Biomedical subjects
I Burn
Publications and source records attributed to I Burn.
Validity of clinical examination and mammography as screening tests for breast cancer.
This study is aiming to determine the validity and observer variability of clinical examination and mammography as screening tests for breast cancer. Women over the age of forty are given two independent clinical examinations of the breasts, and mammograms are taken and read independently by two radiologists. This paper presents the results of screening the first 1215 women to be enrolled in the study. At their first screening attendance, 231 women (19%) were referred for surgical opinion, 119 (9-8%) underwent biopsy, and cancer was diagnosed in 17 (1-4%). 2 further cancers were diagnosed in the ensuing six months among women who had been negative on initial screening, representing a false-negative rate of 2 out of 19 (11%). Clinical examination resulted in 189 referrals (15-6%), 90 biopsies (7-4%), and detected 11 cancers; corresponding figures for mammography were 76 referrals (6-3%), 55 biopsies ((4-5%), and 14 cancers. Observer variability was greater for clinical examination than for mammography. These early results suggest that as a screening test mammography compares favourably with clinical examination, but both tests are necessary if many false negatives are to be avoided.
Letter: Screening for breast cancer.
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Small-bowel metastases from carcinoma of the breast.
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Clinical control of metastases in patients with advanced cancer of the breast.
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Liposarcoma of the thigh: management.
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Two sisters with breast cancer.
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Uptake of gallium-67 in malignant tumours.
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Surgical procedures in the treatment of breast cancer.
Only early breast cancer can be cured. The aim of treatment of early breast cancer should be to provide the patient with the best possible chance of being cured. This should be the surgeon's paramount objective. Many factors must be taken into consideration before deciding whether aggressive curative treatment is justified. These factors include the position and extent of the primary tumour within the breast, the degree of involvement of the regional lymph nodes and the presence or absence of distant occult metastases. Also important are the exact histological type of the tumour, its grade of malignancy and the receptor status, if known. The age, general health and personal attitudes of the patient also will be influential. Total mastectomy continues to be the treatment of choice for early, curable breast cancer, combined as appropriate with radiotherapy to the regional lymph nodes. The recent widespread enthusiasm for breast conservation operations is misplaced. Such procedures should still be regarded as experimental.