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At least 1,261 records · Page 70Linked to original sources
PubMed1998

Early- and late-stage breast cancer in a managed care setting in relation to mammography screening.

A case-control study was conducted to ascertain occurrence of advanced- and early-stage breast cancer, use of mammography, and the relationship between the two. All women with stage III/IV breast cancer (N = 46) were matched to two controls (stage 0/I and stage II) by year of diagnosis and age. Matched-pair analyses assessed antecedent use of screening mammography. Results indicated that advanced-stage patients were significantly less likely than their stage 0/I counterparts to have had antecedent screening within 13 months of diagnosis [chi2: 5.78; OR: 6.0; p < 0.05]. Cases compared with stage II controls did not differ statistically. Efforts should focus on increasing mammography in currently targeted age groups. Considerations might be toward extending regular screening for women 40 to 49 and over 75.

Adult↗
PubMed2001

Perspective on digital mammography.

Digital mammography, particularly through its advanced applications, holds great promise for improved diagnostic accuracy, but the display of the images is not ideal at present. Clinical softcopy workstations are somewhat unwieldy to use, and image processing has not yet been optimized for each machine or for each clinical task. In addition, the cost-effectiveness and accuracy of the technology warrant careful study before digital mammography becomes widely disseminated and potentially replaces screen-film mammography, a technology that has been well documented to reduce breast cancer mortality.

Clinical Trials as Topic↗
PubMed1977

[Automatic exposure for xero-mammography (author's transl)].

During mammography without intensifying screens, exposure measurements are carried out behind the film. It is, however, difficult to construct an absolutely shadow-free ionization chamber of adequate sensitivity working in the necessary range of 25 to 50 kv. Repeated attempts have been made to utilize the advantages of automatic exposure for xero-mammography. In this case also the ionization chamber was placed behind the Xerox plate. Depending on tube filtration, object thickness and tube voltage, more than 80%, sometimes even 90%, of the radiation is absorbed by the Xerox plate. Particularly the characteristic Mo radiation of 17.4 keV and 19.6 keV is almost totally absorbed by the plate and cannot therefore be registered by the ionization chamber. This results in a considerable dependence of the exposure on kV and object thickness. Dependence on tube voltage and object thickness have been examined dosimetrically and spectroscopically with a Ge (Li)-spectrometer. Finally, the successful use of a shadow-free chamber is described; this has been particularly adapted for xero-mammography and is placed in front of the plate.

Lighting↗
PubMed2005

[Digital X-ray mammography: comparison of the image quality achievable with a wet laser imager, a dry infrared laser imager and a dry laser imager using direct thermography].

PURPOSE: To compare the image quality of digital X-ray mammographies obtained with wet imagers with that of standard dry imaging technology. MATERIAL AND METHODS: Beginning 03/08/2003, 200 X-ray mammographies with a digital fullfield mammography system (Lorad Selenia, Lorad/Hologic) were prospectively and consecutively documented with a wet laser imager (Scopix LR 5200, Agfa), a dry infrared laser imager (DryView 8610, Kodak) and a dry imager using the principle of direct thermography (Drystar 4500M, Agfa, N = 166). One X-ray exposure was systematically chosen from each examination and was presented in an anonymous and randomized form to three radiologists who evaluated the films using a structured questionnaire. RESULTS: The visualization of normal anatomic structures was considered being good to excellent for all imagers with the mean assessments 1.0 - 2.4 for the Drystar 4500M, 1.0 - 2.1 for the DryView 8610 and 1.1 - 2.0 for the Scopix LR 5200. The mean assessments were 0.1 - 0.6 points lower in dense than in normal parenchyma, thus, the parenchymal density is the predominant factor for image quality. CONCLUSION: In view of the comparable image quality obtained with the different imagers used in the study, individual decisions to purchase a specific imager will be based on economics rather than on diagnostic points of view.

Computer Peripherals↗
PubMed2006

[Mammography screening in Germany: how, when and why?].

It is well-known from several large randomized trials that regular mammography screening can reduce breast cancer mortality. While in many countries mammography screening programs have been in existence for quite some time, an organized population-based screening program is only now being implemented in Germany. In this review article, the different elements of a mammography screening program and their effect on the cost-benefit ratio are discussed and the planned German screening program is compared to the international programs.

Breast Neoplasms↗
PubMed1999

[Direct digital magnification mammography with a large-surface detector made of amorphous silicon].

PURPOSE: To investigate the image quality of a new direct digital mammography system using a large-area amorphous silicon X-ray detector in a phantom study. MATERIALS AND METHODS: The contrast-detail resolution as a function of the tube voltages, the magnification factors and the mean glandular doses were investigated using dedicated test objects. RESULTS: The contrast-detail resolution was significantly improved in comparison with conventional screen-film mammography. Usually, the doses necessary to obtain these high-quality survey mammograms were smaller. CONCLUSIONS: By combining the direct magnification technique and a digital flat panel detector the limited spatial resolution of such image receptors can be overcome. With this direct digital mammography technique, a digital image was directly captured without an intermediate step of optical or mechanical scan.

