Dr. Susan Love's breast book

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The landscape of breast cancer has changed. New, non-invasive diagnostic techniques, new knowledge about prevention, new genetics, new treatments, new alternative and complementary resources are beginning to turn breast cancer into a chronic and perhaps preventable disease. Dr. Susan Love, whose earlier work has won the trust of women all over this country and abroad, has entirely revised her indispensable guide to reflect the very latest information. Readers of Dr. Susan Love's Breast Book will learn of the recent breakthroughs in genetic research, of Dr. Love's own work in developing a less invasive and highly accurate diagnostic technique, of the latest studies into preventive measures such as tamoxifen and dietary strategies, and of promising outcomes from new treatments for metastatic cancer. In the same warm, supportive, and often delightfully candid tone that has brought confidence to millions of women, Dr. Love helps each reader plan her own path through diagnosis, treatment options, and the changing world of HMO's and insurance. She also offers sound advice about combining alternative self-care with topnotch medical help.

Acknowledgments	p. xv
Introduction to the Third Edition	p. xvii
Part 1 The Healthy Breast
1 The Breast and Its Development	p. 3
The Ductal Anatomy	p. 8
How the Breast Develops	p. 11
Biology of Menopause: The Misunderstood Ovary	p. 19
Bras	p. 21
Breast Sensitivity	p. 23
Lumpiness	p. 24
2 Getting Acquainted with Your Breasts	p. 25
3 Breast Feeding	p. 33
Breast Feeding and Lumps in the Breast	p. 43
Sex and Breast Feeding	p. 45
Breast Feeding When You Haven't Given Birth	p. 46
Breast Feeding vs. Bottle Feeding	p. 47
4 Variations in Development	p. 51
Variations Apparent at Birth	p. 51
Variations Appearing at Puberty	p. 54
5 Plastic Surgery	p. 58
Silicone Implant Controversy	p. 60
The Procedure	p. 67
Breast Augmentation	p. 68
Surgery for Asymmetry	p. 70
Breast Reduction	p. 71
The Breast Lift	p. 74
Inverted Nipples	p. 76
Thinking About Plastic Surgery	p. 77
Part 2 Common Problems of the Breast
6 "Fibrocystic Disease" and Breast Pain	p. 83
Cyclical Pain	p. 86
Noncyclical Pain	p. 90
Non-Breast-Origin Pain	p. 91
Cancer Concerns	p. 92
7 Breast Infections and Nipple Problems	p. 94
Breast Infections: Intrinsic	p. 94
Breast Infections: Extrinsic	p. 100
Infection and Cancer	p. 101
Nipple Problems	p. 101
8 Lumps and Lumpiness	p. 107
Cysts	p. 108
Fibroadenomas	p. 113
Pseudolumps	p. 117
Cancer	p. 118
What to Do If You Think You Have a Lump	p. 119
Part 3 Diagnosis of Breast Problems
9 Mammography	p. 123
Radiation Risks	p. 125
What Mammograms Show	p. 125
Types of Mammograms	p. 129
Calcifications	p. 130
Mammographic Workup	p. 131
Quality of Mammograms	p. 133
Procedure	p. 133
10 Other Imaging Techniques	p. 136
Ultrasound	p. 136
MRI	p. 139
PET Scanning	p. 140
MIBI Scan	p. 141
CT Scanning	p. 141
Thermography	p. 142
Transillumination and Diaphanography	p. 142
The Future	p. 143
11 Biopsy	p. 144
Fine-Needle Biopsy	p. 145
Core Biopsy	p. 146
Surgical Biopsy	p. 151
How to Read Your Biopsy Report	p. 161
Part 4 Prediction and Prevention of Cancer
12 Understanding Studies and Clinical Trials	p. 167
Kinds of Studies	p. 168
Evaluating Studies	p. 172
Study Biases	p. 174
Becoming Part of a Study	p. 176
13 The Molecular Biology of Breast Cancer	p. 183
DNA, RNA, and Proteins	p. 183
Genes and Breast Cancer	p. 190
Invasion	p. 202
Angiogenesis	p. 205
Metastatic Disease	p. 208
Hormone Receptors	p. 211
Translational Research	p. 214
14 Risk Factors: Genetic and Hormonal	p. 215
Risk	p. 215
Genetic Risk Factors	p. 224
Hormonal Risk Factors	p. 233
15 Risk Factors: External	p. 237
Diet	p. 237
Alcohol Consumption	p. 241
Radiation	p. 242
Hormone Medications	p. 245
