Exfoliative cytology and histology of early occult breast cancer

Abstract

Five cases of early breast cancer, in which exfoliative cytology of abnormal nipple discharge was only a means of detecting malignancy and no tumor mass was discovered even by recent progressed techniques such as echography, are reported.
The cytological materials obtained from the mammillary discharge showed clusters of varing numbers of atypical cells, counting to 50 in most instances but rarely up to 1, 000. Each smear specimen had a bloody background containing numerous foamy histiocytes in addition to the tumor cell clusters. The tumor cells in general were small in size with hyperchromatic nuclei measuring about 9 micron each in their longer diameter.
Histologically, each resected breast tissue had multiple minor cancer lesions in the fibrotic breast tissue, forming to vague tumor mass but intraductal papillary carcinoma, clinging carcinoma and/or cancerization of lobules in the collecting ducts and the lobules beneath the mamilla. Minimal stromal invasion was present in some of the cases. These cancer lesions were compatible with the origin of the tumor cells in the nipple discharge.
Exfoliative and histological characteristics of early breast cancer were comparatively discussed.