THE BREAST: Its Problems--Benign and Malignant by
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THE BREAST: Its Problems--Benign and Malignant

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The scholarly air of the title--reminiscent of classic medical treatises--may very well reflect the age and style of its author. Oliver Cope is a surgeon at Massachusetts General Hospital and professor at Harvard Medical School. He learned the techniques of radical mastectomy for breast cancer in the late Twenties and early Thirties, and his reason for writing this book is his firm belief that the procedure is no longer warranted nor desirable. Removal of breast, pectoral muscles, and lymph nodes is psychologically traumatizing and physically debilitating. Instead he believes in a step-by-step program which begins with a limited excision of the tumor. This is followed by irradiation of the breast if the tumor is invasive, and finally multiple chemotherapy if there is a probability of metastasis. He details the rationale for this program, examining current survival statistics (incidentally pointing out the limitations of five-year survival figures) and explaining how radiation and chemotherapy affect cancer cells at different stages of growth and division. More than any other current popularization, he clarifies the normal function of the breast and describes the many different kinds of tumors, both benign and malignant, that can occur. A careful analysis of type can determine if the malignancy is one that might benefit from hormone therapy, for example, or by removal of the pituitary gland. The approach of immunotherapy is also explained in detail. It is too soon to tell--in terms of case numbers, controls, years since surgery--if the step-by-step procedure is indeed superior to the traditional regimen in breast cancer. What one can say is that Doctor Cope has written a thoughtful, comprehensive, genuinely interesting text on the breast. It should stir discussion among professionals, and, by virtue of its compassionate and hopeful outlook, appeal to any reader who wants to know more.

Pub Date: Sept. 20th, 1977
Publisher: Houghton Mifflin