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At least 19 recordsLinked to original sources

PubMed1979

Breast cancer screening with mammography: a population-based, randomized trial with mammography as the only screening mode.

A population-based, randomized breast cancer screening project was undertaken using mammography alone. Of 17,447 invited women aged 50-69, 12,765 (73%) attended the screening. On the basis of the screening films, malignancy was suspected in 405 women (3.2%) who were recalled for complete mammography. Additional films showed that the suspicion of malignancy was false in 194 women. The remaining 211 women (1.7%) were referred for clinical and cytological examination. Of these, 159 had surgery. Breast cancer was proved in 97 women, corresponding to a prevalence rate of 7.6/1000. Fifty-three (55%) of the carcinomas were either in situ or invasive with a diameter of less than or equal to 1 cm. Axillary metastases were found in 19 patients (19.6%). Cancers detected at screening were significantly less advanced than those in the control group. There was a remarkably high frequency of tubular carcinoma among cancers detected at screening.

Aged↗

PubMed1979

Computed tomographic mammography (CTM).

Breasts of 724 patients were studied by physical examination, mammography, and computed tomographic mammography (CTM) using a scanner designed for evaluation of the breast. Among cases in which CTM was not accompanied by use of contrast material, there were 60 malignant lesions, of which 10% were missed by mammography, 32% by CTM, and 8% by both. Among cases where CTM was supplemented by a 50 ml injection of 75% contrast material, there were 63 malignant lesions, of which 14% were missed by mammography, 16% by CTM, and 3% by both. Among cases where CTM was supplemented by a 300 ml infusion of 30% contrast material, there were 41 malignant lesions, of which 7% were missed by mammography and 5% by CTM, but none by both. Clinically, 22% of the malignant lesions in the infusion series were occult. There were 44 benign lesions in patients studied with the infusion technique. With mammography 68% were suspicious for malignancy, and with CTM, 56%.

Adenocarcinoma↗

PubMed1976

Mammography: a contrary view.

Experimental and clinical data on mammography as a tool for population screening are reviewed. The conclusions are that [1] there is good evidence that annual history, physical examination, and mammography can reduce short-term and midrange breast cancer mortality by about one third; [2] the evidence that mammography alone plays a significant role in this reduction is weak and indirect; [4] data on long-term effects of mammography are lacking; [4] no satisfactory investigations of associated radiation hazards have been published; and [5] the possible benefits of mammography have received more emphasis in the clinical literature than have its defects. Promotion of mammography as a general public health measure is premature.

Adult↗

PubMed1979

Indications and risk-benefit of mammography.

Mammography has recently undergone a striking improvement in image detail along with a corresponding decrease in radiation exposure. Although the data of the Breast Cancer Detection Demonstration Project is tainted by an absence of a control group of women, the high rate of detection of early cancer by mammography alone in the participants above or below age 50 years implies that mammography is useful in detecting breast cancer before the appearance of a palpable mass. Early diagnosis results in higher survival rates. Mammographers should continuously seek the least radiation exposure consistent with a sharp image. Given present knowledge of its benefit and potential risk, mammography should be performed when a significant suspicion of breast cancer exists at any age, but it should not be performed under age 35 years without such suspicion. A baseline mammogram should be performed in the 35 to 40-year age group. The periodicity of survey mammography in asymptomatic women under 50 years should be determined by analysis of relative risk factors for breast cancer. For asymptomatic women age 50 years and older, periodic screening mammography is sound medical practice.

Adult↗

PubMed1976

The addition of mammography to breast carcinoma screening in a general gynecology practice. One year's experience.

Obstetrician-gynecologists must be in the vanguard of the effort to reduce the death rate from breast carcinoma for it is they who regularly examine a large number of American women. Routine mammography was incorporated into a general gynecologic practice and was recommended for all women over 30. Of 750 women clinically examined, 524 had mammography, and there were 8 carcinomas detected in this group. Six of these were detected by mammography, 5 by mammography alone. Four of these 5 were in situ lesions. In 2 cases the clinical examination was suspicious and the mammography negative. Only 2 of the 8 patients with cancer fell into the commonly cited "high-risk" groups. Based on this experience, suggestions are made for incorporation of mammography into the routine gynecologic examination.

Adult↗

PubMed1976

Developments in mammography.

Mammography is presented for the primarily nonradiologic audience. A brief historical review calls attention to some of the milestones in mammography and how it has changed. Xerororadiography is discussed, as it is one of the newer developments and is rapidly gaining broad acceptance in the United States. Clinical applications are included, with a discussion of the various entities which the radiologist can identify on the mammogram. Although the mammographic examination can be extremely accurate in the hands of interested examiners, some carcinomas will not be identified; of these, some can be discovered by routine physical examination. If mammography is made to stand alone, without a physical examination, some women with breast cancer will not be identified and will not receive prompt, adequate treatment. Mammography is an adjunct and a complement to the physical examination. Breast cancer screening appears to be effective in finding small, nonpalpable tumors, many very early in their growth. Definite evidence is now available that early diagnosis of breast cancer leads to prolonged survival. There is promise of further developments in the field of mammography.

