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Calvin T. Klopp, M.D.; John D. Hoyle, M.D.; Brian B. Blades, M.D.
JAMA. 1952;150(9):856-858. doi:10.1001/jama.1952.63680090004009.
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For many years pathologists have observed, in otherwise normal surgical and autopsy specimens, minimal changes that represented the first visible morphological step in the development of cancer.1 They also described in medical literature minute microscopic lesions that were unquestionably malignant.2 In some instances the progressive growth of such lesions was followed until clinically visible cancer developed. Such changes have been observed in the epithelium of human breast tissue but not as frequently as in surface epithelium that was exposed so as to permit repeated biopsies under direct vision.3 The available knowledge of the histology of minute, early breast cancer indicates, however, that the criteria for the clinical diagnosis must be revised, and the facts that we teach regarding the detection of early breast cancer must be modified.

Education of lay persons has sharpened public awareness of minimal, asymptomatic physical changes. Women are being made more aware of


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