The relationship of surgeons and pathologists.
Diagnosis of breast cancer starts in the office with the routine aspiration of every nodule. Aspiration biopsy divides patients who have nodules into two categories: (1) those with positive cytologic results who are admitted to the hospital and, when there is any doubt about the diagnosis, are further evaluated by open biopsy and frozen section, followed by definitive treatment, and (2) those who have negative cytologic results and, if the mass persists, are treated by excisional biopsy without being admitted to the hospital; if the biopsy shows malignancy, definitive treatment is given later. If all thyroid nodules were subjected to aspiration biopsy, 90% of thyroid operations could be avoided, and the subsequent growth of the nodules could be prevented by giving suppressive doses of thyroid. Largely as a result of this practice, the incidence of operations on the thyroid at the Cleveland Clinic has fallen from more than 300 a year to fewer than 30. It is time that surgeons in this country took a lesson from their European counterparts and began to do needle biopsies routinely on nodules of the thyroid and breast.
D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery; D004470:Economics, Medical; D005260:Female; D013502:General Surgery; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D010336:Pathology; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery