To my lovely wife Patti—my best friend, companion, and golfing partner—and to the amazing children (James, Matthew, Patrick, Amanda, Ian, and Joanna) and grandchildren (Alexandra, Juliana, Grace, Logan, and Carter) that we share. I will forever be grateful to all of you for your love and support.
And to my parents, Herman and Maralee Hicks, who were my first teachers. Your encouragement and unwavering belief in me has made all the difference.
DGH
To my wonderful former chairman, Ramzi Cotran, who stopped me in the hall one day when I was a senior resident, slapped his hands in his classic fashion, and said, “Susan, Susan, where can I find a breast pathologist?” I said, “I could be a breast pathologist.” And only 20 years later, here is this book.
SCL
Preface
It is truly amazing how rapidly medicine is progressing and how quickly the field of pathology is advancing. Nothing makes this pace of change more readily apparent than attempting to write and update a second edition of a textbook! When we were asked to write the first edition of this book as part of the Diagnostic Pathology series from Amirsys, we both had the same thought, “What can we contribute that hasn’t already been done?” There are several breast pathology texts by excellent authors currently in print. As we thought about it further, however, valuable resources specific to this project became evident. For example, both of us have many years of experience as surgical pathologists and have developed complementary specific areas of expertise. Two authors working closely together are able to maintain a consistent approach and style and can provide different, but reinforcing, points of view. With the publication of the first edition, we were first pleased with the final results but then flooded with ideas about how the book could be improved. We began to make plans in anticipation of having an opportunity to incorporate these ideas into a second edition. We truly wanted to create a resource that we wish we could have taken advantage of when we were first struggling to learn these topics so many years ago.
One of the things that excited us was the knowledge that our breast pathology book and all of its updated content would become part of a larger online diagnostic support tool available to pathologists and clinicians alike—not just a paper book read off a computer screen. With the release of ExpertPath, the Amirsys/Elsevier online collection of all of the books in their Diagnostic Pathology series, this real-time diagnostic support tool is a reality, allowing the user to access this excellent material, which is updated quarterly, user friendly, and contains additional content and photographs not found in the print version. While working on the second edition, we have made extensive updates of new information from the literature and integrated into almost every chapter the new technologies and molecular approaches rapidly making their way from the basic science laboratory into clinical diagnosis and therapeutic decision-making. In addition, there are a number of new chapters that did not appear in the first edition covering a wide variety of topics, including commonly seen histologic patterns (e.g., spindle cell and papillary lesions), familial cancer syndromes (e.g., BRCA1 and 2 and Li-Fraumeni), unusual tumors (e.g., carcinomas with osteoclast-like giant cells), and newly described entities (e.g., IgG4-related sclerosing mastitis). Another important goal was to make sure that information was consistently presented and easily accessible. We were supported by an excellent team of medical artists, and together we created unique illustrations to illuminate difficult areas in diagnosis and classification. Photographs of cases from both of our institutions, including many additional outstanding and unusual cases we observed in the interval since the first edition, and the vast array of images from the publisher’s image bank were available.
Preparing this material has been a very long and challenging, but rewarding, process. We would not have completed the book without the outstanding assistance of the Amirsys staff—especially Arthur Gelsinger, Rebecca Hutchinson, Angela Terry, Laura Sesto, Andrea Mayo, and Sarah J. Connor—who guided us through this complicated process with helping hands and gentle humor. Dave Chance, the editor for the first edition, must also be gratefully acknowledged, as we would not have gotten this far without him. We are also tremendously
SECTION 1: Normal Breast
SECTION 2: Breast Specimens, Processing
SECTION 3: Diagnostic Patterns
SECTION 4: Disorders of Development
SECTION 5: Benign Epithelial Lesions
SECTION 6: Carcinomas
SECTION 7: Stromal Lesions
SECTION 8: Inflammatory Lesions
SECTION 9: Other Types of Malignancies
SECTION 10: Hereditary Breast Disease
SECTION 11: Unusual Presentations of Breast Lesions
