Dr. Susan Love's Breast Book

by Susan M. Love, Karen Lindsey (Primary Contributor), Elizabeth Love (Primary Contributor)

"The Bible for women with breast cancer" -- New York Times




For more than two decades, readers faced with a diagnosis of breast cancer have relied on Dr. Susan Love's Breast Book to guide them through the frightening thicket of research and opinion to find the best options for their particular situations. This sixth edition explains advances in targeted treatments, hormonal therapies, safer chemotherapy, and immunologic approaches as well as new forms of surgery and radiation. There is extensive guidance for the many women now living for years with metastatic breast cancer. With Dr. Love's warm support, readers can sort the facts from the fads, ask the right questions, and recognize when a second opinion might be wise.

Genres: Nonfiction, Health, Medical, Reference, Medicine, Womens, Education

704 pages, Paperback

First published January 1, 1990

Reviews

[Nick · Rating 5 out of 5]

I hope you never need this book for the reason that I did: a loved one was diagnosed with breast cancer. But if you do, get this book and read it, use it, and keep it handy. It's a godsend for de-mystifying a horrible, frightening process. Dr. Love is clear, up to date, sensible, kind, thoughtful, and even has a very gentle sense of humor. All of those qualities are necessary when you're faced with cancer. This book will help.

[Melissa B · Rating 4 out of 5]

Very comprehensive. Anything anyone wanted to know about breast cancer. I am a survivor, and found a lot of information in this book that was useful. It was long, a bit intimidating to begin with, and might be easier looking through the table of contents and finding what you might need there.
It was user-friendly, and doesn't speak to the lowest-common-demoninator. The author assumes the reader is intelligent enough to understand her words.
I recommend it to anyone with a first-hand knowledge of breast cancer, or to caregivers and families.

[Irene · Rating 5 out of 5]

The first thing that struck me was the very first line of the Acknowledgments, in which Dr. Susan Love says that she revises this book every 5 years. From my own limited research, it's clear that the treatment of breast cancer has had major developments over the last few decades, and it's good to know this book stays abreast (haha) of new advancements.

The second thing that struck me was the very first line of the Introduction, in which Dr. Love notes that this sixth edition, published in 2015, will probably be the last revision. I hope this is not really the case, because this book is such a thorough, accessible, go-to reference for breast cancer. It would be a shame if future women don't have an up-to-date resource like this one! I hope that maybe someone else from the Dr. Susan Love Research Foundation will take over the book and ensure it's continued relevancy. (Maybe they figure everything should just be online these days...)

Dr. Love's writing style is colloquial, her descriptions and explanations are clear and easy to understand. A quote on the front cover touts this book as "the bible for women with breast cancer," and it really is. I think any woman who has been diagnosed with breast cancer should get their hands on this book as soon as possible and keep it close by for reference.

This isn't a book that needs to be read cover to cover; chapter titles are self-explanatory, and there is a complete index, so you can look up terms and topics and questions as they come up. (In fact, there are sections towards the end titled "How Long Do I Have?" and "End-of-Life Planning: Making Your Wishes Known" that I really hope I don't ever have to read.)

That said, this book isn't just for women who have already been diagnosed with breast cancer. Any woman who has started getting mammograms, or who has found a lump and is facing a possible diagnosis, should have this book, too. There are entire chapters on screening and diagnosis that I imagine would be very helpful if they are read even before being diagnosed, or while going through it.

In my personal experience, I wish I had this book for reference as soon as I felt a lump. I received this book as a gift in the time between diagnosis and double mastectomy, but I admit I didn't read it right away, and that's on me. I should have read the sections on mastectomy and sentinel lymph node biopsy before my surgery. All the information is so straightforward and thorough; the book included everything that I had otherwise gathered from multiple web sites and online support groups, plus some. Moreover, my online research involved having to filter out random pieces of information that didn't apply to me, and it took a lot longer than if I had just read a few pages of this book instead.

