By far the majority of women presenting with a breast complaint will be diagnosed as having a benign rather than malignant condition. Despite this, clinical and research interest has always favoured breast cancer, and few publications have attempted to cover benign breast disorders as an independent entity focusing instead on benign breast disease in relation to breast cancer and none provide the complete and pragmatic coverage found in this text."Hughes, Mansel and Webster's Benign Disorders and Diseases of the Breast" represents the distillation of over 35 years of clinical experience and research in the Cardiff Clinic and is unique in its depth of coverage of the entire spectrum of benign breast complaints. The third edition of this critically acclaimed book provides practical and detailed management guidelines. Relevant investigations are discussed and clear advice is given for the most effective treatment strategies in each condition, including dealing with treatment failures and recurring problems. The underlying pathology and physiology are also discussed from the clinician's viewpoint to help understand clinical presentations and response to treatment.
Foreword Preface Acknowledgementsi Dedication Chapter 1 Problems of concept and nomenclature of benign disorders of the breast Key points and new developments The source of the problem History The present and the future References Chapter 2 History of benign breast disease Introduction Sir Astley Paston Cooper, Bt. FRS DCL GCH. 1768-1841 Alfred Velpeau. 1785-1867 John Birkett FRCS Fellow of the Linnean Society. 1815-1904 George Lenthal Cheatle. 1865-1951 Joseph Colt Bloodgood. 1867-1935 Charles F. Geschickter. 1901-? An analysis of the contributions of these six men References Chapter 3 Breast anatomy and physiology Key points and new developments Development Changes at puberty Adult anatomy Microscopic anatomy Biochemical control of breast epithelium Cyclical changes in breast epithelium Changes during pregnancy and lactation Postmenopausal involution References Chapter 4 Aberrations of normal development and involution (ANDI): a concept of benign breast disorders based on pathogenesis Key points and new developments Introduction Recognition of the normality of much benign breast 'disease' Problems with the conventional view of benign breast disease The physiological processes underlying the ANDI concept A framework based on pathogenesis Reasons for including various benign breast disorders as part of ANDI An extension of the concept of ANDI to include most benign breast disorders? Implications for the management of benign breast disorders Aberration to disease? Recent developments having a bearing on the ANDI concept References Chapter 5 The approach to diagnosis and assessment of breast lumps Key points and new developments Part 1: The differential diagnosis and clinical assessment of breast lumps Clinical assessment of a breast lump Features of individual lesions Follow-up after assessment and/or benign breast biopsy Management of recurrent lumps following biopsy Breast masses related to different life periods Part 2: Triple assessment and organization of the breast clinic Fine needle aspiration cytology Ultrasound in triple assessment Wide-bore needle biopsy Mammotome or vacuum-assisted biopsy Organization of clinics Medico-legal issues References Chapter 6 Imaging of the breast Key points and new developments Introduction Breast density Mammography Breast ultrasound Breast magnetic resonance imaging Biopsy techniques Breast localization techniques References Chapter 7 Fibroadenoma and related tumours Key points and new developments Terminology Fibroadenoma simplex Cancer and fibroadenoma Multiple fibroadenomas Giant fibroadenoma Phyllodes tumour and phyllodes sarcoma (cystosarcoma phyllodes) Pseudoangiomatous hyperplasia References Chapter 8 Breast pain and nodularity Key points and new developments Introduction Historical note Frequency of breast pain Mastalgia in breast cancer Classification Aetiology of mastalgia and nodularity Management of patients with mastalgia Natural history of mastalgia Plan of management for patients with mastalgia Mastalgia in the postmenopausal patient Patients with refractory mastalgia The relationship of cyclical mastalgia to premenstrual stress Conclusion References Chapter 9 Sclerosing adenosis, radial scar and complex sclerosing lesions Key points and new developments Introduction Sclerosing adenosis Radial scar and complex sclerosing lesions References Chapter 10 Cysts of the breast Key points and new developments Introduction Pathology Incidence Pathogenesis and cyst types Aetiology Clinical features Age Natural history Investigation Differential diagnosis management Galactocele Papillary tumours associated with macrocysts References Chapter 11 The duct ectasia/periductal mastitis complex Key points and new developments Introduction Historical survey Pathology and pathogenesis of duct ectasia/periductal mastitis The development of the duct ectasia/periductal mastitis complex The clinical spectrum of duct ectasia/periductal mastitis Breast masses associated with periductal mastitis Frequency of duct ectasia/periductal mastitis Radiology Management The consequences and results of operations for duct actasia Recurrent infection after surgery for periductal mastitis References Chapter 12 Disorders of the nipple and areola Key points and new developments Introduction Nipple inversion and retraction Cracked nipples Nipple crusting Erosive adenomatosis Syringomatous adenoma Nodular mucinosis Simple fibroepithelial polyp Eczema Leiomyoma Traumatic lesions Nipple pain Nipple disease and HIV infection Montgomery's glands Sebaceous cyst of the nipple Viral infections Hidradenitis suppurativa of the areola References Chapter 13 Nipple discharge Key points and new developments Introduction Definition Incidence Character and significance of discharge Pathology underlying nipple discharge Assessment Management References Chapter 14 Infections of the breast Key points and new developments Introduction Lactational breast infection Subclinical mastitis Nonlactational breast abscess Infections in immunocompromised patients Iatrogenic abscess Specific infections of the breast Infections of associated structures References Chapter 15 Congenital and growth disorders Key points and new developments Introduction Developmental anomalies Premature breast development Hypertrophic abnormalities of the breast Excessive postlactational involution Genetic abnormalities involving the breast Surgical treatment References Chapter 16 The male breast Key points and new developments Development of the male breast Gynaecomastia Other male breast disease References Chapter 17 Miscellaneous conditions Introduction Trauma Fat necrosis Paraffinoma and silicone reactions Lipoma Hamartoma (adenolipoma) Oedema of the breast The post-irradiated breast Fibrous disease of the breast Fibromatosis (desmoid tumour) Nodular fasciitis Diabetic mastopathy Idiopathic granulomatous mastitis (non-specific granulomatous disease) Sarcoid Amyloid Blood vessels Atherosclerosis and aneurysm Mondor's disease Infarction Skin-related conditions Hidradenitis suppurativa of the breast Tumours of nerve origin Granular cell tumour (myoblastoma) Artefactual disease of the breast Foreign bodies Mammalithiasis Phantom breast syndrome Mammary mucocele-like lesion Breast tumour of pregnancy (lactating adenoma) Collagenous spherulosis of the breast Gynaecomastia-like lesions in women References Chapter 18 Operations Introduction Tissue diagnosis in the clinic Removal of giant fibroadenoma and phyllodes tumour Microdochectomy Excision of mammary duct fistula Major duct excision (Adair/Urban/Hadfield) Drainage of a lactational breast abscess Subcutaneous mastectomy in male patients Subcutaneous mastectomy or skin sparing mastectomy in women Operations for inverted nipples References Chapter 19 Psychological aspects of benign breast disease Key points and new developments Introduction Psychological problems resulting from presenting with breast problems Psychological abnormality as a cause of benign breast disease References Chapter 20 Risk assessment and management Summary Breast cancer: the disease The breast cancer genes Conclusion References Index