It is an exciting time to be working in the area of breast disease. There are immense changes under way in all phases of investigation and management, including imaging with the introduction of digital mammography, the more routine adoption of guided biopsy, the use of MRI scanning in regular practice, and even surgeons being involved in ultrasound scanning. Vacuum assisted biopsy techniques are becoming established. The introduction of sentinel node biopsy and oncoplastic techniques to allow breast conservation have revolutionized surgical practice, which was once seen as conservative, destructive, and unexciting. New approaches to the systemic treatment of cancer with targeted monoclonal antibodies and tyrosine kinase inhibitors have taken the recognition of a risk factor for poor prognosis to an agent which prolongs survival.
All this makes the writing of this book more difficult as the ground is constantly shifting. We have tried to provide a contemporary account of breast cancer diagnosis and treatment with clues as to developments expected over the next few years, but some aspects will doubtless be out of date within months. This reflects a vibrant specialty and is a healthy sign.
This book is, however, not intended to be a comprehensive textbook. The text is intended to be a brief but practical guide to the disease. The illustrations form the core of any Atlas and we hope they serve to illuminate as well as illustrate.
Such a book is never the work of the listed authors alone and many colleagues in a variety of disciplines have contributed particularly by contributing photographs and checking over the text. To them we are extremely grateful. Special thanks, however, is reserved for the patients who allowed us to intrude on a traumatic event in their life to take and reproduce photographs. All were extremely accommodating and one is reminded again that there is no such thing as a brave doctor – only brave patients.
Matthew D Barber
Jeremy St J Thomas
J Michael Dixon