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Biomedical subjects

M Pamilo

Publications and source records attributed to M Pamilo.

At least 19 recordsLinked to original sources
PubMed1991

Classification of findings in mammography screening--a method to minimise recall anxiety?

STUDY OBJECTIVE: The aim was to find out if it is possible, by classifying screening mammograms according to the likelihood of malignancy, to divide the recalled women to a group in which there is high suspicion of malignancy, most having breast cancers, and a group with more obscure findings. DESIGN: Screening mammograms of recalled women were classified according to the likelihood of malignancy. 0 = technically insufficient, 1 = normal, 2 = benign tumour, 3 = malignancy cannot be excluded, 4 = strongly suspicious for malignancy, 5 = malignant. SETTING: This study was a population based survey of mammography screening in Helsinki and surroundings in Finland. PATIENTS: 21,417 women (aged 50-59 years) were invited to be screened, 18,012 (84.10%) participated. Of these 579 (3.21% of those screened) were recalled for further studies; 124 of these were referred for surgical biopsy and 82 had breast cancer. MEASUREMENTS AND MAIN RESULTS: All cases classified as 5, 60% of the cases classified as 4, 6.5% of the cases classified as 3, 0% of the cases classified as 2 or 1, and 1.2% of the cases classified as 0 proved to have breast cancers. However classification 5 represented 5.9% of all recalled women and 41.5% of all screening detected breast cancers; classification 4, 6.0% of all recalled women and 25.6% of all screening detected breast cancers; classification 3, 68.9% of all recalled women and 31.7% of all screening detected breast cancers; classification 2, 11.7% and classification 1, 2.9% of all recalled women. No breast cancers were detected with these classifications. Classification 0 represented 4.5% of all recalled women and 1.2% of all screening detected breast cancers. Classifications 5 and 4 represented only 11.9% of all recalled women but 67.1% of all screening detected breast cancers. CONCLUSIONS: By classifying screening mammograms according to the likelihood of malignancy, recalled women can be divided into two groups: (1) a quite small subgroup in which everyone or almost everyone will be shown to have breast cancer; and (2) a much larger subgroup in which only a few will be proven to have breast cancer. The invitation procedure for the further studies should be improved on this basis of minimising anxiety among recalled women.

Anxiety↗
PubMed1991

Ultrasonography of breast lesions detected in mammography screening.

Mammography screening was carried out in 18,012 women (aged 50-59) of whom 579 (3.21%) had to be recalled for clinical mammography. After completion of the clinical mammography each woman also had ultrasonography (US) with a hand-held real-time apparatus using a 7.5 MHz probe. There were 79 verified breast cancers; 32 of these were palpable and were also depicted at US, but only 29 (61.7%) of non-palpable breast cancers (n = 47) were found at US. Twenty-two of the non-palpable breast cancers were seen at US as a tumor-like lesion, 2 because of local echo-architecture distortion, and 5 only because of acoustic shadowing. The US image did not help to differentiate between malignant and benign lesions.

Breast Neoplasms↗
PubMed1990

Mammography screening--reasons for recall and the influence of experience on recall in the Finnish system.

The reasons for recall and the influence of experience on recall were studied in 579 women (3.21%) recalled from mammography screening. The proportion of recalls for further studies was the greatest (6.30%) at the onset of screening. With increased experience, the proportion decreased by stages and in the second screening round it was only 2.04%. The proportion of cases referred for surgical biopsy in the first screening round was 0.7% and the proportion of screening-detected breast cancers was 0.52%. These change little with increasing experience. In the second screening round, however, the proportion of referrals for surgical biopsy (0.43% of those screened) and of screening-detected breast cancers, (0.30%) were both low. A tumour-like density was the commonest finding resulting in recall for further studies, and the number caused by superimposition of normal parenchymal structures decreased with experience, while the proportion of breast cancers and benign tumours increased. The proportion of cases with parenchymal distortion resulting in recall for further studies was similar in both screening rounds but the number of those referred for biopsy fell dramatically in the second screening round. The number of recalls for microcalcification also fell with experience and the proportion of breast cancers in this group increased over the two screening rounds. A high ratio of malignancies in surgical biopsies can be expected when the radiologists undertaking primary screening also perform all further studies.

Biopsy↗
PubMed1989

Mammography screening for breast cancer: first year results from Helsinki and surroundings.

