Positioning for oblique projection in mammography.
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Biomedical subjects
Publications and source records attributed to B Lundgren.
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A nonselected population of women screened by single-view mammography was followed up to 2 years after screening, and breast carcinoma cases diagnosed were registered; 28,350 women were followed for 1 year. At screening, 132 invasive carcinoma cases were detected, and during the first year after screening, 10 cases were detected. According to an efficiency index, which takes into consideration both detections at screening and interval cases, the 1-year efficiency was 93%. The efficiency of single-view mammography for breast cancer screening was found to be satisfactory.
Single-view mammography was used for the screening of a total population of women living in a defined geographic region in Sweden; 37,640 women were invited and 31,074 participated. The average participation rate was 82.6%, and in the age group 40-69 years it was 91.7%. The rate of referrals from screening to clinical examination was 1.2%. Of 209 surgical biopsies performed, 130 primary mammary carcinomas were detected, 91% of which had no clinically detectable metastatic nodes. Because of the few false-positive cases, the low rate of benign biopsy specimens, the high rate of early detected carcinomas, and the low costs, screening by single-view mammography is considered a satisfactory method, provided the positioning of the oblique view is correct and the image quality is high.
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A consecutive series of 302 cases of microscopically confirmed mammary carcinoma was reviewed mainly with regard to abnormalities indicating malignancy at mammary radiography. Most important was the demonstration of a tumour mass and distortion of adjacent tissues. Calcifications of malignant type were present in 31 per cent of all cases, but led alone to a preclinical diagnosis of malignancy in only 2 per cent of the cases. Carcinomas detectable by both clinical examination and mammary radiography seemed to be as advanced irrespective of whether they were detected at a referral clinic or at screening of asymptomatic women.
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The effect on heart rate (HR) and blood pressure (BP) of metoprolol, propranolol and terbutaline, applied alone or in combinations was studied in spontaneously hypertensive rats. Terbutaline had little effect on BP and HR. Propranolol combined with terbutaline had no effect while metoprolol combined with terbutaline decreased BP by 48 mm Hg without affecting HR. Thus the beta2-mediated increase in peripheral vascular resistance after terbutaline was revealed by a drop in BP after beta1-blockade by metoprolol, but not when both beta1-and beta2-receptors were blocked by propranolol.
Doubling times were estimated for 15 breast carcinomas in 13 patients, and were found to be between 42 and 397 days with the average at 211 days. The mean lead time at mean growth rate from the average size of 44 preclinical to the average size of 118 clinical tumors was estimated to be 3 years. This period may be considered the probable time gained through screening for mammary carcinomas by the methods used in our studies, particularly single-view mammography. However, the wide range of observed growth rates and tumor sizes and probably measurement errors decreases the validity of this study.
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In 1974 a new approach to breast cancer screening was introduced--the single view mammography method. An urban nonselected population of 6845 women of more than 34 years of age were screened with one roentgenogram of each breast. By this method it has been possible to reduce the radiation dose, while the patient flow is increased and the costs are decreased to an acceptable level. Forty cases of breast carcinoma were detected (6.7/1000). Twenty cases were preclinical.
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In 1969-1970 a breast mass-screening was undertaken in Gävle, with thermography and questionnaire. Mammary radiography and clinical examination of subjects with abnormal screening reports and of a group of normal subjects were performed. In spite of having achieved early detection of malignant tumours in many cases with a preponderance of carcinoma cases in the abnormal group, thermography was found to have considerable drawbacks as a screening method.
A model for ergonomic studies of domestic work in varying patient groups has been constructed. A control group of 15 healthy women, 30-59 years of age, 9 female patients with hemiplegia and 13 with multiple sclerosis (MS) were studied with exercise test on a bicycle ergometer. Recordings of time consumption, heart rate and subjectively perceived exertion were made during a 4.5-5 hour domestic work program. Four of the more strenuous work elements were restudied also with respect to oxygen uptake. The hemiplegic patients required more time and had higher perceived exertion, but lower heart rate and oxygen uptake for the same work tasks than did the controls. The MS-patients also had higher perceived exertion. There was a rather poor relationship between determined and indirectly estimated energy expenditure. Various explanations are discussed. The results demonstrate the importance of the perceived exertion in choosing the work intensity.
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