Breast cancer: Early diagnosis of precursor lesions and clinically inapparent carcinoma by fine needle aspiration
- 16 Downloads
Breast cancer death rate has remained stable at 26 per 100,000 for over 50 years. This control failure is due in large part to difficulty in early diagnosis.
Combined clinical evaluation, mammography and fine needle aspiration (FNA) offer the best opportunity for early diagnosis. Non-directed FNA is a useful adjunctive technique and three illustrative cases are presented. Cancer evolves from proliferative epithelial disease of ducts and lobules. Atypical duct hyperplasia in association with family history is a pertinent marker for development of cancer.
Identification of hyperplastic lesions traditionally occurs after surgical biopsy and histopathologic review. FNA demonstrates patterns of both duct hyperplasia and atypical duct hyperplasia. Ploidy studies of such smears offer the possibility of selecting precancerous lesions for extirpation. A combination of directed and undirected punctures and ploidy studies may yield early diagnosis of precancerous lesions.
Key wordsBreast cancer Precursor lesions FNA Duct hyperplasia Occult malignancy
Unable to display preview. Download preview PDF.
- 1.Ca —A Cancer Journal for Clinicians 41, 26 (1991).Google Scholar
- 9.McGinnis L S: The importance of clinical breast examination.Cancer (Suppl)64, 2657 (1989).Google Scholar
- 10.Linsk J A, Franzen’ S:Fine-Needle Aspiration for the Clinician. Philadelphia, J B Lippincott (1986).Google Scholar
- 11.Shapiro S, Venet W, Strax P, Venet L, Roeser R: Ten-to-fourteen year effect of screening on breast cancer mortality.J natn Cancer Inst 69, 349 (1982).Google Scholar
- 12.U.K. Trial of Early Detection of Cancer Group: First results on mortality reduction in the U.K. trial of early detection of breast cancer.Lancet ii, 411 (1988).Google Scholar
- 13.Morrison A S: Review of evidence on the early detection and treatment of breast cancer.Cancer (Suppl)64, 2651 (1989).Google Scholar
- 15.Azevedo E, Svane G, Auer G: Stereotactic fine- needle biopsy in 1594 mammographically detected non-palpable lesions.Lancet 1033 (1989).Google Scholar
- 16.Urbanski S, Jensen H M, Cooke G: The association of histological and radiological indicators of breast cancer risk.Er J Cancer 58, 474 (1988).Google Scholar
- 18.Franzen’ S, Zajicek J: Aspiration biopsy in diagnosis of palpable lesions of the breast. Critical review of 3479 consecutive biopsies.Acta Radiol (ther) 7, 241 (1968).Google Scholar
- 19.Linsk J A, Franzen’ S: Breast aspiration, in Linsk J A, Franzen’ S (ed):Clinical Aspiration Cytology, p. 111. Philadelphia, J. B. Lippincott (1989).Google Scholar
- 24.Zajicek J: Breast, in Zajicek J (ed):Aspiration Biopsy Cytology, p. 136. Basel, S. Karger (1974).Google Scholar
- 28.Ewing J: Precancerous diseases and precancerous lesions, especially in the breast.Med Rec 86, 951 (1914).Google Scholar
- 29.Rogers L W, Page D L: Epithelial proliferative disease of the breast — a marker of increased cancer risk in certain age groups.Breast 5, 2 (1979).Google Scholar
- 32.Hutchinson W B, Thomas D B, Hamlin W B, Roth G I, Peterson A V, Williams B: Risk of breast cancer in women with benign breast disease.J natn Cancer Inst 65, 13 (1980).Google Scholar
- 35.Gould D W, Moralis A R: Breast, in Hensen D E and Albores-Saavedra J (ed):The Pathology of Incipient Neoplasia, p. 233. Philadelphia, W. B. Saunders (1986).Google Scholar
- 36.Fentiman I S:Detection and Treatment of Early Breast Cancer. Philadelphia, J. B. Lippincott (1990).Google Scholar