Jeanne A. Petrek, MD

The recommendations derived from the existing clinical trials of postmastectomy adjuvant radiation therapy seem to parallel the lessons learned from the trials of postoperative adjuvant chemotherapy conducted during the previous 20 to 30 years. From

In 1992, the FDA decided that silicone gel-filled breast implants would be available only through controlled clinical studies, despite the fact that they had been used for mammoplasty in millions of women around the world

Since physicians have stressed complete rehabilitation after breast cancer treatment, including breast reconstruction and psychosocial aspects, it follows that young women who have undergone such treatment may wish to resume their life roles, which often include motherhood. Consequently, the issue of pregnancy after breast cancer treatment has assumed paramount importance. This pertinent, accurate review of such a complex issue can be so brief because there are so few data on the subject. Given the diversity of the issues presented in the review, it is helpful to consider them individually.

Lymphedema continues to plague women after breast cancer treatment. The cosmetic deformity cannot be disguised with normal clothing; physical discomfort and disability are associated with the enlargement; and recurrent episodes of cellulitis and lymphangitis may be expected. Added to the physical symptoms is the distress caused unintentionally by clinicians, who are more interested in cancer recurrence and often trivialize the nonlethal nature of lymphedema.

Since the initial publication of Dr. Susan Love's Breast Book 5 years ago, every oncologist has seen this guide in the arms of many patients. When I read the cover to the second edition, stating that the book was "fully revised," I could not imagine how the universally excellent first edition could have been improved. The original text, in fact, remains essentially unchanged in the second edition. What has changed is the addition of some 138 pages addressing recent developments or expanding on various issues.