I finally picked this book up about 3 weeks after my surgery, just before meeting with my medical oncologist. Once I saw how accessible the information was, I jumped ahead, searched the index, and read the pages about types of cancers and different kinds of treatment. Reading just these select pages helped me feel more prepared for my appointment. And as soon as my oncologist confirmed my treatment plan, including chemotherapy and hormone therapy, I went straight to relevant sections of the book.

I did notice that the book does not use some common terms, even when it does address the particular issue. For example, it mentions that after a mastectomy, "surrounding tissue under the arm may seem baggy and excessive and hang over your bra," (p. 475) but it doesn't use the term "dog ears", which is how the condition is referred to in online forums. It also describes "axillary web syndrome" (p. 348) as a side effect of lymph node surgery, but does not use the word "cording", and neither term is included in the index. As someone who happened to develop cording after surgery, an index reference to this topic would have been nice.

Additionally, not every drug is specifically mentioned. For example, in the section on gonadotropin-releasing hormone agonists, Zoladex (name brand for goserelin) is discussed, but not Lupron (name brand for leuprolide). Taxol (name brand for paclitaxel) is also not in the index. I understand that not every single drug can be covered, but as someone being prescribed these medicines, the omissions were noteworthy for me.

I might have given the book 4 1/2 stars (if 1/2 stars were possible) because of the above two observations, but I do wonder if the book being published in 2015 is a contributing factor. Like maybe the terms "dog ears" and "cording" have only recently become more widely used? Or maybe Lupron and Taxol are less common these days? I don't know.

Because this book is more like a reference book, I have not read it in its entirety. I certainly plan to use it as needed moving forward.

[Bionic Jean · Rating 5 out of 5]

The best book about breast cancer. Written by the world-famous expert, surgeon, researcher, teacher and activist. Essential and comprehensive. The latest edition is a large paperback and over 850 pages, but clear and understandable by a lay person, as well as those medically trained. It is available as an ebook, but you may prefer the print copy, as the diagrams may be clearer.

[Karen · Rating 5 out of 5]

Every doctor I saw told me to buy this book. At the Seattle Cancer Care Alliance, they'll give you a copy to borrow if you need one. I brought this with me to every appointment, used it to decipher every pathology report, and read some parts over and over again. Every woman should have this book-- doesn't matter if you've had cancer or not.

[Amy · Rating 5 out of 5]

They don't refer to it as "the Bible for women with breast cancer" for nothing! Dr. Love deciphers difficult concepts, clearly explains risk (which I would venture to say 99% of society does not understand), and offers detailed information on the most recent studies (including the problems with each study and also discusses studies currently being done whose results will help answer currently unanswered questions). A great resource for every step of the journey from diagnosis, to surgery, to treatment, to the important 5 year milestone. Buy the book for anyone you know who has recently been diagnosed with breast cancer and prepare to dog-ear and highlight your way to becoming an expert.

[Laurie · Rating 5 out of 5]

A must read for all women, and an excellent reference for those with questions. It has helped me to know that my Mom's doctors are on the right track with her treatment, and gave me the tools to ask the right questions.

The book is updated every five years, so make sure you read the most up to date version for the lastest in science.

Also check her website: http://www.dslrf.org/index.asp

[Joann · Rating 5 out of 5]

This is the most comprehensive and educational book I have ever read on diagnosis and treatment particles. I read the book as soon as was diagnosed and this helped immensely. There were no surprises and I had time t absorb the information before having to deal with it. I have leant my book more times than I canrememberover the last17 years. If you, or someone you love is faced with this battle, you must read this book.

[Km · Rating 5 out of 5]

I am reading the sixth edition, and I would recommend that only the most recent edition be used as a resource.

The book is my go-to book, and I reference it continuously. It is well-organized, and the author writes with depth of knowledge, empathy, and a frankness that caring physicians bring to their practice.

It would be a very thoughtful gift for anyone who is personally impacted by breast cancer.

[Chickenlips422 · Rating 4 out of 5]

Wish that there was a separate section for women of color-such as noting the subtle differences---do not get red dots after radiation, but black dots Really appreciate that this edition is totally rewritten to include the new research about DCIS and to highlight the collateral damage that has not been spoken about, which the author, Susan Love discovered with her own diagnosis. Book continues to be a bible for women with breast cancer.

