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Biomedical subjects

M Moskowitz

Publications and source records attributed to M Moskowitz.

At least 55 records · Page 3Linked to original sources
PubMed1984

Breast cancer screening: significance of minimal breast cancers.

Analysis of cancers occurring during an aggressive screening program indicates: (1) In our study, during 3 years of active incidence screening of women under the age of 50 years, 24 cancers occurred, 14 of which were minimal. In the 3 years that there has been very limited screening, 23 cancers occurred, only five of which were minimal (p = 0.02393). (2) We projected that 110 breast cancers should have occurred in the incidence years of observation of this self-selected population of 10,531 women. In our screened population, 124 cancers occurred. This is not significantly different from the expected number. (3) In a similar period of observation of a similar sized screened population 112 cancers occurred in Louisville and 113 cases of cancer occurred in Seattle. There is no significant difference from the 124 cases reported in Cincinnati nor from the 110 cases expected. However, of all forms of cancer (prevalent, incident, interval) in Cincinnati, 67 cases were minimal, as against 35 in Louisville and 23 in Seattle (p = less than 0.0001). All in all, these data supported the concept that screening for breast cancer does not in any significant way increase the number of cancer cases detected, it only advances the stage of detection. The data also suggest that, for an aggressive screen, length-biased sampling does not seem to be an insurmountable obstacle.

Adult↗
PubMed1984

Screening for breast cancer in Europe: achievements, problems, and future.

Several breast cancer screening programmes are being carried out in Europe. Clinical examination in combination with mammography is the screening method used in Guildford and Edinburgh (United Kingdom) as well as in Utrecht (Netherlands). Mammography is the only screening modality in the Swedish programmes of Falun (Kopparberg County), Linköping (Ostergötland county), and Malmö and in Nijmegen (Netherlands). Clinical examination is the initial screening method in Turku (Finland). The Swedish programmes are population-based, controlled, and randomised. They are designed to assess the impact of screening on the mortality of breast carcinoma. Comparing the results of all the European screening programmes is expected to give some answers to the hitherto unanswered questions concerning the screening method and ideal interval in different age groups. The results achieved so far indicate that although mammography is a sensitive method for the detection of early breast cancer, clinical examination and an aggressive biopsy policy may be necessary to reduce mortality from breast cancer in certain age groups. It is also evident that there is no universally applicable ideal screening method or rescreening interval for all age groups.

Adult↗
PubMed1984

Mammography to screen asymptomatic women for breast cancer.

Despite the lack of absolute confirmation from a properly controlled clinical trial, there is now sufficient evidence to permit the working assumption that screening mammography beginning at age 40 will play a substantial role in controlling breast cancer. An analysis of available data indicates that the benefits of mammographic screening far exceed potential risk, and that earlier detection of cancer will actually add years to life rather than simply permit an earlier diagnosis. American radiologists are now challenged to provide screening mammography in an easily accessible and inexpensive form, so that it is effectively available to all women over age 40.

Adult↗
PubMed1983

The predictive value of certain mammographic signs in screening for breast cancer.

Prospective evaluation of aggressive screening for breast cancers which are either 5 mm in size or, alternatively, wholly intraductal or in situ lobular, was performed. Twenty-one percent of all cancers were identified by the presence of microcalcifications; 71% of these were minimal and the predictive value of microcalcifications was 11.5% (+/- 1.7). The probability of cancer given a radiographically benign, dominant mass over 1 cm in size, palpable or not, was 2% (+/- 0.8) and two-thirds of these cancers were minimal. If diagnosis had not been established by biopsy for these benign appearing lesions six percent of all cancers would not have been detected. Had clinical examination been omitted from screening, 32 cancers (16%) would have been eliminated, 13 of which were minimal. However, the false-positive rate would have been halved. The range of predictive values, true-positive rates, and percent of minimal cancers detected are presented for each of several mammographic signs when clinical examination was either positive or negative.

Biopsy↗
PubMed1983

Reproducibility of mammographic classifications.

Wolfe's mammographic classification and a percentage classification are statistically evaluated for inter- and intraobserver bias and agreement by seven mammographers with a set of 200 xeromammograms. The results demonstrate significant bias and disagreement with both methods, raising questions about the clinical limitations of these or other mammographic classifications. However, about 90% of the percentage classifications of pairs of readers are within adjacent categories. This suggests that (1) more experience with precisely defined classifications and protocols, (2) the development and application of readily available instructional materials, and (3) studies to identify and evaluate sources of variation in such classifications may eventually lead to acceptable levels of reproducibility.

Breast Neoplasms↗
PubMed1982

Growth stimulation of rous sarcoma virus-transformed BHK cells by biotin and serum lipids.

Biotin or a serum lipid extract stimulated proliferation of G1 arrested Rous sarcoma virus-transformed BHK cells in modified Eagle's MEM (BM). The cells could be maintained continuously in BM plus biotin (BMB), but not in BM plus serum lipid extract (BM X L). Avidin inhibited growth stimulation when added to BMB, but did not inhibit growth when added to BM X L. 14C-acetate incorporation into total cellular lipids was stimulated in BMB, but not in BM. Thin-layer chromatography of the labeled cellular lipid extract indicated that relatively large amounts of 14C-acetate were incorporated into phosphatidylserine and little into the other major phospholipids. In the neutral lipids, the largest amount of incorporation was in cholesterol. G1 arrested cells multiplied rapidly in BM supplemented with dialyzed serum (BM X DS), but they did not multiply in BM with delipidized serum (BM X DLS). The addition of biotin or serum lipid extract to BM X DLS stimulated growth. Growth stimulation in BM X DLS by biotin was inhibited by avidin, but avidin had no effect on growth stimulation by serum lipid extract. Biotin stimulated additional multiplication in BM X DS and avidin inhibited this additional growth stimulation. These results suggest that growth stimulation requires lipids supplied by serum lipids or by de novo synthesis stimulated by biotin. In the absence of serum, the stimulation of the synthesis of growth factor(s) by biotin are also required for continuous multiplication.

