Diagnosis of Breast Cancer

To the Editor.—  In his article "The Diagnosis of Breast Cancer by Fine-Needle Aspiration Smears," William H. Kern, MD (241:1125, 1979), makes several misleading statements. He says that as a rule, aspiration of nonneoplastic breast tissue shows only scantily cellular material and therefore cannot be considered insufficient. I disagree with that statement. In my experience, if a mass is present, an adequate specimen will be of sufficient cellularity for diagnosis. If a specimen is scantily cellular, it is usually insufficient. Unfortunately, Dr Kern does not tell us what technique was used in aspirating the breast lesions. Was an aspirating device used? How many aspirates were obtained?I have found that when an experienced physician takes several aspirates (three to six) with the use of an aspirating device like a syringe holder, the cellular yield is much greater than without such a device or with only one aspiration. Finally, if the