[Lucy Takeda · Rating 4 out of 5]

I was diagnosed with DCIS in April this year. This is reportedly THE book for reference for breast cancer patients. It had quite a bit of useful info. The index was essential for locating data related to DCIS specifically. However, I purchased a huge book, and only about 1/6 of it applied to my scenario.

[Karen]

* 40 Books to Read Before Turning 40
The manual for making your first four decades the most joyful, wise and stress-free of your life.

This 752-page tome tells you everything you need to know about your mammary glands, including new research about the ways that local environments influence the odds of your getting breast cancer.

[Shauna · Rating 5 out of 5]

I read this shortly after being diagnosed with breast cancer. I was in my final year of college and one of my Spanish professor's loaned it to me. Very helpful and informative. I recommend it to anyone who is recently diagnosed with any kind of cancer.

[Brenda · Rating 5 out of 5]

Fantastic resource if you have breast cancer. Easy to read and a great resource to refer back to.

[Nicholas Wright · Rating 5 out of 5]

There are not enough amazing things I can say about this book.

I am so incredibly grateful that someone recommended this book to me when my wife was diagnosed. I think having someone close to the diagnosed, rather than the diagnosed themselves read the book would be my recommendation. There is a lot of information in the book, and not all of it would be healthy to try and digest all in one go right after being diagnosed. Being able to read it and filter the necessary information through to my wife worked well for us.

The book simply and calmly takes you through every single step of the journey and educates you along the way on everything from receiving and understanding your diagnosis to treatment options all the way to living life as a cancer survivor.

As a husband it helped contextualise what my wife was going through, thinking, struggling with etc. It is so holistic that it addresses everything from the physical symptoms to the mental and emotional difficulties women have as a result of breast cancer. It was invaluable for me to support her at home and in the Drs' offices.

A breast cancer journey can feel like a whirlwind with no time at all from receiving a diagnosis to having to make really difficult, lifelong decisions. This book allowed me to support my wife in finding the right thoughts; helped us understand the different dimensions of each of the decisions and ultimately allowed us to be as informed as possible when hearing the opinions of her Drs and discussing options.

There is a lot to digest in here and not all of it is necessary, so I recommend reading the chapters that are relevant to the part of the journey you are about to go through. This will mean that you'll be equipped with the right information as and when you need it, but stops you from having to think too far in advance.

Get the book!

[Kristy · Rating 4 out of 5]

This is an extremely comprehensive and readable book that will be particularly interesting to anyone diagnosed with breast cancer but which should be required reading for anyone with breasts. Full disclosure: I read the 2005 edition, which was the most recent edition at half price books when I was shopping -- things have been changing so fast in the world of breast cancer treatment that it is woefully out of date, but, tbh, the most recent edition (from 2015) will be equally behind the times. Since I have done A LOT of reading about breast cancer, reading a book from 15+ years ago was an enlightening time capsule on how different treatment for breast cancer (and especially metastatic breast cancer) was not that long ago. What isn't dated is Love's helpful and detailed descriptions of the anatomy of the breast and the basics of how cancer develops and progresses. I was also really drawn to her to-the-point discussion of the limitations of mammograms and breast self exams. Love has an authentic, opinionated, and personable writing voice and a sly sense of humor. The line drawings that illustrate the book are sometimes helpful and sometimes hilarious, but I mostly loved them. If I see the 2015 version at a used book store in the future, I will probably pick it up to see how Love's viewpoint has changed over the years. Highly recommended in combination with other sources that cover more recent developments.

[Debbie · Rating 5 out of 5]

I only wish I’d read this in 2010, during my first round with breast cancer. This time around I discovered this amazing volume of information.

It has helped me understand pathology lingo and prepare questions for my surgeon. This time around I feel better prepared, thanks to Dr. Love.

