Showing papers on "Mammography published in 1974"
122 citations
TL;DR: The excellent results obtained by adequate treatment of minimal breast cancers attest to the need for reliable mass screening techniques to detect occult, asymptomatic breast cancer, and for the availability of these techniques to the public at large.
Abstract: Modified radical mastectomy was performed in 162 patients with minimal breast cancer between 1953 and 1972 (JAU). The majority of lesions were small infiltrating cancers (52), non-infiltrating duct cancer (37), lobular carcinoma in situ (49), Paget's disease with non-infiltrating cancer (12), and also a small group of miscellaneous low-grade cancers (7), and malignant cystosarcoma phyllodes (5). Major indications for surgery were the presence of a mass, nipple ulceration, positive mammograms, and the discovery of an occult cancer on contralateral biopsy. Mammography was accurate in 60% of patients with minimal breast cancer. Contralateral biopsy proved to be a very sensitive diagnostic technique, and was positive in 35 patients, most of whom were negative by clinical examination and mammography. Residual cancer was found in the mastectomy specimens in 52% after generous excisional biopsies. Sixteen percent of patients with minimal infiltrating cancer and clinically negative axillae had micrometastases (2mm or less) in axillary nodes. The crude survival rate free of disease was 93 of 95 patients (98%) at 5 years, and 42 of 44 patients (95%) at 10 years. There were no local recurrences. No postoperative radiation was used on these patients. Modified radical mastectomy is recommended as the ideal treatment for minimal breast cancer as it yields excellent long term salvage, complete local control, and is more acceptable cosmetically than the classical radical mastectomy. It is to be preferred over extended lumpectomy (tylectomy) with radiation therapy since it avoids the potential long-term carcinogenic effects of ionizing radiation. The excellent results obtained by adequate treatment of minimal breast cancers attest to the need for reliable mass screening techniques to detect occult, asymptomatic breast cancer, and for the availability of these techniques to the public at large.
109 citations
TL;DR: A group of 4621 well women has been screened for the detection of early breast cancer by clinical examination and thermography, with mammography when the initial screening indicated the need for further investigation.
Abstract: 4621 completely asymptomatic women underwent thermographic screening followed by clinical examination for breast cancer. 628 of the women were found to have abnormal thermograms and were referred for mammography. Of these 326 were abnormal but negative for malignancy 198 were negative 42 were positive for malignancy and 62 were suspicious of malignancy. Of the 62 9 were found positive at repeat roentgenogram indicating that thermography may indicate a malignant change at a time when the lesion is too small to be demonstrated radiographically. A positive thermogram should be considered as an indication for further study rather than biopsy. The false negative rate was 1.7 per 1000 women screened. Advantages of thermography are: 1) it provides simplicity of performance and repetition with no radiation hazard 2) it can provide an indication for further examination and 3) all women have nondeviating thermographic patterns except for older women who become progressively less vascular. Disadvantages include: 1) the "coldness" of scirrhous cancer 2) bilateral cancers may be interpreted as negative 3) there is no spatial relationship to the cancer and 4) thermographic signs of cancer occur in benign conditions.
53 citations
TL;DR: A group of 2684 women, selected as being at higher than average risk of breast cancer, has been screened by clinical examination, thermography, and mammography and the pickup rate for preclinical breast cancer is 19.3 per 1000.
Abstract: A group of 2684 women, selected as being at higher than average risk of breast cancer, has been screened by clinical examination, thermography, and mammography. The pickup rate for preclinical breast cancer is 19.3 per 1000. False positive and false negative rates are discussed. Cancer 33:1671–1679, 1974.
50 citations
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44 citations
TL;DR: This report presents the results of 125 consecutive biopsies that involved specimen radiography during surgery and found that benign lesions most often suggested carcinoma because of calcification in the mammograms were papillomatosis and sclerosing adenosis.
Abstract: As radiologic techniques have improved in the past decade an increasing number of nonpalpable breast lesions is being found by mammography. Specimen radiography is a simple procedure which can be incorporated into the routine activities of the pathology laboratory to facilitate the diagnosis of these minimal lesions. When calcifications are present they provide a useful marker that can be used to localize the lesions radiologically for histologic examination. Employing a team approach that involves radiologists, pathologists, and surgeons, we have developed an efficient procedure to perform specimen radiography of biopsies to confirm the excision of lesions that had been shown to contain calcifications by prior mammography, and to localize them for histologic study. In addition to a detailed description of a procedure for specimen radiography, this report presents the results of 125 consecutive biopsies that involved specimen radiography during surgery. Carcinoma was identified in 32 (25%). The benign lesions that most often suggested carcinoma because of calcification in the mammograms were papillomatosis and sclerosing adenosis.
