Acknowledgments
John:
The inspiration for writing this book came from my patients. Their stories have taught me more about medicine than all the textbooks I have read and the lectures I have attended.
The book could not have been written if it were not for the support from my wife, Jan West, RN. She gave me the encouragement to start the project and provided ongoing support until the last words were written.
I’ve had support from so many friends, family, and patients that it is not practical to mention them all, but a few deserve special acknowledgment.
Breast care has reached the level of complexity that it takes a team to ensure optimal care and the same was true for this book. My physician support team included Drs. June Chen (breast radiologist), Michael Schoen (pathologist), John Link (breast oncologist), and Nimmi Kapoor (surgical oncologist). Their patience and expertise are greatly appreciated.
Technical support was also essential. Special thanks to Steven A. Feig, MD (the mammography controversy); Joel Moskowitz, PhD (cell phones); Evrin Ruzic, MD (organ transplant); Tim Taylor, PhD (toxicology); Kimberly Banks, MS, CGC, MBA (genetics); and Jennifer Swisher, PA (genetics). It should be noted that I take full responsibility for how I interpreted the advice they provided.
A special thanks to my many friends who were so gracious with their time and talent. The short list includes: Gary Liebl, LHD, and Helen Hess (legal) were of great help in clarifying technical details. Abra Negreti and Judy Herrick helped fine-tune the final draft. Tracy Frantz provided insightful comments on what it is like to have a young daughter with a cell phone–related breast cancer. Maralyn Watson was gracious in sharing details about her daughter, Michelle.
I was also fortunate to be assisted by the BenBella team, who were highly professional and a joy to work with. Special thanks to Leah Wilson and Eryn Carlson, who walked me through the progression of transforming my draft proposal into an intelligible book. The process was grueling, but they made it all worthwhile.
Finally, I would like to express my appreciation to Maralys Wills, who is a patient, a friend, and a gifted writer. It was clear from the start I needed help on this project. When Maralys agreed to come on board, I knew we had a winning team. Without her experience and expertise, this book would never have come to print.
Maralys:
As always, I’m indebted to my husband, Rob, who accepts—nay, maybe enjoys—a kind of bachelorhood while I’m writing a book. But he goes beyond acceptance: He takes me out often for dinners, and he’s apt to say, “I’m fine down here, babe. Go back upstairs and work.”
With thanks to my critique group, who read each chapter and offered much-needed advice: Allene, Pam, Barbara, and P.J., who understood perfectly what we were trying to do. But a special thanks to the two men, Erv and Terry, who were not appropriately equipped but were willing, nonetheless, to take the long view on the presentation.
Thanks, also, to numerous family and friends who listened patiently as I enumerated various little speed bumps in the project.
Contents
Introduction: Why This Book Was Written
1 The Controversies That Drive This Book
General Breast Care Guidelines by Age and Sex
2 For Children, Teens, and Women Under Forty
4 For Women of Childbearing Age: Birth Control, Pregnancy, and Lactation
7 Abnormal Mammograms: Calcifications and Densities
Uncommon but Perilous Breast Problems
10 Infiltrating Lobular Cancer: The Devil’s Cancer
11 Inflammatory Breast Cancer: The Silent Killer
12 Paget’s Disease of the Nipple
SECTION IV
Controversies in Breast Care
13 The Breast Self-Exam Controversy
14 “My Mammogram Was Normal, and Now I’m on Chemo”
15 Shame on You, Dr. Krauthammer: Why He’s Wrong About Mammograms
16 Mammograms: The Spin Stops Here
17 Your Bra: A No-Phone Zone
18 Genetic Testing
SECTION V
Prevention
19 Beating the Genetic Odds: Exercise, Diet, and Weight Control
20 Alcohol, Vitamins, and Hormones: What Helps and What Hurts
21 “Why Me?” . . . Think DDT: The Connection Between Environmental Toxins and Cancer
SECTION VI
After Diagnosis
22 Just Diagnosed: Questions You Might Have
23 Who Needs a Second Opinion—and Why?
24 Mastectomy Versus Lumpectomy
25 Breast Reconstruction After Mastectomy