[Esther · Rating 4 out of 5]

The problem with all of these super helpful books about breast cancer–including The Complete Guide to Breast Cancer by Trisha Greenhalgh and Liz O'Riordan, two doctors, one a breast cancer surgeon, who have both experienced BC; Living Through Breast Cancer, by Carolyn Kaelin, another breast cancer surgeon who survived BC only to die of brain cancer; and Dr. Susan Love's Breast Book by, of course, Susan Love, yet another breast cancer surgeon who died of leukemia less than a year ago–is that we don't read them UNTIL we have breast cancer.

Ideally I'd have boned up on breast cancer prior to diagnosis. I can't imagine why it never occurred to me to do so.

It would have been great if I had known back when the knowledge would have done me some good that it was not in fact absolutely vital that I begin radiation within six or at most eight weeks following surgery. Had I known that (wouldn't you think my surgeon could have told me?) I would have waited for that appointment with radiation oncologist Dr. H rather than sticking with Dr. W, about whom I had soooo many misgivings, which as it turned out were more than justified.

I thought I needed to start as soon as possible, as in yesterday, and Dr. W was the soonest of the possibles. Live and learn. At least I hope I'll live. I have certainly learned.

For my own future reference, the things Dr. Sue mentions that resonated, hit a nerve, whatever, that I may want to revisit in future:

76: "We all probably walk around with dormant cancer cells."
103: Factors that increase the relative risk for IBC, which apply to me. Age 65+. Dense breasts. Alcohol consumption. Early menarche. Late age at first-term pregnancy. Late menopause. One first-degree relative with breast cancer.
107: Finally, DES is given serious consideration. My mother took it. She developed BC in her 70s. I was exposed in utero. I developed BC in my 60s. "This was tragically demonstrated during the 1950s and 1960s; a synthetic estrogen, diethylstilbestrol (DES), was widely prescribed to pregnant people to prevent miscarriages.... A recent followup study suggested...a definite increase in (breast cancer) risk in (those patients' children) over age 40."
108: "People who menstruate for more than 40 years seem to have a particularly high risk." If you subtract the 27 months I spent pregnant, and the 36 I spent breastfeeding, that still leaves 39 years.
110: "Dense breast tissue seems to represent an activated breast tissue more prone to cancer." And yet Dr. C did not advise further screening.
134: Tamoxifen should not be prescribed if there is a history of TIAs. And yet it was prescribed to my mother, with her history of TIAs. She was still taking it when she died...as the end result of vascular dementia.
241: "And having sensation is significantly better than having bilateral mastectomies with numb reconstructions...reconstruction is a cosmetic procedure, not a functional one."
255: "...others may want to get it all over with as soon as possible and get back to their lives as though it never happened...but you need to remember that, as I said earlier, it HAS happened, and you can never go back to your life exactly the way it was."
259: "The reason for adjuvant or neoadjuvant systemic therapy is the fact that breast cancer deaths rarely occur because of what is in the breast. You could have a lump as big as a basketball, and it would not kill you. What kills people with breast cancer are the breast cancer cells that are in other, more important parts of the body such as the lungs, liver, bone, or brain.... Obviously many patients have undetectable microscopic cells in other parts of their bodies at the time of diagnosis...we know that cells have circulated well before the cancer was discovered."
296: "...most patients diagnosed with LCIS or DCIS think of themselves as having cancer, and, indeed, in medicine we've tended to move from the language of 'precancer' into that of 'non-invasive cancer.'"
302: "Surgeons often have a bad habit of saying they 'got it all,' which is misleading. People tend to think of cancer as a pea that expands to a marble and ultimately a golf ball. Dr. Stephanie Graff...tells patients cancer is much more like a pile of salt. 'And if you hold your salt shaker upside down on your kitchen counter, you get a pile of salt–the bigger it is, the more it spreads,' Graff explains. 'So when your surgeon says "I got it all," what they mean is "I cleared up your pile of salt," and your radiation oncologist is then the o ne who clears up the salt sprinkles that are all over the kitchen, which in this analogy includes your skin, the remaining breast, the muscle of the chest wall, and the fat and structures of the armpit.'"
319: Numbers, in studies, impress oncologists, but individual women must take into account side effects and how they affect quality of life.
336: Dr. Love used to explain to women what they could expect in surgery, unlike Dr. Bott, or Nurse Robbie, who responded to my questions with, "Don't overthink it Esther."
400: "(Radiation treatment) lasts about five weeks, often using about 4,500 to 5,000 rads–also known as centigrays–of radiation (a chest x-ray is about a fraction of a rad)."
403: "After a course of radiation to treat your breast, you may be given a boost–extra radiation to the spot where the tumor was. This is delivered by the same radiation machine, but instead of x-rays, it uses an electron beam, in contrast to the rest of the treatment, which delivered photons. Electrons are a special kind of charged particle; they give off energy that doesn't penetrate very deeply, so most of the dose is deposited shallowly in the breast or skin.... It was added in the days when we did not demand clean margins." Well, since I had a positive anterior margin (which I didn't clue into till AFTER radiation, my surgeon having said she got "all the cancer"), I guess it's a very good thing I got the boost.
409 & 477: "Another side effect can occur between three and six months after you've finished your (radiation) treatment. the muscle that goes above and behind your breast, the pectoralis major muscle, will get extremely sore, and it's worse if you grab it between your fingers. That's because the radiation causes inflammation of the muscle, and as it begins to regenerate, it can get sore and stiff, just as it would if you threw it out during strenuous exercise." Thank you dead Dr. Love. No one, but no one, warned me this would happen. I began to experience exactly what she describes beginning a few weeks ago, two months after finishing radiation. Epona forbid that these fricking oncologists tell you ANYTHING. Oh wait, Dr. Love WAS an oncologist.
475: "I (as in, Dr. Love) always knew intellectually that there were side effects from cancer treatment, but it took my own experience with the disease (leukemia) to fully understand what I call the collateral damage....Yet when acting in the capacity of a physician, I often downplayed the extent of the collateral damage. My great revelation was that the doctors who treat you are comparing you to the people who died and are patting themselves on the back, metaphorically, because you are still alive. But patients like us are COMPARING OURSELVES TO HOW WE WERE BEFORE AND WE ARE ACUTELY AWARE OF THE PRICE WE PAID, BOTH PHYSICALLY AND EMOTIONALLY." Emphasis mine.
505: "Aside from feeling that your body has betrayed you, there can be a feeling of invasion from the treatments. All these strangers have been poking and prodding you for weeks, YOU MAY ALMOST FEEL VIOLATED...." Emphasis mine. Yes, and yes, and yes. When the prickling and heat and swelling from radiation were at their most intense, I sometimes wanted to just throw open my shirt to the cool March air. Who cared if some passerby saw the poor thing. Everyone else already had anyway.
526: "We have always known that some types of breast cancers–the hormonal ones–like to spread to the bones and skin, whereas the hormone-negative ones are more likely to go to the lungs, liver, and brain."
529: "Diagnosing metastatic disease early on a scan or blood test does not make the treatment easier or more effective. This means you do not have to kick yourself for not complaining sooner."

[Kat · Rating 5 out of 5]

My mother has survived breast cancer twice. Twice. My family has survived breast cancer twice also. I still remember watching my mother emerge from a shower - I was sitting on her bed talking to her and the light hit her breast and I saw the color and the texture and something just resonated in me that something wasn't right. I was right and that began the journey to mastectomy. I hit the books, hit the internet and became as informed as I could so I could be the help my mother would need and Dr. Susan Love was a godsend. I remember going to her website and looking at the pictures of mastectomies so I could know what I was going to have to look at on my mother. I also knew that my face would tell her so much and I wanted my face to be real, informed, loving and complete in its non-verbal message of acceptance. I am a firm believer in the truth and if I know what to expect I can face anything. Truth really does set you free. It was there in full color - I will never forget the picture slowly emerging from the bottom up. (downloads were slow then!) and voila, there was this 40ish woman in jeans and bare from the belly up and she was beautiful and grinning and breastless. It didn't matter - she was radiant with the healing. For that one image, I am grateful to this informed doctor for her empowerment. We went, we fought the cancer and we, as a family surrounded our mother with love abundant. She survived one surgery and then found, through the fingerprint test on the other breast that she needed a second surgery. Again, the book, the answers and the guidance through a gifted physician's insights and compassion. Highly recommended.