Fertility Drugs	p. 254
Pesticides and Other Environmental Hazards	p. 254
Occupational Exposures	p. 256
Electromagnetic Field (EMF) Exposure	p. 257
16 Precancerous Conditions	p. 260
Lobular Carcinoma In Situ	p. 263
Ductal Carcinoma In Situ	p. 267
17 The Intraductal Approach: A Breast Pap Smear?	p. 280
18 Prevention	p. 291
Lifestyle Changes	p. 291
Hormones	p. 294
Tamoxifen and Other SERMS	p. 296
Retinoids	p. 305
Preventive Mastectomy	p. 305
BRCA1	p. 308
BRCA2	p. 309
The Future	p. 310
Part 5 Diagnosis of Breast Cancer
19 Screening	p. 313
Evaluating screening Tests	p. 313
Breast Self-Exam	p. 316
Breast Physical Exam	p. 317
Mammography	p. 319
Screening Recommendations	p. 322
20 Diagnosis and Types of Cancer	p. 324
Types of Biopsy	p. 325
How to Interpret a Biopsy Report	p. 326
Biomarkers	p. 332
21 Staging: How We Guess If Your Cancer Has Spread	p. 336
22 Fears, Feelings, and Ways to Cope	p. 347
Coping: What to Tell Your Children	p. 355
Coping: Fears of Our Loved Ones	p. 358
Searching For Information	p. 359
What to Look For in a Doctor and Medical Team	p. 359
Second Opinions	p. 362
Part 6 Treating Breast Cancer
23 Treatment Options: An Overview	p. 367
Local Treatments: Surgery and Radiation	p. 368
Systemic Treatments: Chemotherapy	p. 380
Systemic Treatments: Hormonal Therapy	p. 389
Combinations of Chemotherapy and Hormonal Therapy	p. 394
Complementary Treatments	p. 395
The Future	p. 395
24 Special Cases	p. 397
Locally Advanced Breast Cancer	p. 397
Inflammatory Breast Cancer	p. 400
The Unknown Primary	p. 401
Paget's Disease of the Breast	p. 403
Cystosarcoma Phylloides	p. 404
Cancer of Both Breasts	p. 405
Cancer in the Other Breast	p. 406
Breast Cancer in Very Young Women	p. 406
Breast Cancer in Elderly Women	p. 409
Cancer in Pregnancy	p. 411
Women with Implants	p. 413
Breast Cancer in Men	p. 414
Other Cancers	p. 415
25 Surgery	p. 417
Anesthesia	p. 418
Preliminary Procedures	p. 422
Partial Mastectomy and Axillary Dissection	p. 424
Risks and Complications of Partial Mastectomy	p. 431
Total Mastectomy	p. 435
26 Prosthesis and Reconstruction	p. 444
Prostheses	p. 446
Reconstruction	p. 447
27 Radiation Therapy	p. 464
Initial Consultation	p. 466
The Planning Session	p. 468
The Treatments	p. 470
The Boost	p. 472
Side Effects	p. 474
The Future	p. 477
28 Systemic Treatments	p. 478
Adjuvant Chemotherapy	p. 482
Adjuvant Hormonal Therapy	p. 491
29 Complementary and Alternative Treatments	p. 496
Complementary Therapies	p. 498
Alternative Treatments	p. 509
Part 7 Living With Breast Cancer
30 Life After Breast Cancer	p. 517
The Follow-Up	p. 517
Lifestyle Changes	p. 520
Healing the Mind	p. 521
Sex	p. 523
Physical Adjustments	p. 526
Long-Term Side Effects of Chemotherapy	p. 534
Pregnancy	p. 537
Insurance and Getting a Job	p. 539
31 Dealing with Menopausal Symptoms	p. 541
Hormone Replacement Therapy	p. 543
Soy Protein: A Natural SERM?	p. 544
Natural Progesterone Cream	p. 546
Prevention: Osteoporosis	p. 548
Prevention: Heart Disease	p. 550
Treatment for Perimenopausal Symptoms	p. 551
32 When Cancer Comes Back	p. 555
Local and Regional Recurrence	p. 556
Distant Recurrence (Metastatic Disease)	p. 561
Taking Care of Yourself Emotionally	p. 570
When to Stop Treatment	p. 571
33 Metastatic Disease: Treatments	p. 575
Hormonal (Endocrine) Treatments	p. 577
Chemotherapy	p. 580
Immunotherapy	p. 583
Bisphosphonates	p. 584
Other Treatments	p. 585
Pain Control	p. 585
Experimental Treatments	p. 586
34 The Politics of Breast Cancer	p. 588
Appendices
A Drugs Used for Systemic Treatment of Breast Cancer	p. 599
B Resources, References, and Additional Reading	p. 602
C Comprehensive Cancer Centers	p. 639
D The Wellness Community Physician/Patient Statement	p. 646
Notes	p. 648
Glossary	p. 675
Index	p. 684
About the Authors	p. 700

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