Mammography: Diagnosis and Pathological Analysis

Mammography: Diagnosis and Pathological Analysis was originally published in German, in 2003, by Dr. Marton Lanyi, a respected and important contributor to the field of mammography. The translated version, with a forward by Dr. Edward A. Sickles, is a detailed yet easy-to-read book. In it, Dr. Marton Lanyi describes the major diseases affecting the breast and how imaging techniques can be used in combination with clinical and pathologic findings to evaluate breast disorders. The numerous galactograms in this book are helpful; however, there is little material on breast ultrasound, MRI, or imaging-guided interventional procedures. A more thorough discussion of breast sonography and breast MRI would have been beneficial.

The book starts with a solid introductory chapter, which describes the anatomy and the physiology of the normal, healthy breast. The book is then divided into chapters that are based on the location of lesions and have titles such as “Lesions of the Terminal Ducts and Lobules” and “Simultaneous Lobular and Intraductal Changes.” Each chapter is then subdivided into sections that discuss the details of specific lesions. The book ends with a discussion of diseases of the male breast. A section discussing mammographic techniques and positioning would have been helpful. Also, a discussion of the benefits of screening mammography would have been a welcome addition.

Mammography: Diagnosis and Pathological Analysis is designed for readers with a solid understanding of breast diseases and breast imaging. We would suggest that one read Dr. Lanyi's book after having studied an introductory breast imaging text. This book is not intended for medical students or inexperienced residents who have no previous exposure to mammography.

There are 400 figures, with 695 figure parts, and the black and white drawings are particularly helpful. Many of the mammographic images are grainy, whereas the pathologic images are superb. Numerous figures throughout the book lack legends, and this is a major deficiency. For example, Figures 2.41 and 2.42 are gross and microscopic images, respectively, of a phyllodes tumor, which the author refers to in the text as cystosarcoma phyllodes. Both images are beautiful, especially the color picture of the gross tumor. Beside the images is the notation “See text.” It is difficult to fully appreciate the images without an adjacent legend. More important, without legends, the book is not suited for image review purposes.

A particularly strong component of the book is the wonderful material on calcifications and ductal carcinoma in situ (DCIS). Dr. Lanyi's coverage of microcalcifications—a troubling topic for most mammographers—is comprehensive, practical, and easy to digest. This section should be required reading for all breast imaging fellows.

The book is an easy read, and the author intersperses numerous anecdotes and personal experiences. Scattered typographic errors, especially in the reference sections, were noted along with some layout mistakes. For example, on page 120, the author discusses DCIS, including the Van Nuys classification scheme. The text discusses complete removal of DCIS calcifications and refers to Figure 3.40, an image of an intraductal papilloma. This figure was misplaced; it should have been placed in the section on intraductal papillomas and papillary carcinomas, starting on page 122. Errors of this sort detract from the solid information that Dr. Lanyi presents.

Overall, Mammography: Diagnosis and Pathological Analysis is a good book. It should be an educational asset for upper-level radiology residents and fellows in breast imaging and breast pathology. With an extensive index and a lengthy list of references at the end of each chapter, the book is a valuable resource. The book would be a good addition to most radiology departmental libraries. For novices, Breast Imaging, by Dr. Kopans; Diagnosis of Diseases of the Breast, by Dr. Bassett and colleagues, or Breast Imaging, by Dr. Cardeñosa, is suggested.