A working reference

Breast Cancer

Biology, heterogeneity, and the decisions that follow, for oncologists who have to act on both.

Fourteen parts and seventy-nine chapters, written for people who already treat this disease. The biology is carried once, in full, and the management chapters cite it rather than restate it, which is what keeps a decision chapter short. The load-bearing part is the sixth, on heterogeneity: it sits before every treatment chapter so that all of them can assume it.

24 of 79 chapters built

Part I · Foundations and the global landscape

Two centuries of being confidently wrong about where breast cancer goes and why. Each idea is read for the error it corrected and the one it introduced.

  • 1History of breast cancer
  • 2Epidemiology and the changing burden of disease
  • 3Conceptual frameworks for understanding breast cancer

Part II · Normal biology, carcinogenesis, and inherited susceptibility

What the normal breast does, and how much of it a tumor keeps. Precursor states come before any malignant biology, because that is the order the tissue works in.

  • 4Normal breast development and physiology
  • 5Breast carcinogenesis and precursor states
  • 6The somatic genomic landscape
  • 7Inherited susceptibility and familial breast cancer
  • 8Risk assessment and prevention

Part III · Pathology and classification

Every taxonomy in this field was built for a purpose. The useful question is not whether a classification is true but what it was built to decide.

  • 9Histopathology and the spectrum of breast neoplasia
  • 10Clinical and molecular classification
  • 11Receptor assessment and the measurement problem
  • 12Triple-negative and other biologically diverse phenotypes

Part IV · Molecular biology and therapeutic vulnerabilities

Organized by pathway rather than by drug. Each chapter closes on the resistance mechanisms that the metastatic chapters will have to act on.

Part V · Immunology and the tumor microenvironment

Compartments first, then function, then spatial arrangement, then the host. Checkpoints arrive late here on purpose.

Part VI · Heterogeneity, evolution, and metastatic biology

The core of the book. It sits before the treatment chapters so that all of them can assume it, and every chapter in it separates what is biology from what is measurement.

Part VII · Detection, diagnosis, and biomarker assessment

Every assay here is a sampling procedure. What it measures, what it stands in for, and how far apart those two can drift.

  • 37Screening and early detection
  • 38Diagnostic evaluation and staging
  • 39Prognostic and predictive assays and somatic profiling
  • 40Liquid biopsy and longitudinal monitoring

Part VIII · Therapeutic foundations

Modality and drug class, carried once and in full. The disease chapters cite this part instead of repeating it, which is what keeps them short.

  • 41Principles of multidisciplinary treatment
  • 42Surgery and reconstruction
  • 43Radiation oncology
  • 44Endocrine therapy
  • 45Cytotoxic chemotherapy
  • 46Targeted therapy
  • 47Antibody-drug conjugates and targeted delivery
  • 48Immunotherapy

Part IX · Management of nonmetastatic disease

Decision-focused. Mechanism lives in Part VIII, so these chapters spend their length on who gets what, and when.

  • 49Atypia and in situ disease
  • 50Early hormone receptor-positive, HER2-negative disease
  • 51Early HER2-positive disease
  • 52Early triple-negative disease
  • 53Locally advanced and inflammatory breast cancer
  • 54Locoregional recurrence
  • 55The neoadjuvant setting as a scientific platform

Part X · Management of metastatic disease

Organized by biology rather than by line of therapy. Agents change faster than the reasons for choosing them.

  • 56General principles of metastatic management
  • 57Metastatic hormone receptor-positive, HER2-negative disease
  • 58Metastatic HER2-positive disease
  • 59Metastatic triple-negative disease
  • 60Expression and alteration-defined treatment across subtypes
  • 61Organ-specific metastases and complications

Part XI · Special populations and uncommon presentations

The patients trials enroll least and clinics see often enough. Extrapolation is the default here, so each chapter says how far it is being stretched.

  • 62Young adults, fertility, and pregnancy
  • 63Older adults and complex comorbidity
  • 64Sex, gender, and uncommon disease contexts

Part XII · Supportive care, survivorship, and patient experience

A full part rather than an appendix. Most of what a patient actually lives with sits here.

  • 65Treatment toxicity and supportive care
  • 66Rehabilitation and survivorship
  • 67Psychosocial care and lived experience
  • 68Communication and shared decision-making
  • 69Palliative and end-of-life care

Part XIII · Disparities, access, and health systems

Biology and access are separated at every step, and race is not allowed to stand in for either.

  • 70Disparities across the breast cancer continuum
  • 71Access, affordability, and financial toxicity
  • 72Global breast cancer care
  • 73Implementation, policy, and quality of care

Part XIV · Research methods, evidence, and emerging therapy

The part that will age fastest. Organized by mechanism rather than by agent, so that a new drug does not require a new chapter.

  • 74Experimental models and discovery platforms
  • 75Clinical trials and evidence interpretation
  • 76Data science and precision oncology
  • 77Emerging therapeutic platforms
  • 78Emerging treatment strategies
  • 79Unresolved questions and future directions