[Morphological breast diagnosis in daily practice]

Two approaches are currently in use for diagnosis of breast cancer: triple diagnosis or excision for histopathologic evaluation. For practical and economical reasons we favor the bioptic approach, because it closes the diagnostic endeavour in malignant and in benign lesions. Objections to biopsy based on arguments of tumor-biology are not scientifically founded. If the palpatory finding and the mammography are indicative of carcinoma, the diagnosis can also be sufficiently confirmed by fine needle aspirate cytology to warrant further therapy. If, using this triple-diagnostic measure, a carcinoma is not unequivocally confirmed, the suspect lesion has to be excised. At the slightest suspicion of a cyst we use diagnostic punction in order to avoid unnecessary cystectomies. Areas that are not palpable but suspicious on mammography can only be diagnosed reliably by excision under radiologic control.