Search PubMed⌕ Search

Biomedical subjects

R L Egan

Publications and source records attributed to R L Egan.

At least 37 records · Page 2Linked to original sources
PubMed1982

Multicentric breast carcinomas: clinical-radiographic-pathologic whole organ studies and 10-year survival.

Selection of breast cancer patients with microscopically limited disease but with excess mortality or women with regional disease and lessened mortality has remained an unsolved and critical challenge. The many usual histologic features such as tumor size, stage of disease or tumor differentiations were found reduced to lessened significant prognostic factors by the presence of multicentricity of tumors and multiplicity of histologic types of carcinoma. This observation was noted upon review of 161 clinical, radiographic and histopathologic whole breast studies on 156 patients with follow-up from 11-15 years. Epidemiologic, clinical, and radiographic data had been compiled prospectively prior to diagnosis. Women with single site and single type of carcinoma had a better prognosis (2.5% mortality per year) than those with multiple sites and multipe types (15% mortality per year) even though the stage of the disease may be similar. When the latter groups contained a scirrhous type duct carcinoma, the annual mortality rate approached 25%.

Adenocarcinoma↗
PubMed1980

Intramammary calcifications without an associated mass in benign and malignant diseases.

During a 16-year period, 42,888 clinical and radiographic breast studies were performed on 8,000 women. Of this number, 1,161 malignant and 5,270 benign lesions were histologically confirmed. Biopsy of 468 of the 721 breasts that had clustered calcifications not associated with a mass and that were subject to a five- to 16-year follow-up demonstrated 353 benign and 115 malignant lesions. Radiography of the biopsy specimen assured removal and proper study of the area of concern. Radiographic characteristics of the calcifications provide clues to estimate the risk of carcinoma. However, these signs are so nonspecific that all radiographically demonstrable clusters of stippled calcification require histopathologic study. Treatment prior to the formation of a mass provides an excellent prognosis.

Adult↗
PubMed1979

Estimated risk and occurrence of breast cancer in asymptomatic and minimally symptomatic patients.

Mathematical procedures, some unique to this study, were applied to 114 suggested risk factors, with as many as 10 subsets, from history, physical and x-ray examination on 30,904 breast studies on 7,252 patients referred from the Emory University Clinic since 1963. One-fifth of the cancers were unrelated to symptoms; 82% of the cancers were free of axillary lymph node metastasis. There was no sign or symptom that predicted preclinical cancer. Interaction of numerous indicators subjected to strong statistical procedures could contribute to establishing risk of even early breast cancer. The results of hierarchic discriminant analyses demonstrated the feasibility of using simultaneously large numbers of risk factors in a systematic way to pinpoint patient with mammary cancer. Based on usual clinical and x-ray assessment of the women 12.5% of the noncancer patients required biopsy to demonstrate 70% of the cancers with a cancer to benign rate of 1 to 4. Using the same data with discriminant analyses, 5.6% of the patients would require biopsy, at the rate of 11.9% of the population. A computerized system has been developed for widespread application to provide the clinician with a highly objective and totally consistent assessment of risk for breast cancer in each of his patients.

Age Factors↗
PubMed1979

Mammographic parenchymal patterns and risk of breast cancer.

A 15-year prospective study of mammographic parenchymal patterns in 7,123 women over 30 with 658 prevalent and 131 incident primary breast neoplasms demonstrated that no pattern is a reliable indicator of initial or developing cancer. Cancer in glandular breasts is less frequent, more difficult to detect by mammography, and tends to remain prevalent compared with the more frequent tumors in fatty breasts. As women get older, their breasts assume similar patterns and the incidence of both prevalent and incident tumors increases. Parenchymal patterns cannot signify which breasts may remain glandular, nor which women may be at risk of cancer.

Adult↗
PubMed1978

Metamorphosis of breast cancer.

In two decades there has been a sweeping metamorphosis of the antiquated conception of breast cancer as a solitary mass of questionable operability, accompanied by numerous axillary lymph nodes and probably distant metastasis. An undreamed-of recognizable preclinical stage of breast cancer has drastically changed attitudes and reactions in physicians and patients. These changes have paralleled the applications of clinical mammography. The smallest of premammography breast cancers are now advanced cancers. The average size of operable breast cancers at Emory University is now less than 1 cm in diameter, and ten-year cure rates with minimal cancers exceed 95%. The treatment of these minimal breast cancers, often in a two-stage surgical procedure with the patient participating in decisions, may include psychotherapy and reconstructive surgery. Pathologists have assumed new roles in coping with disturbing epithelial cellular changes in premalignant and borderline malignant breast lesions. Today predictive clinical signs and symptoms are associated with advanced cancer, with limited specific clinical changes relating to early breast cancer. Over one third of breast cancers are being discovered in women under 50 years of age, and mammography is the primary means of detecting these cancers.

Attitude↗
PubMed1977

Conventional mammography, physical examination, thermography and xeroradiography in the detection of breast cancer.

From July 1, 1973, through January 15, 1975, at the Emory University Clinic independent physical examinations, conventional mammography, thermography and xeroradiography of the breast were carried out on 1,003 symptomatic patients by both physicians and radiologic technologists. One year after completion of the study there had been 360 breasts biopsied with 53 malignant and 307 benign lesions demonstrated. Seventy-three percent of the cancers were histologically Stage 0 or Stage I. The detection rate of the cancers by physician and technologist respectively were: 1) conventional mammography 87 and 74%; 2) xeroradiography 65 and 46%; 3) physical examination 62 and 51%; and 4) thermography 29 and 27%. In non-malignant breasts the physician and technologist designated cancer respectively in: 1) thermography 4 and 6%; 2) conventional mammography 6 and 6%; 3) xeroradiography 8 and 10%; and 4) physical examination 11 and 12%.

