Book review: Diagnostic Pathology – Breast 4th edition

The 4th edition of Diagnostic Pathology: Breast by David G Hicks and Susan C Lester, first published in July 2025, provides an excellent tool in the diagnosis of breast lesions using good quality images, comprehensive descriptions and a simple, easy to follow layout, which makes it also great for exam revision.

The book is divided into 10 sections, which are colour coded to aid finding the right information more easily. As a pathology resident, I used this book during my breast rotation. I found the Overview section particularly useful and would highlight this chapter. In this section, the different lesions that share a feature, e.g. spindle cell lesions, are listed and then discussed, summarised in a table and illustrated with side-by-side pictures, which helps in considering possible differential diagnoses quickly and can guide further investigations.

Each lesion is then covered later in the book in more detail, including several good quality example pictures. The molecular profile of the lesions and ancillary tests that can help in the diagnosis are also listed in these sections, along with a list of the differential diagnoses to consider and a brief description of each.

The book contains a breadth of information yet remains easy to read throughout, with a layout that is logical and makes finding the required information simple, as the lesions are categorised into chapters based on their nature.

There is also a section on prognostic and predictive factors, which aids understanding and helps to correlate the items of the report to patient outcomes. Another section covers the familial syndromes associated with breast lesions, which is also of benefit for residents preparing for an exam. Most of the references cited in the book are very recent, ensuring the information is up to date.

The book comes with an ebook version, accessible on the Elsevier website using the code within the printed copy. This version is easily searchable and can be annotated. The pictures can be further enlarged, which is very useful for histological images, although the resolution does not change. The pictures can be used to create flashcards to aid studying and, using the Elsevier app, the book can be read anywhere on mobile devices without having to carry the heavy physical copy.

Furthermore, the ebook version also includes video tutorials on handling breast specimens, which can be of value for more junior residents or biomedical scientists who are not yet familiar with these procedures.   

One slight downside of the book, however, is the use of the AJCC protocols rather than UICC, and the reporting guidelines and protocols, where mentioned, are based on the American system, which may differ in the UK and therefore are less relevant.

Overall, this is a very useful book to diagnose breast pathologies. With its comprehensive descriptions and illustrations, it can be of great benefit to any pathologist who encounters a breast lesion with a diagnostic dilemma, to help narrow down the differentials, and with the ebook version it can be quickly accessed anywhere.

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