Adenofibroma↗

PubMed1979

Mammography: a surgeon's experience.

Most reports advocating mammography have been written by radiologists rather than by clinicians who are frequently confronted by women with breast complaints. The value of mammography in managing patients with breast problems was studied by reviewing its role in 1026 breast consultations; there were 129 patients with cancer. Mammography was performed in 95 patients. The procedure hastened the diagnosis of one comedocarcinoma, and in another patient was suspicious 3 years before she presented with a locally advanced lesion. It missed six cancers. In seven patients it recognized clinically obvious cancers, though in one of these it had given negative results 10 months before the patient presented with a lesion 15 cm in diameter. It also falsely suggested the possibility of cancer in 28 women. In the other 52 patients the clinical diagnosis of a benign condition was usually fairly evident. The morbidity caused by mammography does not seem to have been widely appreciated, no doubt because of the hope that clinically unrecognized cancers would be found by it. Most breast problems can be diagnosed without mammography.

Attitude of Health Personnel↗

PubMed1977

The accuracy of mammography: an analysis of 655 histologically verified cases.

The accuracy of the mammography was studied on 655 breasts which were investigated and biopsied or treated surgically shortly afterward. The mammography reports were classified according to the confidence level of the statements. In 279 cases the mammography was interpreted as positive for malignancy. A total of 224 malignant tumors were found. In 30 cases the malignant lesion was missed on the mammograms. The diagnoses made with a high degree of certainty were correct in 90% of the cases. The sensitivity of the mammography was 86.6% at a specificity of 80.7% for malignant tumors. The value of mammography for the diagnosis of chronic mastopathy could not be determined objectively. The sensitivity for solitary benign tumors or cysts was 80%.

Adult↗

PubMed1976

Radiation exposure of the breast in film- and xero-mammography.

In addition to other advantages, xeoradiography, compared with film-mammography, seems to result in a lower radiation dosage to the breast. In order to get some valid information concerning this point, depth dose measurements, were carried out in a plexiglas phantom for the different radiographic factors used in film- and xero-mammography. It could be shown that the exposure of the skin and the mean exposure of the breast are generally lower in xero-mammography than in film-mammography, and that this difference increased with increasing thickness of the breast. Therefore it can be concluded that xero-mammography should be preferred on account of its lower radiation exposure, whenever it is possible from the diagnostic point of view.

Breast Neoplasms↗

PubMed2026

Neighborhood Deprivation and Screening Mammography Utilization: A Retrospective Cross-Sectional Study.

RATIONALE AND OBJECTIVES: Access to screening mammography reduces breast cancer mortality disparities. The Area Deprivation Index (ADI) is a validated measure of neighborhood socioeconomic disadvantage linked to adverse health outcomes. There is limited data evaluating mammography utilization among patients residing in areas of higher deprivation. This study evaluated the association between ADI and screening mammography utilization within an accountable care organization (ACO) affiliated with a multicenter academic medical center in the Upper Midwest. METHODS: This retrospective cross-sectional study included women aged 40-85 years attributed to the ACO in 2022, based on Wisconsin Collaborative for Healthcare Quality criteria. The primary outcome was receipt of screening mammography within two years. The primary exposure was ADI, analyzed by decile (ordinal) and as low (deciles 1-5) versus high (deciles 6-10) deprivation. The logistic regression models evaluated associations between ADI and screening, unadjusted and adjusted for age, race, ethnicity, and preferred language. RESULTS: Among 7463 participants with geographic data, 74.4% completed screening. Screening rates were 75.7% in low-deprivation areas versus 66.2% in high-deprivation areas. Increasing ADI decile was associated with reduced screening in unadjusted (OR 0.891, 95% CI 0.87-0.91, p<0.001) and adjusted analyses (OR 0.897, 95% CI 0.88-0.92, p<0.001). Black participants (OR 0.444, p<0.001) and individuals preferring non-English languages (OR 0.333, p<0.001) had lower screening odds after adjustment. CONCLUSION: Higher neighborhood deprivation is independently associated with lower screening mammography utilization. Targeted, equity-focused interventions addressing neighborhood, racial, and language-related barriers are needed to reduce screening disparities.

Area deprivation Index↗

PubMed1979

Mammography in symptomatic women 50 years of age and under, and those over 50.

