A prospective study of 622 consecutively registered patients with 650 breast tumors was performed to appraise the reliability of combined physical examination, mammography, and fine‐needle puncture (triple test) in the preoperative diagnosis of such tumors. All malignant as well as benign test results were confirmed by subsequent histologic examination. The diagnostic accuracy of the triple test at benign changes is comparable to that of histologic examination, but participation of experienced radiologists and cytologists as well as persons skilled in fine‐needle puncture is required. Twenty‐eight percent of the planned excisional biopsies were made superfluous by the fine‐needle puncture, which immediately revealed the tumor as a cyst, abscess, or hematoma. For this reason, too, fine‐needle puncture is recommended as a routine procedure.