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The Pursuit of the Occult Cancer of the Breast

Robert S. Sherman, MD; Richard D. Brasfield, MD; Ruth E. Snyder, MD; Robert V. P. Hutter, MD
JAMA. 1967;201(10):782-783. doi:10.1001/jama.1967.03130100080031.
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To the Editor:—  The relationship of diagnostic radiology to pathology is usually one of dependence because radiologists must use the firmest foundation possible upon which to base their efforts. In a small but highly significant number of breast cancers, it was the radiologist who directed the pathologist to the correct diagnosis through the medium of mammography.How has this situation developed? How is it efficiently managed? Two of 25 representative case reports state the problems and suggest answers.

Case 1:—  The patient had had two previous routine mammograms, one in 1964 and another in 1966, each reported as showing no disease. In 1967, on the third examination, a group of calcifications suggesting cancer were detected in the upper outer quadrant of one breast near the nipple. No gross abnormality was seen or felt by the surgeon or the pathologist in the quadrant excision. This was first roentgenographed and then studied


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