Thirty-six carcinomas of the breast were pathologically verified in the first 207 biopsies performed to date on women attending the Breast Cancer Detection Center at The University of Cincinnati. Fifty-three percent of these have been minimal breast cancer, 14 being totally in situ. This is compared with a similar number of breast biopsies performed prior to the opening of the Breast Cancer Project. In the latter group of cases there were 45 carcinomas proven, only 1 of which was in situ, 24 of which were invasive Stage I and 20 Stage I1 or higher. In addition, 65 biopsies demonstrated proliferative disease of varying degrees of severity as compared to a total of 13 in the non screened population.
Cancer 36:2245-2250, 1975.
ARCINOMA OF T H E BREAST CAN FREQUENTLY
C be diagnosed radiographically before it is clinically palpable, i.e. while it is occult. It is often implied that the clinically occult carcinoma is either "early or small." Neither one of these latter assumptions may be true. The size of the breast, the consistency of the carcinoma, vis a vis the consistency of the breast, and the astuteness of the physical examiner all interplay in determining whether a lesion will be palpable. Furthermore, some so called "occult" carcinomas are invasive. Once diagnosis is based on the x-ray characteristics of a mass, whether or not that mass is clinically palpable, one is dealing with well established neoplastic disease. In fact, it has been ~u g g e s t e d ' ~ that one may be able to predict from the radiographic appearance of these well developed neoplasms how aggressive they are likely to be.
Therefore, if early diagnosis is to be emphasized, the detection of merely clinically occult carcinoma is insufficient. Rather must our efforts be concentrated towards detecting the neoplasm at its earliest possible pathologic stage. Ideally, this would be while the lesion is first From the