A brief historical perspective on the pathology of the breast: from Cheatle to Azzopardi and beyond

The modem pathological study of disorders of the breast begins with the intraoperative macroscopical examinations of such late-nineteenth-century American and British surgeons as Drs. John Collins Warren, Joseph Colt Bloodgood, and Sir George Lenthal Cheatle. Technical advances in the fields of microscopy and histology led to a shift in the nature and conduct of pathological studies in the first part of the twentieth century. Microscopical examination became the primary method of study, and pathologists assumed the leading role in this line of research. With the studies of Drs. Frank W. Foote, Fred W. Stewart, and Arthur Purdy Stout, pathologists began to explore the territory of breast pathology in detail, describing the microscopical features of breast lesions and developing theories regarding their pathogenesis. The spread of the use of biopsy procedures to establish diagnoses led pathologists of the mid-twentieth century to assume the new role of clinical diagnostician. Exemplified by the work of Dr. John G. Azzopardi, pathological research of the latter half of the twentieth century came to emphasize microscopical diagnostic criteria and differential diagnosis. With ever more sophistication and increasingly powerful techniques, this trend continues to this day.