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Biomedical subjects

M Moskowitz

Publications and source records attributed to M Moskowitz.

At least 73 records · Page 4Linked to original sources
PubMed1979

Screening is not diagnosis.

Mammography and physical examination, usually employed as diagnostic tools, may be used to screen for early detection of breast cancer. A study of these modalities used to aggressively screen patients in Cincinnati and Milwaukee is presented and compared to more traditional methods of breast cancer detection and diagnosis as done in Louisville. For a similar-sized group over the same period, the rate of cancers detected in Louisville did not exceed that in Cincinnati-Milwaukee. Aggressive screening will not increase the overall number of detected cancers but will decrease the number of advanced cancers. Mammography as a screening device is not in itself a diagnostic tool, since its potential benefit is maximized only through the use of nondiagnostic, indirect radiographic criteria.

Aged↗
PubMed1979

Breast cancer missed by mammography.

Because a "negative" mammogram that is followed by a biopsy diagnostic of cancer is a matter of deep concern, a retrospective review was conducted of 48 such missed diagnoses at four Breast Cancer Detection Centers. The study group comprised 40,000 women participating in breast cancer screening examinations. From 3,271 biopsies during screening, 499 cancers had been found. Biopsies in the interval between screening examinations totaled 630 and yielded 48 malignancies. These 48 interval cancers were studied in an attempt to discover why they were not found on the preceding mammographic examination. Three major categories of error were disclosed and each is discussed: (1) poor radiographic technique; (2) absence of radiographic criteria of cancer; (3a) obvious oversight by the radiologist; and (3b) lack of recognition of subtle radiographic signs. This last reason is discussed in detail in the belief that better recognition of these indirect radiographic signs will lead to more accurate diagnoses, particularly in early cancers.

Adult↗
PubMed1978

Benefit/risk analysis of aggressive mammographic screening.

Based on the results of aggressive screening of 20,000 women and an annual average midbreast absorbed dose of 1 rad per year, the authors describe a model for estimating the benefit/risk ratio for mammography in screening populations of asymptomatic, randomly selected women. Benefits in terms of breast-cancer deaths averted over not screening are estimated. The "worst-case" estimate of the benefit/risk ratio for five annual mammographic examinations on randomly selected asymptomatic women age 35-49 at the start of screening is 3.4 +/- 1.1 to 1. The corresponding "most probable" estimate is 8.0 +/- 3.1 to 1.

Adult↗
PubMed1977

Special lecture: the breast cancer screening controversy: a perspective.

Analysis of the data of the Health Insurance Plan of New York Breast Cancer Screening Study indicates that in patients whose cancers were found by screening, the case fatality rate at all ages is almost half the case fatality rate of controls. The data also strongly suggest that maximal benefit in young women resides in the detection of in situ cancers. Due to relatively low yield of these early lesions, projected 20 year survival in that study may be little different for all women screened compared to controls. We have shown that the yield of these early lesions can be increased by aggressive screening and liberal use of biopsy. Furthermore, where J.C. Bailar has indicated a net gain (or loss) of -4 to +8 lives per 20,000 women using the HIP data, using his method and our data we find a savings of 25-27 lives/20,000 women by 3 year screening to date. These are lives that have been saved by mammography alone.

Adult↗
PubMed1977

Mammographic screening for breast cancer by lateral view only: is it practical?

If a single lateral examination would suffice for mammography, sose and risk would be cut in half in screening procedures. This prospective study of 150 lateral xerographic images would indicate that, while 80% true positive rate can be achieved using a single lateral view, the projected savings in radiation exposure does not offset the losses due to cancers not detected by this single exposure screening method.

Breast Neoplasms↗
PubMed1976

Materials released into culture medium by normal and oncogenic virus-transformed mammalian cells.

Materials released into culture medium by transformed and untransformed baby hamster kidney cells labelled with glucosamine, sulfate, fucose or leucine were characterized. Some of the components could also be labelled by iodination of intact cells, indicating their surface origin. Analysis on gradient polyacrylamide sodium lauryl sulfate gels demonstrated that a group of high apparent molecular weight glucosamine-labelled components were more abundant in materials released from Rous sarcoma virus-transformed baby hamster kidney cells than from baby hamster kidney cells or polyoma virus-transformed baby hamster kidney cells. The relative rates of release of glucosamine-labelled components from transformed and untransformed cells were similar except that the transformed baby hamster kidney cells released some large molecular weight components slightly more rapidly than baby hamster kidney cells. Treatment of labelled medium materials with testicular hyaluronidase removed much glucosamine label from the materials but did not affect the amounts of other labels. After treatment with hyaluronidase, the patterns of labelled conditioned media from both transformed and untransformed baby hamster kidney cells were qualitatively and quantitatively very similar, suggesting that the differences seen in untreated labelled conditioned media were due to the presence of hyaluronidase-sensitive materials associated with medium materials rather than to actual differences in glycoproteins.

Avian Sarcoma Viruses↗
PubMed1976

Lack of efficacy of thermography as a screening tool for minimal and stage I breast cancer.

In a study of thermograms of 42 patients with Stage 1 or smaller carcinomas of the breast, 44 confounding cases and 64 randomly selected subjects being screened, we found that the ability of expert thermographers to identify the patients with carcinoma correctly (true positive = 0.238) varied little from the ability of untrained readers (true positive = 0.301). Furthermore, in the expert group, the indexes of suspicion were so high (0.436) and the true-positive levels were so relatively low (0.238, P = 0.0005) that thermography may well have a very limited role as a screening or pre-screening modality for the detection of minimal or Stage 1 breast cancers.

Breast Neoplasms↗
PubMed1976

On the diagnosis of minimal breast cancer in a screenee population.

As a result of screening of 8100 consecutive volunteers, 67 breast cancers have been detected. Fourteen percent of these cancers were found in women aged 35-44 years. Eighty percent of the cancers found in this age group were minimal breast cancer. This percentage decreased significantly in each subsequent decade until age 65 years, or older, when it began to rise once more. While mammography was responsible for detecting the majority of in situ or minimal cancers, 13 were found on physical examination, six of which were found only by physical examination.

Adult↗
PubMed1976

Breast cancer screening. Benefit and risk for the first annual screening.

Of 96 cancers which have been detected as a result of the first annual screening of 10,470 volunteers, 46 have been clinically occult. Forty-one of these have been Stage 1 or less carcinoma, and 26 of these 41 have been minimal cancer. For the radiographic parameters used, the benefit of detecting these cancers vs. the risk of induced cancer is estimated as 103:1 and 65:1, respectively.

Adult↗
PubMed1976

Lack of specificity for detection of breast lesions with radioactive cesium chloride.

Detection of breast disease at an early stage was evaluated with 131CsCl. The tissue distribution study showed that malignant tumors could be distinguished from both benign and normal tissue by the degree of 131Cs concentration. However, the external counting method was not sensitive enough to warrant general application to patients with a suspected malignant tumor of the breast. False-positive breast study findings using radionuclides, such as 131CsCl, require close follow-up study in view of possible malignant changes in benign disease of the breast.

Adenofibroma↗