Adult↗
PubMed1977

Breast cancer mammography patterns.

Mammography studies, from 1963 through 1972, on 5,918 women over age 30 years with 327 breast cancer on initial studies, were prospectively categorized on a scale of 1 to 4 of increasing amounts of fibroglandular tissue. Approximately 60% of the cancers occurred in classes 1 and 2 breasts, about one-third of the patients, while 40% of the cancer were in the remaining two-thirds, comprising classes 3 and 4. There were 54 cancers that developed in breast that previously were free of symptoms, clinical signs, and x-ray abnormality. Up to 36 months one cancer was found in class 1, while 26 cancers were detected in class 4 breasts; two cancers developed in class 2 and seven in class 3. Cancers developing 38 to 88 months after normal examination had an incidence of 0.23% in combined classes 1 and 2 and an incidence of 0.21% in classes 3 and 4. Dense fibroglandular tissue delays detection of breast cancer by mammography. Apparent increase in cancer risk in such breasts is due to this delay. More than a 3-year follow-up is required to assess the life history of breast cancer by mammography.

Adult↗
PubMed1977

High risk breast tumor patients.

A unique scheme for placing the most breast carcinoma patients into the least population includes newly developed systems to analyse 64 clinical and radiographic risk factors in combinations. The calibration sample consisted of 540 cancerous and 641 non-cancerous breasts. In an independent validation sample of 73 carcinoma and 462 non-carcinoma breasts, 90 percent of the potential malignant breasts were correctly classified with only 12 percent of the non-malignant breasts misclassified. Thus, the scope of prediction and delineation of malignant and non-malignant and non-malignant groups is extended.

Breast Neoplasms↗
PubMed1976

Bilateral breast carcinomas: Role of mammography.

From 1963 to 1973, at Emory Clinic, out of a total of 1112 patients with breast carcinoma studied with mammography, 83 had carcinoma in both breasts. The carcinoma in the second breast was primary in 67 patients and metastatic in 16 patients; in 18 patients there were simultaneous bilateral primary carcinomas. Mammography proved highly effective in detecting the second carcinoma and was reliable in differentiating a second primary from metastatic carcinoma. Forty-one of the second primary carcinomas were not associated with a palpable mass; 31 of these were having mammography as a routine check-up. The second nonsimultaneous carcinoma was considerably smaller than the first and fewer axillary lymph node metastasis. The second primary occurred within 6 years of the first in 86% of the cases with the remaining 14% scattered evenly up to 23 years. At 4 years after the diagnosis of the second primary, 25 of 27 deaths had occurred and only 1 patient was alive with cancer. Breast cancer patients need close follow-up for at least 6 years after the first primary carcinoma; and 4 years past the second primary signals a more optimistic prognosis.

Adult↗
PubMed1975

US citizens and foreign medical schools.

The foreign medical schools that are accepting an increasing number of applicants rejected by US medical schools are not comparable to US medical schools. Until population trends lessen the number seeking a medical education, several pathways are available to identify and assist the qualified student to return to US medicine.

Certification↗
PubMed1975

Breast biopsy priority: cancer versus benign preoperative masses.

From 1963 to 1973 at Emory Clinic 17,288 breast examinations, including history, physical examination, and mammography, were performed on 6342 patients. The resulting 2793 breast biopsies included 2056 benign and 737 malignant lesions. High-risk and low-risk groups of breast cancer patients were observed for presence or absence of a mass or masses clinically and by roentgenograph, age, and breast pathology. The breast biopsy rate was the same for all age groups studied. The percentage of cancer per biopsy varied from 0 to 100 when the various combinations of mass (masses), no mass, and age were considered. Low priority (less than 5% cancer) groups were: in all age groups no mass by roentgenograph or clinically and no mass by roentgenograph and clinical multiple masses: for the 0-32 age group, all categories except single mass by roentgenograph and clinically; and for the 0-38 age group all categories except mass or masses both by roentgenograph and clinically. Using this wide range in the ratios of cancer, priority for biopsy can be established for each group. The surgeon can use additional clinical assessment of relative risk to contribute to an increased priority scheme.

Adult↗
PubMed1975

Evolution of the team approach in breast cancer.

Dr. Wendell G. Scott hailed mammography as the first significant contribution to the control of breast cancer since Halsted described the radical mastectomy in 1903. Mammography as engendered new approaches and has supplied new concepts of breast cancer. Through the tenacity of a few physicians convinced something could be done for the breast cancer patient, the team against this dread disease has gradually, but solidly, been built and continues to grow.

Biopsy↗
PubMed1975

Mammography, xeroradiography, and thermography.

The concept of early breast cancer as a palpable mass with limited secondary manifestations is rapidly changing. Thanks largely to mammography, a malignant breast neoplasm can be detected long before it forms a mass. Because cure rates in this stage are high, reliable means of early detection and diagnosis are of deep concern. Early detection has certainly been the major influence in reducing mortality from cancer of the cervix, and results of recent studies indicate that this will also be true for cancer of the breast.

Adult↗