Acetates↗
PubMed1982

Evidence of breast cancer mortality reduction: aggressive screening in women under age 50.

Five year follow-up data for breast cancer screening of 10,531 self-selected women are presented. The data are compared with the Health Insurance Plan of New York population and it appears that the magnitude of the mortality reduction in these two populations is similar. However, contrary to the New York findings, the data demonstrate that the benefit to screening this population was maximal in women under age 50. No breast cancer deaths have been recorded in 5 years of follow-up in this younger population (6,030 individuals). Interpretation of the data is that aggressive screening for breast cancer can favorably alter breast cancer mortality, particularly in younger women.

Adult↗
PubMed1982

Observer variation in the interpretation of xeromammograms.

We have examined variation in the interpretation of xeromammograms among radiologists designated to take part in a Canadian multicenter randomized controlled trial of screening for breast cancer. Radiologists read 100 xeromammograms comprising 10 histologically proved cancers, 40 benign abnormalities, and 50 normal films. Radiologists' opinions differed widely on the frequency of suspected or identified cancer. The diagnostic category "suspicion of cancer" or "cancer" was selected by radiologists for 10-55% of the films, and biopsy or aspiration was recommended for 21 to 53% of patients whose films were examined. Agreement on specific diagnostic categories was greatest for the diagnosis of cancer; agreement was least for the diagnosis of benign abnormalities and intermediate for the diagnosis of normality. Known cancers were in general correctly identified. These results indicate a need for development of methods to reduce observer variation in a interpretation of xeromammograms while preserving diagnostic sensitivity and validity. Results also emphasize the importance of developing strategies to ensure quality control in multicenter trials.

Breast Neoplasms↗
PubMed1981

The potential value of liquid-crystal thermography in detecting significant mastopathy.

Liquid-crystal thermography (LCT) was assessed as a means of detecting proliferative disorders of the breast independently of other clinical or radiological data. There was no statistically significant difference between positive diagnosis rates for LCT of the breast in biopsy-proved proliferative disorders and in clinically and radiologically normal volunteers. While this experiment was not designed to evaluate LCT for detection or diagnosis of advanced, clinically occult, or minimal breast cancer, the data suggest that this technique can identify some large, bulky tumors, and that the smaller the lesion, the less likely that it would be detected by LCT.

Breast Neoplasms↗
PubMed1981

Mammographic screening: significance of minimal breast cancers.

Analysis of cancers occurring during an aggressively performed screening program indicates: (1) In this study, during 3 years of active incidence screening of women under age 50, 24 cancers occurred, 14 of which were minimal. In the 3 years of very limited screening, 23 cancers occurred, ony five of which were minimal (P = 0.02393). (2) It was projected that 110 breast cancers should have occurred in the incidence years of observation of this self-selected population of 10,531 women. In the screened population, 124 cancers occurred. This is not significantly different from the expected number. (3) In a similar period of observation of a similar sized screened population in Louisville, Ky., there were 112 cancers, and during a similar period in Seattle, Wash., 113. There is no significant difference from the 124 reported in Cincinnati, Ohio, or the 110 expected. However of all the cancers (prevalent, incident, interval) in Cincinnati, 67 were minimal; in Louisville, 35; and in Seattle, 23 (P less tha 0.0001). All in all, these data support the concept that screening for breast cancer does not in any significant way increase the number of cancers detected; it only lowers the stage of detection. The data also suggest that, for an aggressive screen, length-biased sampling does not seem to be insurmountable obstacle.

Adult↗
PubMed1980

Proliferative disorders of the breast as risk factors for breast cancer in a self-selected screened population: pathologic markers.

A study was done to quantify the pathologic risk of subsequent breast cancer in women whose biopsies demonstrated proliferative histologic conditions. Out of a total of 10,530 patients, 1,408 had biopsies which were classified as either bland fibrocystic or hyperplastic. The behavior of the disease in these patients was compared to that of the general screened population. It was concluded that women whose biopsies reveal hyperplastic disorder, primarily atypical hyperplasia and fibroadenoma, run the greatest risk of getting cancer. For women with atypical hyperplasia, the risk is 13 times that of the general population, and for those with fibroadenoma it is three times greater.

Breast Diseases↗
PubMed1980

Mammographic patterns as markers for high-risk benign breast disease and incident cancers.

A study was done to determine whether the risk of cancer development can be calculated through the use of mammographic patterns. Hyperplasia, bland fibrocystic disease, and incident cancers were correlated with Wolfe's mammographic classification scheme. Intraobserver and interobserver consistency were measured in the 8,033 classified mammograms. Maximum observer agreement was achieved by combining high-risk and low-risk categories. The data presented do not support the contention that diffuse mammographic patterns are useful predictors for determining strategies of screening or patient management; large-scale studies are needed before mammographic classification is adopted.

Adult↗