43 citations
TL;DR: Percutaneous needle localization of microcalcifications within the breast is recommended for its accuracy, patient acceptance, and reduction in size of the biopsy specimen.
Abstract: Mammography occasionally reveals the presence of suspicious appearing clustered microcalcifications without an associated mass. Clinical localization of these microcalcifications within the breast is difficult, even using the 2 dimensional effect of a mammogram.Percutaneous needle localization of these microcalcifications is recommended for its accuracy, patient acceptance, and reduction in size of the biopsy specimen.No complications of this procedure have been encountered.
31 citations
TL;DR: To make needle aspiration biopsy easier in nonpalpable tumors detected at mammography, a specially designed compression device has been constructed.
Abstract: To make needle aspiration biopsy easier in nonpalpable tumors detected at mammography, a specially designed compression device has been constructed.This device and its practical application are discussed.
30 citations
TL;DR: High-contrast proton radiography may be used to show variations in tissue density and tumor-bearing areas within the breast under identical conditions and requires a lower tissue dose than that used in conventional mammography or xeroradiography.
Abstract: High-contrast proton radiography may be used to show variations in tissue density and tumor-bearing areas within the breast. Under identical conditions, this technique may provide better visualization of these structures than present radiographic methods and requires a lower tissue dose than that used in conventional mammography or xeroradiography.
25 citations
22 citations
TL;DR: It is concluded that specimen mammography represents a useful but not essential adjunct to the pathologic study of mammary disease.
Abstract: The incidence of calcification and appearance of opacities in specimen roentgenograms of 228 consecutive breast specimens representing a variety of disorders are presented. Although some diseases manifest distinctive roentgenographic features, overlapping is noted. This, as well as an inherent technical difficulty, appears to be reflected by the relatively high incidence of false-negative and false-positive diagnoses conveyed by clinical mammography. The detection of only 0.7% occult carcinomas (clinically and pathologically non-palpable) by specimen mammography in calcifications unassociated with a dominant mass and only 7.4% of all calcifications, including those in the latter group, tends to minimize the practical significance of clinical mamography for the detection of occult cancer of the breast. The occult carcinomas detected by specimen mammography in this study were found only in breasts with overt carcinomatous lesions, which represents an incidence of 9% multicentric cancers. Recognition of a similar incidence of such lesions by the histopathologic study of single sections from randomly selected blocks obtained from the uninvolved quadrants of breasts harboring an overt carcinoma, and the detection of such noninvasive carcinomas in benign breast disease by “extended” histopathologic study, signify the limitations of specimen mammography for the detection of these occult cancers. It is concluded that specimen mammography represents a useful but not essential adjunct to the pathologic study of mammary disease.
TL;DR: Seventeen cases of fibrous tumor of the breast are reported in persons between 23 and 55 years of age, 16 women and one man, with a localized proliferation of the interlobular and perilobular connective tissue with hypoplasia of the mammary ducts and lobules.
Abstract: Seventeen cases of fibrous tumor of the breast are reported in persons between 23 and 55 years of age, 16 women and one man. Mammography was not diagnostic. It is a localized proliferation of the interlobular and perilobular connective tissue with hypoplasia of the mammary ducts and lobules. It is the rarest of the benign tumors of the breast. Local excision was done in all cases and no recurrences have been observed. In one breast, a fibrous tumor was found at another area at a later date.
TL;DR: A significant incidence of “false–negative” pertechnetate mammograms and “ false-positive” mammograms suggests that this procedure does not fulfill requirements for a successful screening test.
Abstract: Localization of pertechnetate ion in malignant breast tumors has been described by several groups. The authors tested pertechnetate mammography (scintigraphy following intravenous 89mTc pertechnetate) in a group of 36 volunteers with palpable breast nodules, and compared diagnostic results with roentgen mammograms obtained for each patient. A significant incidence of “false–negative” pertechnetate mammograms (1 of 6 proved carcinomas) and “false-positive” (6 of 30 proved or presumed benign nodular disease) suggests that this procedure does not fulfill requirements for a successful screening test.