Our experience with the use of mammography as a diagnostic aid in symptomatic women with breast complaints has been presented. One-third of all cancers were found in women 50 years of age and under. The detection of cancer by mammography in the younger age group was similar to that experienced in the older age group. Radiation exposure by mammography has diminished markedly during the last 15 years--only one-third to one rad per exposure with modern technique. Recent hysterical criticism of the use of mammography in women under 50 years of age is unwarranted in the light of current findings. This diagnostic modality should be utilized when indicated in all age groups over 30. It is probable that screening clinics should include all women over 35 years of age.

Adult↗

PubMed1975

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.

Adult↗

PubMedDate not supplied

Relative carcinogenic effects of different mammography techniques.

Comparisons of different mammography techniques can be significantly altered by assumptions about the relevant measures for carcinogenic effects in mammography at low doses. Using a combination of recent data available from the literature, a study as been made of the significance of various assumptions concerning both the appropriate measures for carcinogenesis in mammography and the shape of the dose-effects relationship. It is found that for techniques typical of current reduced-dose mammography systems, the comparison of the relative carcinogenic effects of the techniques is significantly affected by both the measures that are used and the shape of th dose-effects relationship.

Breast Neoplasms↗

PubMed1977

Risk versus benefit in mammography.

Controversy surrounds the use of mammography in asymptomatic women 35-49 years of age. There is agreement that routine mammography is useful beyond 50 years. By extrapolating data from relatively high radiation exposures, a radiation carcinogenic risk at diagnostic levels has been calculated by some workers. Benefit for asymptomatic women in the 35-49 year age group has been questioned. This paper presents evidence that significant numbers of breast cancers are found in this age period on the basis of x-ray examination alone. Data also indicate absorbed dose from modern-day mammography is half to one quarter of that previously assumed. Based on these data, mammography is recommended as a tool for diagnosis of nonpalpable carcinomas of the breast.

Adult↗

PubMed1977

Cancer of the breast--induction by radiation and role of mammography.

Conflict in the management of cancer of the breast exists. Diagnosis by x-ray mammography provides early effective treatment, but x-ray exposure to the breast is cancerogenic. Prudence requires the use of low dose x-rays in mammography, and limits the use of x-ray mammography in the young. Guide lines for the indications for mammography are changing, and large scale population exposure to radiation should await results of demonstration projects in the United States.

Acne Vulgaris↗

PubMed1978

[Critical notes on risk calculations in mammography (author's transl)].

Since 1971 a Mammography Screening Study was carried out in Hamburg. This project shows that mammography is the only method to detect a high percentage of minimal breast cancer. The chance to cure these patients (10-years-survival) then is 80% and more. With mean literature values for parenchym dose, incidence rate and induction period the risk of cancer induction by mammography as a function of age was calculated. It is shown that benefit exceeds risk not only for women over 50 years of age. Even for younger women the use of mammography seems justified, if longer inspection periods from 2 to 5 years are considered.

Adult↗

PubMed1976

Bilateral breast carcinomas: Role of mammography.

From 1963 to 1973, at Emory Clinic, out of a total of 1112 patients with breast carcinoma studied with mammography, 83 had carcinoma in both breasts. The carcinoma in the second breast was primary in 67 patients and metastatic in 16 patients; in 18 patients there were simultaneous bilateral primary carcinomas. Mammography proved highly effective in detecting the second carcinoma and was reliable in differentiating a second primary from metastatic carcinoma. Forty-one of the second primary carcinomas were not associated with a palpable mass; 31 of these were having mammography as a routine check-up. The second nonsimultaneous carcinoma was considerably smaller than the first and fewer axillary lymph node metastasis. The second primary occurred within 6 years of the first in 86% of the cases with the remaining 14% scattered evenly up to 23 years. At 4 years after the diagnosis of the second primary, 25 of 27 deaths had occurred and only 1 patient was alive with cancer. Breast cancer patients need close follow-up for at least 6 years after the first primary carcinoma; and 4 years past the second primary signals a more optimistic prognosis.

Adult↗

PubMed1977

Conventional mammography, physical examination, thermography and xeroradiography in the detection of breast cancer.

From July 1, 1973, through January 15, 1975, at the Emory University Clinic independent physical examinations, conventional mammography, thermography and xeroradiography of the breast were carried out on 1,003 symptomatic patients by both physicians and radiologic technologists. One year after completion of the study there had been 360 breasts biopsied with 53 malignant and 307 benign lesions demonstrated. Seventy-three percent of the cancers were histologically Stage 0 or Stage I. The detection rate of the cancers by physician and technologist respectively were: 1) conventional mammography 87 and 74%; 2) xeroradiography 65 and 46%; 3) physical examination 62 and 51%; and 4) thermography 29 and 27%. In non-malignant breasts the physician and technologist designated cancer respectively in: 1) thermography 4 and 6%; 2) conventional mammography 6 and 6%; 3) xeroradiography 8 and 10%; and 4) physical examination 11 and 12%.

Adult↗