations only, pertinent in certain situations but to be disregarded in others. I acknowledge that I have not met any of my goals completely. Nevertheless, I fervently hope that the information contained within these pages will make it easier for practicing pathologists to resolve certain of the diagnostic problems in breast pathology with confidence.
Many persons contributed to the creation of this book. I wish that I could acknowledge each of them by name and that I could recount the help that each of them offered, but space does not allow me this luxury. Nevertheless, with great pleasure and much appreciation I give credit to the following colleagues and collaborators.
Three eminent surgical pathologists of the latter part of the twentieth century inspired my study of mammary pathology. Dr. Robert E. Scully, Emeritus Professor of Pathology at Harvard Medical School and, until recently, the senior pathologist at the Massachusetts General Hospital, showed me the intellectual elegance and beauty inherent in the practice of academic surgical pathology. Dr. John G. Azzopardi, Emeritus Professor of Oncology at the Royal Postgraduate Medical School and formerly an Honorary Consultant in Pathology at the Hammersmith Hospital, demonstrated the power of detailed morphologic observation in the characterization of mammary lesions. Dr. Paul Peter Rosen, Professor of Pathology at Weill Medical College of Cornell University and Chief of Breast Pathology at New York Presbyterian Hospital-Cornell Medical Center, taught me the specific features of many mammary lesions and inspired me to try to discern the biologic mechanisms giving rise to these entities. From all three pathologists, I learned the importance of clear thinking and the need for critical reflection when evaluating both the common wisdom and one's personal observations, for, as Professor Azzopardi warned, “Experience can be merely the repetition of the same error often enough.” It was the intellectual rigor in the pursuit of an understanding of mammary diseases shown by these scholars that inspired this young and callow pathologist to follow their lead.
The motivation to put these thoughts on paper came from many sources. Friends, family members, students, clinical colleagues, fellow pathologists, and trainees in the Department of Pathology at the Massachusetts General Hospital all encouraged me in many ways and at many times. Among the latter, Dr. Paula M. Arnell deserves special mention for her consistent and enthusiastic encouragement. Many ideas in these pages evolved during conversations with colleagues. Drs. Horacio M. Maluf and Melinda F. Lerwill listened to many off-beat ideas and unconventional notions with more patience and open-mindedness than one should expect even from friends. I must express my gratitude to these two intellectual companions for their interest, patience, generosity of spirit, and refusal to despair during our many exploratory discussions.
The text would never have materialized had Dr. Robert H. Young, Robert E. Scully Professor of Pathology at Harvard Medical School and Director of Gynecologic and Urologic Pathology at the Massachusetts General Hospital, not introduced me to the publishing staff at Elsevier and encouraged me at many points during my several years of writing. Mr. William Schmitt graciously but forcefully pried the manuscript from my hands, and Ms Katie DeFrancesco and Mr. Norman Stellander oversaw every detail of its transformation into the final text. To all, I express my heartfelt thanks.
Many persons contributed to the creation of this book. I wish that I could acknowledge each of them by name and that I could recount the help that each of them offered, but space does not allow me this luxury. Nevertheless, with great pleasure and much appreciation I give credit to the following colleagues and collaborators.
Three eminent surgical pathologists of the latter part of the twentieth century inspired my study of mammary pathology. Dr. Robert E. Scully, Emeritus Professor of Pathology at Harvard Medical School and, until recently, the senior pathologist at the Massachusetts General Hospital, showed me the intellectual elegance and beauty inherent in the practice of academic surgical pathology. Dr. John G. Azzopardi, Emeritus Professor of Oncology at the Royal Postgraduate Medical School and formerly an Honorary Consultant in Pathology at the Hammersmith Hospital, demonstrated the power of detailed morphologic observation in the characterization of mammary lesions. Dr. Paul Peter Rosen, Professor of Pathology at Weill Medical College of Cornell University and Chief of Breast Pathology at New York Presbyterian Hospital-Cornell Medical Center, taught me the specific features of many mammary lesions and inspired me to try to discern the biologic mechanisms giving rise to these entities. From all three pathologists, I learned the importance of clear thinking and the need for critical reflection when evaluating both the common wisdom and one's personal observations, for, as Professor Azzopardi warned, “Experience can be merely the repetition of the same error often enough.” It was the intellectual rigor in the pursuit of an understanding of mammary diseases shown by these scholars that inspired this young and callow pathologist to follow their lead.
