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Biomedical subjects

A H Letton

Publications and source records attributed to A H Letton.

At least 19 recordsLinked to original sources
PubMed1989

Routine breast screening for cancer.

Breast screening for cancer has increased the survival for women over age 50 as well as those younger than 50 years old. The 13-year average follow-up period disproves the claim that the survival gain is due to lead-time bias. The information brought forth in this presentation proves that higher-risk women must be screened in order to reduce the constant death rate from breast cancer.

Breast↗
PubMed1986

Routine breast screening. Survival after 10.5 years follow-up.

Beginning in 1973, the Breast Cancer Detection Demonstration Project at Georgia Baptist Medical Center screened 8058 supposedly asymptomatic volunteers. Those screenees found to have cancer were treated by various surgeons, using all types of treatment with varying expertise. There has been 100% follow-up after 10.5 years. The overall survival is 90.8%. The women over 50 in all categories survived longer than the younger age group. Those women with lesions 1 cm or smaller survived longer than those with larger lesions. The women whose tumor was not palpable clinically and was discovered by roentgenogram had the best survival rates (96.8%). In the less-than-50 age group whose cancer was detected by roentgenogram alone, 88.2% survived 10.5 years, while 100% of the older group is still living. These results do not consider the type of therapy nor the skill with which it was administered and is the result of routine screening only.

Age Factors↗
PubMed1981

Five-year-plus survival of breast screenees.

Seven years have elapsed since the first group of screenees were examined in the Georgia Baptist Medical Center (BCDDP). Of 8058 women studied, 135 had cancer. Forty-five percent of the tumors were found by x-ray alone. In 912 biopsies, 10.9% had axillary metastases and 8.5% had bilateral cancer. Among patients under 50 years of age, 26 had cancer lesions of which were less than 1 cm in diameter. There were 21 in situ carcinomas. Among those over 50 years of age, 46 had lesions 16 of which were 1 cm or less in diameter. There were 26 in situ carcinomas. Three of this latter group have died. Of those women undergoing surgery five or more years ago, 21 were in the group of patients under 50 years of age; one has died. Thirty-eight were in the group over 50 years of age and two have died. This is a 94.2% five-year survival rate. Two others are living with metastatic lesions, a five-year disease-free rate of 93.01%.

Breast Neoplasms↗
PubMed1980

The treatment of nonpalpable carcinoma of the breast.

Screening programs have discovered an increasing number of non-palpable breast cancers. There are several methods of locating these lesions by measuring the distance from the nipple and either excising an adequate margin around the measured point or more accurately locating it with a needle and further x-rays. The lesion, one excised, should be submitted for specimen radiography and compared with the mammogram to ascertain that the lesion has been excised. Many times, it is wise to submit the whole excised area for permanent sectioning to improve the reliability of diagnosis. For minimal carcinoma (0.5 cm or less), a total mastectomy with dissection of the level one nodes and with immediate pathological examination is done. If there is no metastasis or if metastasis in the nodes is two millimeters or less, it is probably adequate treatment. If larger metastases are present, a Patey Modified Mastectomy should be done. When the lesion is in the medial half of the breast, radiation to the parasternal area should be given.

Breast↗
PubMed1977

The value of breast screening in women less than fifty years of age.

In the four years our Breast Cancer Detection Demonstration Project has been receiving patients, 5,810 women under the age of fifty have been examined. Our findings definitely indicate screening of asymptomatic women by xeromammography is of advantage in this group whose greatest cause of death is cancer of the breast; 71.8% of their cancers were found by xeromammography. Of these 43.8% had in situ cancer and only 12.5% of those cancers found had axillary spread. This group should have a five-year cure rate of 87.1% rather than 63% as is the experience of unscreened women. The absorbed rads averaged 0.4632 to each breast per year. At the end of five years this would cause an estimated increase in risk from 7% to 7.162%. To increase survival rate by 24.1% against a theoretical increased risk of 0.16% is definitely worthwhile.

Adult↗