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L Tabár

Publications and source records attributed to L Tabár.

At least 55 records · Page 3Linked to original sources
PubMed1987

What is the optimum interval between mammographic screening examinations? An analysis based on the latest results of the Swedish two-county breast cancer screening trial.

Further results are presented from the Swedish two-county breast cancer screening trial. The reduction in the rate of advanced cancers and of breast cancer mortality in the group allocated to screening when compared to the control group has accelerated with a further year of follow-up. Mortality due to other causes and the rate of other cancers remains similar in the two groups. Attention has been focused on the rate at which cancers start re-emerging among women with negative mammograms. Among women over 50 years of age at entry to the study, relatively few interval cancers are seen in the first two years after a screening test; in the third year the rate rises to nearly 50% of the comparable rate in the control group. Among women aged 40-49 years at entry, by contrast, the rate of interval cancers even in the first post screening year is nearly 40% of that in the controls and in the second year nearly 70%. In older women in the group allocated to screening, much of the breast cancer mortality comes from the refusers and little from the interval cancers; in younger women the picture is reversed. The implications for screening policy, including the interscreening interval are discussed.

Adult↗
PubMed1987

The control of breast cancer through mammography screening. What is the evidence?

There are few forms of cancer that can be effectively controlled. Now that there is sufficient evidence demonstrating that mortality from breast cancer can be reduced with the help of mammography screening, we are faced with the challenge of applying this method on a large scale. What are the major practical problems? The medical profession and decision makers must be made familiar with nature of the recent achievements and with their practical implications. The personnel who will be responsible for undertaking screening have to be adequately trained before screening gets under way. Women should understand the benefits that they can gain from mammography screening so that they will be sufficiently motivated to attend. This can be achieved by sincere, periodic information through the mass media. It is important that every woman eligible for screening understand that her risk of dying from breast cancer will be half as much if she participates in screening as it would be if she fails to participate. She should also be aware that the smaller cancers detected at screening can often be removed by breast conserving surgery without the need for mastectomy. Because mammography does not prevent breast cancer, women must be aware of the fact that mammography has to be repeated at regular intervals if the benefits of screening are to be maintained. Additionally, breast self-examination should be practiced in the interval between screens. Finally, decision makers will have to realize that screening with mammography can, in the long run, lead to reduction of health service costs. It is obvious that the expenses involved in taking care of a patient with advanced breast carcinoma can be very high. As it has been clearly demonstrated that properly performed screening will significantly decrease the number of advanced, costly breast carcinomas, a large proportion of these expenses will be saved in the population invited to screening. Because screening itself drains economic resources, the costs of screening outweigh the savings until the number of advanced cancers decreases; however, after this occurs the expenses of screening will be far less than the savings. The savings arise from the smaller number of advanced, costly cases. The results to date are convincing enough to justify recommending large-scale mammographic screening. The Swedish government has recommended screening with mammography for all women aged 40-74. This recommendation repeatedly emphasizes the necessity of high quality examinations interpreted by well-trained radiologists.

Breast Neoplasms↗
PubMed1985

Reduction in mortality from breast cancer after mass screening with mammography. Randomised trial from the Breast Cancer Screening Working Group of the Swedish National Board of Health and Welfare.

A randomised controlled trial to investigate the efficacy of mass screening with single-view mammography in reducing mortality from breast cancer was started in Sweden in 1977. 162 981 women aged 40 years or more and living in the counties of Kopparberg and Ostergötland were enrolled in the study and divided at random into 2 groups. Each woman in the study group was offered screening every 2 or 3 years depending on age. Women in the control group were not offered screening. This report is confined to the 134 867 women aged 40-74 years at date of entry. The results to the end of 1984 show a 31% reduction in mortality from breast cancer and a 25% reduction in the rate of stage II or more advanced breast cancers in the group invited to screening. 7 years after the start of the study the excess of stage I cancers in the study group largely outweighs the deficit of advanced cancers.

Aged↗
PubMed1985

Basic principles of mammographic diagnosis.

The only hope we have at present to control breast cancer is to diagnose and treat it at the earliest possible stage. It has already been convincingly demonstrated that properly performed mammography interpreted by a well-trained mammographer can detect breast cancer before it has grown to a stage at which it is incurable. But in order to be an effective diagnostic method mammography must be performed at a very high level of quality. This article describes the radiologist's role in building up and taking the responsibility for the observation of details in screen/film mammography. The basic principles of the mammographic interpretation are specified.

Breast Diseases↗
PubMed1985

Significant reduction in advanced breast cancer. Results of the first seven years of mammography screening in Kopparberg, Sweden.

A population-based, randomized, controlled breast cancer screening trial with single-view mammography as the only means of primary detection has been under way in Kopparberg county, Sweden, since October 1977. The 7-year results of the study show (1) a significant change in the stage distribution of breast cancers in the cohort invited to undergo screening (ASP) as compared to the control group. (2) This change is seen as an initial decrease in the proportion of advanced (stage II and more advanced) cancers in the ASP as compared to the control population, followed in the second and third round of screening by a significant decrease in the absolute number of these advanced cancers in the ASP relative to the control group. (3) A thorough follow-up of both populations will answer whether these preliminary findings will result in decreased breast cancer mortality in the population invited to screening.

Adult↗
PubMed1983

Galactography: the diagnostic procedure of choice for nipple discharge.

Galactography was performed in 204 women with a nipple discharge and the secretion confirmed histopathologically. All 116 intraductal tumors (papilloma, papillomatosis, carcinoma), which were associated with a serous or bloody discharge, were detected preoperatively. A palpable mass had little diagnostic significance, and exfoliative cytology was positive in only 11% (2/18) of the patients with carcinoma. The authors recommend that all patients with a spontaneous bloody or serous discharge from a single lactiferous orifice undergo galactography in addition to physical, cytological, and mammographic examination. Intraductal injection of methylene blue dye will demonstrate the affected duct system to the surgeon and can often make surgery less radical or even unnecessary.

Adult↗
PubMed1982

Mammographic parenchymal patterns. Risk indicator for breast cancer?

Mammographic parenchymal patterns, originally presented as a new risk factor for breast cancer, have been prospectively studied in a large (27,157 examinations) consecutive screening population. Although there is a significantly higher risk of breast cancer in the so-called dysplastic breasts (P2 and DY pattern groups), the classification is of little practical value, as more than 72% of the cancers in the prevalent population were found in the so-called low-risk breasts (N1 and P1 pattern groups). A similar trend occurred at repeated screening of younger women, in which most of the "incident" cancers were found in the "low-risk" breasts. These patterns should not be used to influence patient management or screening programs.

Adult↗
PubMed1982

Magnification immersion radiography: better soft tissue visualization in the hands.

We have combined microfocal magnification with immersion radiography and mammographic technique to produce superb soft tissue and bone detail in the hand using a single PA exposure. The lateral projections provide excellent demonstration of the flexor and extensor tendons and joint capsules. This method has proved valuable as the primary radiologic examination in the evaluation of soft tissue lesions in the hands, particularly in patients suspected of having rheumatoid arthritis.

Arthritis, Rheumatoid↗
PubMed1981

The diagnostic and therapeutic value of breast cyst puncture and pneumocystography.

Out of 53,459 women undergoing mammography, 434 pneumocystographic examinations were performed in 338 patients. Thirteen benign and 13 malignant intracystic tumors were detected, for a frequency of 6.0%. Intracystic cancers comprised 1.3% of all malignant tumors. Neither visual nor cytological examination of cyst fluid was sufficient to detect or rule out cancer, and the authors feel that pneumocystography is the only reliable method. Excision is the preferred therapy, and histological examination is the definitive method of differentiating benign from malignant tumors. In more than 97% of cases, pneumocystography of simple cysts is therapeutic. Without evidence of intracystic tumor on pneumocystography, cyst removal is unnecessary. The patient can be followed up with mammography, and any recurrent or new cysts can be diagnosed and treated by pneumocystography alone.

Biopsy, Needle↗
PubMed1980

Breast cancer screening in Sweden. The single modality approach.

Four population-based breast cancer screening projects are in progress in Sweden, three of which are randomized studies. Mammography is the only screening method. 51% of all carcinomas detected at the first screening were either in situ or invasive with a diameter of 10 mm or less. Axillary metastases were found in 16% of the patients. Sensitivity was over 90% in all projects. The ultimate aim of the randomized projects is to demonstrate the effect of screening on breast cancer mortality. It is estimated that mortality statistics will reach significant levels in 1983.,

Adult↗
PubMed1979

Interventional radiologic procedures in the investigation of lesions of the breast.

The interventional radiologist who performs mammography does far more than read films; he examines every patient, punctures cysts, and localizes other breast lesions for precise excisional biopsy. With specimen radiography, he can confirm that suspicious lesions are completely removed by the surgeon and that the tissue in question is selected by the pathologist for examination. Pneumocystography can save the patient the unnecessary, disfiguring surgical removal of benign cysts. Those patients requiring biopsy may be scheduled for the procedure at once, and close cooperation with the surgeon greatly reduces the time the patient must wait to find out whether or not she has breast cancer. Thus, the interventional radiologist can improve the accuracy and speed of diagnosis of breast lesions, establish a definitive diagnosis and expedite the therapeutic management of benign cysts, and save the patient much of the anxiety commonly experienced in waiting for diagnostic results. The end result is better care at a lower cost to the patient and to society.

Adult↗
PubMed1978

[Mammographic mass examinations for breast cancer among rural population selected via physical examination and epidemiologic questionnaire (author's transl)].

The authors report on their four years' experience in oncologic mass examinations focused on the age group above 30. After 43980 serial examinations, they performed mammography in 3082 women with mammary cancer risk. 156 operations were performed, and 33 histologically established cases of mammary carcinoma were recorded, with 21 early-stage cases. Of 21 occult tumors, 18 did not manifest any metastases. Thanks to the epidemiologic questionnaire, 10 mammary cancer patients were registered. The score of confirmed findings exceeded quantitatively, and, especially, qualitatively, the mammary carcinoma morbidity of the region. The results prove the feasibility of the combined method. The major part of the population did not appear for mass examination. The advanced stage of the 55 cases of breast cancer belonging to this group, as well as that of the 10 cases of which became manifest during the examination interval, would indicate that much is to be said for a more effective health promotion campaign among the population.

Adult↗