[Chanequa Walker-Barnes · Rating 4 out of 5]

This book is hands-down the authoritative text on breast health. It begins with an explanation of breast anatomy, providing information that women should, but don't, know about their bodies. The remainder of the book is focused on problems that can develop with the breasts, with a significant component devoted to the etiology, diagnosis, and treatment of breast cancer. Dr. Love manages to distill this information, which can be technically complex, in language that is accessible to non-scientific types. Her aim is to provide clear information that individuals can use to make decisions about treatment options. In particular, she is concerned about the medical establishment's tendency to over-treat breast cancer. However, she doesn't tell readers what to do. Instead, she lays out the information and options so that readers are equipped to talk with their doctors and make informed decisions. She also provides information on external sources of support and information. As a breast cancer patient, this book has been invaluable in helping me make treatment decisions.

[Julie Laporte · Rating 5 out of 5]

Read this one cover to cover, including the parts which didn't apply to my situation, just to get a comprehensive overview. To be used as general information....managing the specifics of your own case are for a different book. After reading this and supplementing with more specific info on the Internet, I was able to communicate effectively with my "team" and ask relevant, important questions which resulted in making the best decision for me. Don't forget to balance your information gathering with soul-searching as well.

My husband also listened to key chapters in the audio version, which empowered him and spared me from having to explain basics to him.

[Deanna · Rating 4 out of 5]

Excellent reference for those fighting breast cancer. Extremely informative and even possible to read as a narrative. Can be overwhelming, but that's no fault of the author; the subject is intense with many unknowns. I found it revealed and reshaped my attitude about breast cancer's seriousness and treatability.

[Nicki Kyle · Rating 5 out of 5]

This book is GREAT for all women, not just those diagnosed with Breast Cancer.
There is alot of information on how the breast develops, to the MYTHS of "Fibrocysistic Breast Disease". It even explains breast feeding, pros and cons of breast enlargement, and augmentation, etc.
Very Informative!!

[Christy · Rating 4 out of 5]

I don't have any history of breast cancer, nor any particular risk factors that I know of, but I eagerly read through 600 pages of this book. Dr. Love has a way of explaining science that really appeals to me-- unlike many authors, she doesn't assume that I'm five years old OR a fellow scientist, but rather an intelligent, capable grown-up.

[Kimmie Durham · Rating 5 out of 5]

Dr. Love's book is the Breast Cancer bible! It is found in most surgeon's offices as well as in the library of most of us that have endured a journey w breast cancer. It is the single BEST gift I pay forward when a person gets diagnosed. Thank you for providing information and guidance! We will find the CAUSE and thus the CURE!

[Karen · Rating 5 out of 5]

A must read resource for anyone with breasts. I am so happy that this volume of information has been continually updated as research advances in the understanding and treatment of breast cancer. This is a great resource for anyone who gets the dreaded 'call back' after an annual mammogram as well as someone now facing a diagnosis of breast cancer.

[Debra · Rating 4 out of 5]

This book gave me a lot of information that I needed when I was newly diagnosed with breast cancer. It was helpful, because going into the cancer "culture" was unknown territory, and patients really need to research their choices and treatments in order to take control of their won lives.

[Terry · Rating 4 out of 5]

I just read this for the purpose of a presentation on Breast Cancer. What a wonderful book for those who have Breast Cancer! It is wonderful that there is this much information out there for patients to have access to!

[Elizabeth]

c2000

inspite of the title, mostly a book about cancer

piercings?
tatoo's?
bondage?
whipping?
lactation with nipple rings?

nothing about these topics are in the index or TOC

the section on lifestyle issues is about whether to delay having children!!

[Susan Johnson · Rating 5 out of 5]

If you or a loved one has been diagnosed with breast cancer, this book has a wealth of information on the breast. Details and drawings are very informative and help take some of the unknown out of your cancer and what you'll be going through.