[Cytopathology of the breast. 1. Secretion and nipple cytology]

Cytological examinations of breast secretions, nipple smears and breast fine needle aspirates can establish important diagnostic findings provided that technical conditions and methodical advantages and disadvantages are taken into consideration. The first part of the paper is dealing with clinically relevant aspects of secretion and nipple cytology. These simple examinations are applicable by every gynaecologist. The source of cell material is the spontaneous exfoliation, which should be increased in nipple smears by additional procedures. Diagnostic findings of secretion cytology can be obtained in breast cancer, duct papilloma, cystic fibrosis, and inflammatory lesions. The value of secretion cytology for breast cancer detection is limited, because pathological secretion is only induced in a small number of patients. Cytological examinations of nipple lesions are useful especially in the presence of Paget's disease and other tumors of the nipple. Limitations are caused by difficulties in cell sampling. Easy practicability and little alteration of the patient are the major advantages of the secretion and nipple cytology, which stands opposite a limited sensitivity as disadvantage.