Four‐quadrant study of breasts removed for carcinoma

IIEKL ARE unresolved aspects of pathology, T whicli, because o f their importance and ficqucnc y oC encounter, warrant periodic reevaluation. Such is the postulated relationship between cystic prolifcrative disease and the development ol cancer in the female breast. Despite many reports,‘, 4 74,597-10 no definite etiological rclationsliip or gcner ally acrepted viewpoint exist 5 . Our approach to this problem was the study of multiple sections lrom the 4 quad1 ants of 1)reasis ieniovecl for carcinoma, in an attempt t o answer the following questions: 1. Is there any difference in the degree of thc benign process as i t appcars in the quadrant hearing thc cancer compared to that in the other quadrants? 2. Since an abnormal endocrine environment may be a common denominator for both rancer and cystic prolifei ative dhease, do cancer pat ients with a grc‘iter clcgree or benign prolift.r,itive epithelial ac tivity yield a higher incidence of nodal metastasis? If this be true i t might indicate a common stimulus for the growth ol both the benign and malignant ocesses. 5. i\re thcrc any differences in the 4-quatlrant study of canceious breasts in wonicn younger than age 55 years compared to those 55 years of age and older? In analyzing the rhart5, age 55 was deemed to give the sharpest dividing line between thosc in the premenopausal and terminal menopausal states and thosc in the posmenopausal state. Sinre pathologists pay major attention to atypical epithelial hyperplasia as ‘i possible histological precursor to the subsequent development o f carcinoma in situ and invasive carcinoma, it was deemed nercrsary that this process be particularly evaluated in this /&quadrant study. Atypical hyperplasia is one aspect No. pi.