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Tavassoli FA, Devilee P: Pathology and Genetics: Tumours of the Breast and Female Genital Organs. WHO Classification of Tumours series - volume IV. Lyon, France: IARC Press

2003. 250pp. ISBN 92 832 2412 4


Editors: Fattaneh A Tavassoli and, Peter Devilee. World Health Organisation classification of tumours – new series, IARC Press, Lyon 2003.

As with all members of this series, this book is well presented and represents exceedingly good value for money.

In general the quality of production is good, with the photography of high to very high quality with good illustrations and colour balance. Plentiful micro and macroscopic pictures are presented, the latter being particularly helpful in the sections dealing with gynaecological lesions. Unfortunately in some cases the illustrations are poor, for example fig 1.105c is out of focus or too small, fig 184 which is stated to show ADH is of too low power to serve any useful purpose.

The text offers a well-organised and comprehensive review of breast and gynaecological tumours. In particular this volume deserves a lot of praise, particularly for its synthesis of taxonomy with molecular pathology and probably gives the best ready reckoner for molecular and cytogenetic alterations in breast and gynaecological cancer within a pathology text book, to date. This synthesis could have been taken further, for example in the breast section no reference to the work relating HER2 amplification with epidermotropism and Paget's disease is given [1, 2].

Like all such books there was clear evidence that this text had been written by a committee and in several places the opportunity for reaching a consensus view on some important issues was lost. Most notably, with regards to microinvasion, multiple different definitions were given; one would have thought that the WHO were just the body that would provide some unification with regards to this sort of contentious area. On the other hand I am glad to see a cautious approach to the premature concept of lobular intraepithelial neoplasia (LIN) and ductal intralobular neoplasia (DIN) was adopted. The concept is, in theory, attractive but until the various and probably multiple lines of breast cancer evolution are more clearly identified, this concept must remain in cold storage.

In other areas apparent consensus in the book is not matched by reality; the section on mucinous cystic lesions associated with pseudomxyoma peritonei rather oversimplifies what remains a still contentious area of pathology.

The pattern of referencing in the text was to a certain extent patchy and didn't include some of the original descriptions of many lesions, for example the co-incidence of mammary hamartoma and PASH [3]. These oversights no doubt relate to the idiosyncratic knowledge of the literature which many specialist histopathologists have. Occasionally the selectivity is misleading; in the section on lobular carcinoma it is stated that loss of E-cadherin occurs and that loss of E-cadherin is associated with poor prognosis. The implication given was that this related to lobular carcinoma but the references related to breast cancers in general. Even that view has been challenged, because loss of E-cadherin in ductal carcinomas is not independent of grade [4].

With regards to particular diagnostic aspects of the text, there are perhaps several areas that might have been further explored, although I appreciate that space is of the premium in a book such as this. For example, ductal adenoma of the breast is dealt with very briefly but in fact these lesions have a hugely diverse morphology which may lead to diagnostic difficulty.

Some of the gynaecological text deserves particular praise; the section on inherited tumour syndromes gives a masterly overview of a complicated subject.

Despite this some criticism then, this book represents a job well done and gives us with an extremely good, though at times selective, overview of current breast and gynaecological pathology in a compact and easy to use volume


  1. Potter CRD, Eechout I, Geerts M-L, Schelfhout A-M, Roels H: Keratinocyte chemotaxis in the pathogenesis of Paget's disease of the breast. Histopathology. 1994, 24: 349-356. 10.1111/j.1365-2559.1994.tb00536.x.

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  2. Schelfhout VRJ, Coene EDB, Delaey B, Thys S, Page DL, De Potter CR: Pathogenesis of Paget's disease: Epidermal heregulin-a motility factor, and the HER receptor family. JNCI. 2000, 92: 622-628. 10.1093/jnci/92.8.622.

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  3. Fisher CJ, Hanby AM, Robinson LRR, Millis RR: Mammary hamartoma – a review of 35 cases. Histopathology. 1992, 20: 99-106. 10.1111/j.1365-2559.1992.tb00938.x.

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Correspondence to Andrew M Hanby.

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Hanby, A.M., walker, C. Tavassoli FA, Devilee P: Pathology and Genetics: Tumours of the Breast and Female Genital Organs. WHO Classification of Tumours series - volume IV. Lyon, France: IARC Press. Breast Cancer Res 6, 133 (2004).

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