Springer Nature is making Coronavirus research free. View research | View latest news | Sign up for updates

Breast cancer: Early diagnosis of precursor lesions and clinically inapparent carcinoma by fine needle aspiration

  • 16 Accesses


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.

This is a preview of subscription content, log in to check access.


  1. 1.

    Ca —A Cancer Journal for Clinicians 41, 26 (1991).

  2. 2.

    Strax P: The Health Insurance Plan of New York study.Cancer (Suppl)64, 2641 (1989).

  3. 3.

    Kreuzer G, Boquoi E: Aspiration biopsy cytology, mammography and clinical exploration: a modern setup in diagnosis of tumors of the breast.Acta Cytol 20, 319 (1976).

  4. 4.

    Hermansen C, Poulsen H S, Jensen J, Langfeldt B, Steenskov V, Frederiksen P, Jensen O M: Diagnostic reliability of combined physical examination, mammography and fine-needle puncture (“Triple Test”) in breast tumors.Cancer 60, 1866 (1987).

  5. 5.

    Cady B: New diagnostic, staging and therapeutic aspects of early breast cancer.Cancer 65, 634 (1990).

  6. 6.

    Tavassoli F A, Norris H J: A comparison of the results of long term follow-up for atypical intraductal hyperplasia and intraductal hyperplasia of the breast.Cancer 65, 518 (1990).

  7. 7.

    Page D L, Dupont W D: Anatomic markers of human premalignancy and risk of breast cancer.Cancer 66, 1326 (1990).

  8. 8.

    Kritchevsky D: Nutrition and breast cancer.Cancer 66, 1321 (1990).

  9. 9.

    McGinnis L S: The importance of clinical breast examination.Cancer (Suppl)64, 2657 (1989).

  10. 10.

    Linsk J A, Franzen’ S:Fine-Needle Aspiration for the Clinician. Philadelphia, J B Lippincott (1986).

  11. 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).

  12. 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).

  13. 13.

    Morrison A S: Review of evidence on the early detection and treatment of breast cancer.Cancer (Suppl)64, 2651 (1989).

  14. 14.

    Winchester D P; Evaluation and management of breast abnormalities.Cancer 66, 1345 (1990).

  15. 15.

    Azevedo E, Svane G, Auer G: Stereotactic fine- needle biopsy in 1594 mammographically detected non-palpable lesions.Lancet 1033 (1989).

  16. 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).

  17. 17.

    Bartow S A, Pathak D R, Mettler F A: Radiographic microcalcification and parenchymal pattern as indicators of histologic “high risk” benign breast disease.Cancer 66, 1721 (1990).

  18. 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).

  19. 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).

  20. 20.

    Sneige N, White V A, Katz R L, Troncoso P, Lipshitz H, Hortobagy G N: Ductal carcinomain situ of the breast. Fine-needle aspiration cytology of 12 cases.Diag Cytopath 5, 371 (1989).

  21. 21.

    Stanley M W, Tani E M, Skoog L: Fine-needle aspiration of fibroadenomas of the breast with atypia.Diag Cytopath 6, 375 (1990).

  22. 22.

    Marshall C J, Schumann B, Ward J H, Riding J M, Cannon-Albright L, Skolnick M: Cytologie identification of clinically occult proliferative breast disease in women with a family history of breast cancer.Am J clin Path 95, 157 (1991).

  23. 23.

    Kern W H, Dermer G B: The cytopathology of hyperplastic and neoplastic mammary duct epithelium.Acta Cytol 16, 120 (1972).

  24. 24.

    Zajicek J: Breast, in Zajicek J (ed):Aspiration Biopsy Cytology, p. 136. Basel, S. Karger (1974).

  25. 25.

    Bibbo M, Scheiber M, Cajulis R, Keebler C M, Wied G L, Dowlatshahi K: Stereotaxic fine needle aspiration cytology of clinically occult malignant and premalignant breast lesions.Acta Cytol 32, 193 (1988).

  26. 26.

    Linsk J A, Kreuzer G, Zajicek J: Cytologic diagnosis of mammary tumors from aspiration biopsy smears: II. Studies of 210 fibroadenomas and 210 cases of benign mammary dysplasia.Acta Cytol 16, 130 (1972).

  27. 27.

    Bondeson L, Lindholm K: Aspiration cytology of tubular breast carcinoma.Acta Cytol 34, 15 (1990).

  28. 28.

    Ewing J: Precancerous diseases and precancerous lesions, especially in the breast.Med Rec 86, 951 (1914).

  29. 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).

  30. 30.

    Page D L, Dupont W D: Anatomic markers of human premalignancy and risk of breast cancer.Cancer 66, 1326 (1990).

  31. 31.

    Kodlin D, Winger D E, Morganstern N L, Chen U: Chronic mastopathy and breast cancer.Cancer 39, 2603 (1977).

  32. 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).

  33. 33.

    Page D L, Dupont W D, Rogers L W: Ductal involvement by cells of atypical lobular hyperplasia in the breast — a long; term follow-up study of cancer risk.Human Pathol 19, 201 (1988).

  34. 34.

    Dupont W D, Page D L: Risk factors for breast cancer in women with proliferative breast disease.New Engl J Med 312, 146 (1985).

  35. 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).

  36. 36.

    Fentiman I S:Detection and Treatment of Early Breast Cancer. Philadelphia, J. B. Lippincott (1990).

  37. 37.

    Teplitz R L, Butler B B, Tesluk H, Min B H, Russell L A, Jensen H M, Hill L R: Quantitative DNA patterns in human preneoplastic breast lesions.Anal quant Cytol Histol 12, 98 (1990).

Download references

Author information

Correspondence to Joseph A. Linsk.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Linsk, J.A. Breast cancer: Early diagnosis of precursor lesions and clinically inapparent carcinoma by fine needle aspiration. Med. Oncol. & Tumor Pharmacother. 8, 169–174 (1991).

Download citation

Key words

  • Breast cancer
  • Precursor lesions
  • FNA
  • Duct hyperplasia
  • Occult malignancy