11,789 women aged 50-59 years were invited for screening by the mammography screening centre of the Cancer Society of Finland in Helsinki. 9829 women (83.37%) attended and 3.85% of those were recalled for further studies. After complete examination seventy-one women (0.72%) were referred for surgical biopsy and breast cancer was histologically detected in 44 (0.45%) of those screened. The proportion of Stage I + TIS breast cancers detected was 75%, and of Stage II or more advanced, 25%. With modern mammography techniques and proper training of technicians and radiologists, with double reading of all the films, it is possible to minimise both the recall rate and the number of women who are referred for surgical biopsy, and still find cancers in their early stages.

Breast Neoplasms↗
PubMed1989

Real-time ultrasound, axillary mammography, and clinical examination in the detection of axillary lymph node metastases in breast cancer patients.

The axillary node status is important in the prognosis of breast cancer. To evaluate the accuracy of various preoperative examination methods in detecting metastatic axillary lymph nodes, we compared the findings of clinical examination, axillary ultrasonography, and axillary mammography of 41 breast cancer patients who underwent axillary dissection and histological examination. The sensitivity was 72.7% for ultrasonography, 38.9% for axillary mammography, and 32.3% for clinical examination. Ultrasonography provides good information about the axillary nodal status. The specificity can be increased by fine-needle biopsy under ultrasound guidance.

Adult↗
PubMed1989

Baseline screening mammography with one versus two views.

Two-view baseline screening mammograms (oblique and cranial views) of 303 women recalled for further studies from among 7,245 women screened were reviewed by four experienced radiologists separately to evaluate the importance of the number of views taken for screening. As compared with the oblique view only, two views, increased the number of cancers detected and decreased the number of false-positive cancer diagnoses of two radiologists, but increased that of the other two.

Breast Neoplasms↗
PubMed1987

[Mammography].

Explore the source record for details and available documents.

Biopsy, Needle↗
PubMed1984

Unidentified liver metastases at ultrasonography or computed tomography.

Sixty-six patients with hepatic metastases, examined by ultrasonography (US) and computed tomography (CT) with an interval of a few days between the two examinations, showed discrepancies between the US and CT findings. The US and CT images were compared lesion by lesion, and the reasons why a metastasis was missed at US or CT were analysed. Lesions larger than 3 cm in diameter could be detected at technically successful examinations with both methods. The unreliable imaging regions with US were the ventrocranial aspect of the right lobe, the caudate lobe, and in obese patients the dorsal part of the right lobe. With CT, the caudal aspect of the left lobe, the area surrounding the gallbladder, and portions beneath the ribs were most unreliably imaged. Sometimes, at either US or CT, the image characteristics of the metastasis were too similar to those of the normal parenchyma to be differentiated.

False Negative Reactions↗
PubMed1983

Ultrasonography of carcinoma of the gallbladder. The images and differential diagnostic problems.

Ultrasonography in the diagnosis of carcinoma of the gallbladder was analysed in a series of 5100 patients, who had a grey-scale sonography of the gallbladder more than 2 years before analysis. Carcinoma has been diagnosed in 12 of the patients. Sonography revealed 8 of the carcinomas. In addition one tumour was diagnosed, which was not considered to originate from the gallbladder. Two patients had carcinoma in situ. The examination of one carcinoma patient was a technical failure. There were 9 false positive findings. Of these 9 patients, one had a metastasis, 5 had a lump of sludge, 3 had a wall thickening caused by chronic cholecystitis and one had an adenomyomatosis.

Aged↗
PubMed1981

The sonographic images of hypernephromas.

The sonographic images of hypernephromas were examined in 46 histologically confirmed cases. The echogenicity of hypernephromas can be higher, equal or lower that of renal cortex. There is no significant correlation between echogenicity and macroscopic vascularity. The infiltration of a tumour cannot be estimated with certainty using sonography. Acoustic enhancement can also be seen behind hypernephromas.

Adenocarcinoma↗
PubMed1979

Accuracy of 100 mm x 100 mm mirror optic camera technique as compared to normal chest radiography technique.

Full size and 100 mm x 100 mm mirror optic camera (photofluorographic) chest films of 121 patients were read by a team of four radiologists. Altogether 2781 diagnostic statements were reported, 968 of which were of primary importance, and only these statements were analysed. Error rates with the standard technique varied between 16 and 31% and with the 100 mm x 100 mm technique between 21 and 38%. The difference in error rates between the techniques used was not statistically significant but there were significant differences between the individual radiologists.

Clinical Competence↗
PubMedDate not supplied

Characteristics of hypernephromas as seen with ultrasound and computed tomography.

The structure of 20 hypernephromas as seen with ultrasound (US) and computed tomography (CT) were compared. The hypervascular and necrotic areas, as well as the areas of normal tumoral enhancement in CT, were seen as markedly, moderately, or minimally echogenic or had mixed areas of minimal and marked echogenicity in US.

Adenocarcinoma↗