A working reference
Biology, heterogeneity, and the decisions that follow. Written for people who already treat this disease, and arranged so that the biology is carried once, in full, and the management chapters cite it rather than restate it.
A breast cancer is never one thing, and the report in front of you is a sample of it. Most of the hard decisions in this book follow from taking that seriously.
Three decisions shape every chapter, and they are worth knowing before you start.
Drug class, modality and pathway are written out in full in Part VIII. The disease chapters in Parts IX and X cite that material instead of repeating it, which is what lets a decision chapter stay short enough to read between clinics.
Every chapter separates what is biology from what is measurement. A threshold, a sampling scheme and a scoring convention are decisions someone made, and most of the disagreement in this field lives in that gap rather than in the tissue.
Part VI sits before every treatment chapter so that all of them can assume it. Chapter 28, on HER2 heterogeneity, is the one to read first if you want to know what kind of book this is.
Fourteen of them, in reading order. History and biology first, then measurement, then treatment, then everything that happens to a patient around it. The chapter count under each part is live.
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.
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.
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.
Organized by pathway rather than by drug. Each chapter closes on the resistance mechanisms that the metastatic chapters will have to act on.
Compartments first, then function, then spatial arrangement, then the host. Checkpoints arrive late here on purpose.
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.
Every assay here is a sampling procedure. What it measures, what it stands in for, and how far apart those two can drift.
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.
Decision-focused. Mechanism lives in Part VIII, so these chapters spend their length on who gets what, and when.
Organized by biology rather than by line of therapy. Agents change faster than the reasons for choosing them.
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.
A full part rather than an appendix. Most of what a patient actually lives with sits here.
Biology and access are separated at every step, and race is not allowed to stand in for either.
The part that will age fastest. Organized by mechanism rather than by agent, so that a new drug does not require a new chapter.
Every part, chapter and section carries a permanent identifier that says nothing about where it sits. A chapter keeps its identifier when it moves, and its file is named for it, so cross-references and citations survive any amount of reordering. Part numbers, chapter numbers and section numbers are computed when the book is built and exist nowhere in the source.
Citations go through a single reference store. A chapter names a study by a permanent key and the printed number is worked out per page, so moving a chapter changes the numeral beside a citation and nothing else.
The whole book installs to a home screen and reads with the network switched off. Nothing on any page is fetched from anywhere.