The motivation to put these thoughts on paper came from many sources. Friends, family members, students, clinical colleagues, fellow pathologists, and trainees in the Department of Pathology at the Massachusetts General Hospital all encouraged me in many ways and at many times. Among the latter, Dr. Paula M. Arnell deserves special mention for her consistent and enthusiastic encouragement. Many ideas in these pages evolved during conversations with colleagues. Drs. Horacio M. Maluf and Melinda F. Lerwill listened to many off-beat ideas and unconventional notions with more patience and open-mindedness than one should expect even from friends. I must express my gratitude to these two intellectual companions for their interest, patience, generosity of spirit, and refusal to despair during our many exploratory discussions.
The text would never have materialized had Dr. Robert H. Young, Robert E. Scully Professor of Pathology at Harvard Medical School and Director of Gynecologic and Urologic Pathology at the Massachusetts General Hospital, not introduced me to the publishing staff at Elsevier and encouraged me at many points during my several years of writing. Mr. William Schmitt graciously but forcefully pried the manuscript from my hands, and Ms Katie DeFrancesco and Mr. Norman Stellander oversaw every detail of its transformation into the final text. To all, I express my heartfelt thanks.
Frederick C. Koerner, MD
Key Features
- Depicts the key aspects of various diseases in real-life detail through more than 1,000 full-color illustrations.
- Focuses on the distinction between benign and malignant lesions, the most crucial challenge faced by the surgical pathologist.
- Places a special emphasis on diagnostic pitfalls and differential diagnosis, to equip you with practical guidance and solutions in reporting difficult or problematic specimens.
- Integrates clinical, gross, microscopic, immunohistochemical, and molecular genetic features of breast tumors and related lesions.
- Emphasizes clinicopathologic and radiologic features and correlations, to enable you to diagnose surgical specimens in light of relevant clinical data.
Website Features
- Consult the book from any computer at home, in your office, or at any practice location.
- Instantly locate the answers to your clinical questions via a simple search query.
- Quickly find out more about any bibliographical citation by linking to its MEDLINE abstract.
- Images Browse a Library of all book images. Easily select, organize, and download your images into a presentation.
- Path Consult DDX Fundamentals Maximize clinical efficiency and productivity with Path Consult, an easy-to-use online resource that will help you quickly and easily confirm diagnoses.
- Chapter 1 - Introduction to the Diagnosis of Diseases of the Breast
- Chapter 2 - Concepts Basic to the Analysis of Epithelial Proliferations
- Chapter 3 - Conventional Ductal Proliferations
- Chapter 4 - Apocrine Proliferations
- Chapter 5 - Mucinous Proliferations
- Chapter 6 - Lobular Proliferations
- Chapter 7 - Concepts Basic to the Analysis of Papillary Proliferations
- Chapter 8 - Papilloma
- Chapter 9 - Papillary Carcinoma
- Chapter 10 - Micropapillary Proliferations
- Chapter 11 - Concepts Basic to the Diagnosis of Sclerosing Lesions
- Chapter 12 - Sclerosing Adenosis
- Chapter 13 - Radial Scar
- Chapter 14 - Low-Grade Invasive Ductal Carcinoma
- Chapter 15 - Concepts Basic to the Analysis of Fibroepithelial Lesions
- Chapter 16 - Fibroadenoma
- Chapter 17 - Myxoid Fibroadenoma
- Chapter 18 - Phyllodes Tumor
- Chapter 19 - Hamartoma and Fibroadenoma Variant
- Chapter 20 - Pseudoangiomatous Stromal Hyperplasia
Product Details
- Hardcover: 384 pages
- Publisher: Saunders; 1 Har/Psc edition (December 10, 2008)
- Language: English
- ISBN-10: 1416026126
- ISBN-13: 978-1416026129
List Price: $182.00