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September 25, 1948


JAMA. 1948;138(4):279-292. doi:10.1001/jama.1948.62900040016005

PROVING THE DIAGNOSIS  The last generation of surgeons had to rely solely on their knowledge of gross pathology in proving the nature of tumors of the breast, and this often led them astray. Thus Bloodgood,3 writing in 1914 of his experience in Halsted's clinic in the diagnosis of breast tumors, stated: "Among 542 benign lesions... 54, or 10 per cent, have been incorrectly treated for cancer [i. e., radical mastectomy was done].... It is interesting to note that among these 54 benign lesions which were treated as malignant, in 27 cases the diagnosis of malignancy was based upon the clinical appearance alone.... In 24 cases, the diagnosis of cancer was based upon the gross appearance at exploratory incision...."Fortunately, this kind of mistake is no longer necessary, for today there are quick and sure methods of proving the diagnosis microscopically. Pathology has grown up and become a senior partner