01 Jan 1974
TL;DR: Mammography proved to be a valuable adjunct to the clinical examination in evaluation of the irradiated breast and more accurate than physical findings in recognition of residual disease, differentiation of radiation fibrosis from persistent disease, and detection of reactivation of disease which is not yet clinically obvious.
Abstract: The role of mammography in assessing the radiation response of inoperable primary breast cancer was evaluated. Forty-three patients with nodular and inflammatory breast tumors were studied. Mammographic changes were correlated with clinical findings and in some cases with biopsy or autopsy findings. Mammography proved to be a valuable adjunct to the clinical examination in evaluation of the irradiated breast. It was found to be more accurate than physical findings in recognition of residual disease, differentiation of radiation fibrosis from persistent disease, and detection of reactivation of disease which is not yet clinically obvious.
TL;DR: Diffuse edema and skin thickening of the breast is a well-known clinical and roentgenographic finding in advanced malignant neoplasia and in acute mastitis.
Abstract: Diffuse edema and skin thickening of the breast is a well-known clinical and roentgenographic finding in advanced malignant neoplasia and in acute mastitis. Such appearances may be simulated by congestive heart failure. (JAMA229:682-683, 1974)
TL;DR: Whether one or two sets of mammograms are sufficient to induce malignant change in a breast is more doubtful, and irradiation of the breast can mount up rapidly, and apparently dangerous levels of radiation can be reached.
Abstract: With the increasing use of mammography in the diagnosis and follow-up of breast cancer, the question of radiation hazard has become of considerable interest (Ostrum, Becker and Isard, 1973; Samuel, 1973). There can be no doubt that ionizing radiation, given in sufficient quantity, is carcinogenic. There is evidence in a number of clinical reports (MacKenzie, 1965; Myrden and Hiltz, 1969; Mettler, 1969; Mole, 1973; Wanebo et al., 1968) as well as additional evidence from experimental work (Shellabargar et al., 1957). Whether one or two sets of mammograms are sufficient to induce malignant change in a breast is more doubtful. However, in problem cases of breast disease, and in screening procedure for breast cancer where yearly mammograms are the custom, irradiation of the breast can mount up rapidly, and apparently dangerous levels of radiation can be reached. Such levels can be greatly reduced if the rads per exposure are kept low (Young, 1974). There has been speculation on the probable increased incidenc...
TL;DR: Skin thickening and increased density of the breast parenchyma are findings that are noted on mammograms following primary radiation therapy of the breasts; however, recurrence cannot be excluded in such breasts on the basis of roentgenographic criteria.
Abstract: Skin thickening and increased density of the breast parenchyma are findings that we have noted on mammograms following primary radiation therapy of the breast.These findings are very similar to those seen in inflammatory carcinoma of the breast. We were unable to distinguish between them on a roentgenographic basis.The presence of such changes on a mammogram is to be anticipated; however, they do not necessarily indicate recurrence of the carcinoma. Unfortunately, recurrence cannot be excluded in such breasts on the basis of roentgenographic criteria.
TL;DR: Categorizing patients into "high-risk" or "problem" cases provides selection for the vital and practical use of mammography in periodic screening and supports decisions in clinical management.
Abstract: Of 309 patients with verified breast carcinomas, preoperative mammograms were positive for 66% This detection rate probably would have been higher if mammograms had not been omitted for many clinically obvious breast carcinomas during the seven-year period of study The significant occurrence of false-negative examination results when mammography is used under day-to-day clinical conditions emphasizes the prime importance of physical examination in the recognition of breast carcinoma The procedure is of greater than supportive diagnostic value, however, in the detection of breast carcinoma, because a significant number (11% in this study) can be detected early only, or primarily, by mammography Categorizing patients into "high-risk" or "problem" cases provides selection for the vital and practical use of mammography in periodic screening and supports decisions in clinical management
TL;DR: The overall end results of breast cancer therapy should be significantly improved if mammography is employed routinely in the evaluation of such patients.
Abstract: Statistical comparison of patients undergoing breast biopsy at a community hospital over a 16-year period indicates the impact of mammography on the management of breast cancer. Three study groups were surveyed: (a) patients biopsied during the 5 years preceding the use of mammography, (b) patients given mammography during the next 10 years, and (c) those studied during the final year. A 19% increase in detection of Stage I cancer was seen. The overall end results of breast cancer therapy should be significantly improved if mammography is employed routinely in the evaluation of such patients.
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