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April 19, 1976

Breast Lumps

Author Affiliations

Fort Myers, Fla

JAMA. 1976;235(16):1689. doi:10.1001/jama.1976.03260420015011

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To the Editor.—  Eckert, in his article "How to Evaluate and Manage Breast Lumps" (234:839, 1975), states, "Cytologic examination of the fluid has not been helpful, for usually it is almost acellular." This statement is false. Sometimes, fluid aspirated from a cyst of the breast is, in fact, acellular, but, in the overwhelming majority of instances, numerous cells are present and if the proper filtration techniques are utilized, these may be of diagnostic value. It is unquestionably true that cytologic evaluation is of value only if cells diagnostic of malignancy are present within the fluid. However, this procedure is innocuous, and insofar as the surgeon has already obtained the fluid, attempts at evaluating it rather than discarding it seem prudent. I have personally seen four cases in which cytologic examination of aspirated cyst fluid was diagnostic of adenocarcinoma in the absence of a palpable breast mass. I am unaware of any