The first three years of the Guildford Breast Screening Project.
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Biomedical subjects
Publications and source records attributed to B A Thomas.
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The clinical, radiological and histological findings are described in nine cases of infiltrating epitheliosis. In seven cases the mammogram revealed 2.5-5.0 cm discoid radial scars which conformed with the histological features and there was no associated significant clinical abnormality. It can be difficult to differentiate the mammographic appearance of infiltrating epitheliosis from those of carcinoma with confidence but, taken in conjunction with the absence of clinical findings, the changes in the larger lesions are sufficiently distinctive to arouse considerable suspicion. The prevalence of the condition is estimated at 0.4/1000 women in the 45-65 years age range.
Of the 24 069 women aged 45-64 registered with a Practitioner in the South West Surrey Health District 69% attended for breast cancer screening by clinical examination and mammography, with the resultant cancer detection rate of 5.5/1000 women screened and a cancer: benign biopsy rate of 1:1.77. These cancers represent 94% of cancers diagnosed in screened women and 84% of all cancers diagnosed in the total population of this age within one year of the screening invitation. Seventy-three percent of the cancers detected by screening and 66% of all cancers diagnosed in the total population within a year of the screening invitation were 2 cm (or less) in maximum diameter.
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A preliminary survey has been carried out to test the feasibility of screening a high-risk group of women for breast cancer, using clinical examination and low-dose mammography, before the establishment of a two-tier screening system of basic well-woman clinics for the over-25s, and breast screening clinics for those over-35s considered to have a higher than average expectation of developing the disease. 7 breast cancers and 1 case of Hodgkin's disease were detected in 618 women (breast cancers 11-3/1000, malignancies 12-9/1000). Though numbers are small they suggest that the women themselves do not suspect the presence of those breast cancers which carry the best prognosis, though being aware of the larger cancers and of many of those benign localised breast lesions requiring surgical treatment.
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Over the 12-month period from April 1984 to April 1985, 512,000 gynecologic (Papanicolaou) smears were examined in the Provincial Screening Program in British Columbia. During this time, 307 patients were found to have smears that contained cells consistent with, or suggestive of, a herpes simplex viral (HSV) infection. The Papanicolaou-stained smears from these 307 cases were subsequently restained, without prior destaining, using an immunoperoxidase technique specific for type 2 HSV (HSV-2) and cross reactive with HSV-1. Of the 205 smears containing cells considered to be consistent with a herpes infection, 187 were positive using the immunoperoxidase technique. Of the 102 smears showing reactive cell changes though unlikely to be causes by an HSV infection, only 5 were positive using the immunoperoxidase technique. The results show that the immunoperoxidase technique is a rapid and reliable method of confirming a suspected diagnosis of herpetic infection and that it is particularly useful in those patients in whom the Papanicolaou smear findings are equivocal.