Cole's precancerous hyperplasia of the breast

Due to his recognition as the discoverer of the first test for visualization of the gallbladder, his profile research on dissemination of cancer and his stimulation and interest in stress and immunity, one of Warren Cole's most significant reports has not been accorded due recognition. In 1944, Cole presented data at the Southern Surgical Association Meeting which clearly identified the premalignant histologic change in the breast. In the published report, Cole and Rossiter [Ann Surg 119:573-590, 1944] presented a classification of benign breast histology: 1) adenofibrosis, 2) parenchymatous hyperplasia, 3) precancerous hyperplasia, and 4) cystic disease. Following the work of Warren in 1940 [Surg Gynecol Obstet 71:257-273], who stated that the chronic cystic mastitis had an incidence of breast cancer over 3 times the expected rate, this report of Cole and Rossiter focused on the worrisome lesion atypical epithelial hyperplasia. Since then, Haagensen ["Diseases of the Breast," Philadelphia: Saunders] has stressed that gross cystic disease is the lesion most associated with increased risk of cancer. In an attempt to resolve these seeming contraindications, we reviewed the charts of patients referred to a private breast clinic. With the advent of mammography, sonography, and thermography, the incidence and management of benign breast diseases has changed over the years. This study focuses on the current management of breast masses and reinforces the significance of Cole's classification.