Book review: Early breast cancer: from screening to multidisciplinary management

Breast cancer is a profound global health problem, with the majority of breast cancers presenting in early stages in developed countries. With deference to the scope of this problem, the editors of Early Breast Cancer: From Screening to Multidisciplinary Management have developed a comprehensive textbook dedicated to issues relevant to early breast cancer in particular. Topics include estimating breast cancer risk, breast cancer prevention, screening programs, diagnostic evaluation, breast pathology, establishing multidisciplinary teams, and treatment with surgery, systemic therapy, and radiation. Many of the sections in this book focus on organizational structure and the impact of various programs, which give a refreshing and relevant viewpoint to readers today who are concerned not only about scientific principles but also about healthcare delivery in general to large populations of people. Most of the authors of this textbook hail from the UK, with several additional contributors from the USA, Italy, Greece, and Australia. As a result, Early Breast Cancer: From Screening to Multidisciplinary Management takes on a characteristically European bent with a population-level viewpoint that underscores the text and organization. Of the 51 chapters in the book, the first 12 chapters are essentially devoted to breast cancer screening, with many examples from screening programs in the UK. The proceeding section on diagnostic evaluation outlines the major imaging modalities with a strong focus on mammography and lighter overviews of the use of ultrasound, MRI, and PET/CT. After straightforward sections including three chapters on biopsy techniques and five chapters on breast pathology, an entire very interesting section ensues comprising four chapters dedicated to issues in multidisciplinary management of breast cancer from a systems approach, again using examples from the UK. The book winds down with three sections on management with surgery, radiotherapy, and systemic therapy, respectively, followed by a final section dedicated to special circumstances. The 18 chapters in these sections highlight approaches specifically relevant to early stage breast cancer. They are organized with overview chapters intermixed with chapters on individual topics, giving more detailed accounts of novel techniques and controversies relevant to contemporary treatment. To summarize, this is an interesting textbook focused on the epidemiology, work-up, and treatment of early stage breast cancer in the modern era. It is designed to speak to practicing oncologists, generalists, and epidemiologists as well as students of these topics. It is also written at a level that could easily be digested by patients themselves who may have a more academic interest in the disease. This book is unique in that it approaches breast cancer from a population-level vantage point, giving examples of healthcare systems to implement breast cancer prevention, detection, and care. As such, it will be an excellent complement to resources that may delve more deeply into individual patient care by providing a larger framework for breast cancer as a public health problem.