Equipment Design↗
PubMed1996

[The value of MR-mammography at 1.5 tesla in the differential diagnosis of non-puerperal mastitis and inflammatory breast carcinoma].

PURPOSE: The distinction between mastitis and inflammatory breast carcinoma is an important one. Current methods of evaluation including mammography, ultrasound and clinical examination do not enable this distinction. Dynamic magnetic resonance mammography (MRM) is a study with potential in this regard. MATERIAL AND METHODS: 12 patients, in whom clinical examination, mammography and ultrasound could not distinguish between both diseases, were reviewed retrospectively by means of MRM using a 1.5 T Siemens Magnetom SP and a circular mamma coil. We used dynamic 3-D gradient echo sequences with a duration of one minute. RESULTS: At present MRM cannot definitely distinguish between mastitis and inflammatory carcinoma, 80% of the inflammatory carcinomas were found to enhance more than 100% in the first minute, compared to 43% for mastitis. No other differences were seen. CONCLUSION: MRM proved useful in the follow-up of treated mastitis to demonstrate the success of antibiotic treatment of mastitis and to diagnose a histologically unconfirmed inflammatory carcinoma by means of a different follow-up.

Adenocarcinoma↗
PubMed1988

[Significance of mammography study in the detection of 2,511 breast cancers 1977 to 1987].

The relation between the way of cancer detection and tumor stage was studied in 2511 cases of breast cancers patients. 85.0% of those patients discovered cancer by themselves. 12.7% of the carcinomas were detected through the screening program (used in FRG). It was found that there exists a clear dependence between the tumor stage and the kind of diagnosis finding. When the breast carcinoma was detected by the patient herself--in spite of attending regularly the above mentioned screening program--it showed that 16.1% had a small, favourable tumor up to 1.0 cm, in 39.8% a rest-tumor and in 48.1% axillary metastases were found. In cases diagnosed through the screening program the number of small carcinomas amounted to 21.4%, a rest-cancer frequency was 30.5%, and the axilla was afflicted in 25.6%. When the tumor was detected only on account of mammography, 47.7% of the women had a small tumor up to a size of 1.0 cm and 89.7% of the patients had no axillary metastases. The results of the study show that the sensitivity of palpation and inspection is insufficient in the search for breast carcinomas. By including the mammography the efficiency of the screening programs is significantly improved. A routine mammography as a part of the screening program on the one hand makes the diagnosis "no cancer" more reliable, and the earlier detection of breast cancer on the other hand statistically renders the chances of healing significantly more favourable.

Breast Neoplasms↗
PubMed1988

[Comparison of raster mammography and real time sonography with histology in carcinoma of the breast].

In a retrospective study, the results of real-time sonography and grid mammography in 161 patients with histologically confirmed breast cancer were analyzed and compared with the histopathologic characteristics of the tumours to assess the diagnostic accuracy of these preoperative image-producing methods. The results showed the determination of the tumour size as obtained by the image-producing methods to correlate closely with the histopathologic findings. Furthermore, both real-time sonography and mammography yielded certain indications allowing prognostically valuable conclusions in respect of malignancy and invasiveness of the carcinomas. Taking into account the different but complementing diagnostic results of both methods, the combination of grid mammography and real-time sonography must be considered as the presently most reliable preoperative diagnostic procedure.

Breast Neoplasms↗
PubMed1984

[Slit-aperture technic in mammography].

Following a discussion of various principles used in the elimination of scatter, the prototype of a simple slit aperture mammography apparatus is described (modified Mammomat, Siemens). The main advantage of this technique compared with grid mammography is a halving of the radiation dose for identical image quality, using an identical film system. The technical requirements (heavy duty tube, new generator) are, however, considerable. If the film-screen systems currently in use are to remain the common systems for the future, then the development of a multi-lamellar slit diaphragm technique carries much promise for mammography.

Mammography↗
PubMed1983

[Comparison of mammography and automated sonography in 700 patients].

700 patients underwent routinely x-ray mammography and breast ultrasound with an automated grey-scale breast scanner. The parenchymal pattern of the ultrasound B-scan was morphological identical to the x-ray film. The echogram gave further informations about the topographic localisation of pathologic lesions to the chest wall including the pectoral muscles. The sonogram was of no value in 10 percent due to diffuse reflection of the breast. In cystic disease the diagnostic accuracy of the ultrasound was with about 100 percent superior to that of x-ray mammography. On the contrary the accuracy of the x-ray mammography was higher than that of ultrasound in the diagnosis of benign or malignant solids. Benign adenoma smaller than 1 cm could not be definetively recognised as carcinoma of this size. The diagnostic accuracy of the sonogram was 70 percent by 40 histologically proved carcinomas. The only use of the automated scanner in the diagnostics of the breast seams to be not justified, even not as a screening method, especially because small tumors with good prognosis are not recognized, however, the ultrasound gives additional important informations in the differential diagnosis of benign and malignant lesions of the female breast.

Adenofibroma↗
PubMed1981

Mammography- misunderstood and underutilized.

A mammography screening program for breast cancer carried out in Sacramento by the University of California Davis School of Medicine, Davis, was canceled because of negative public reaction to sensationalized reports in the lay press on the potential carcinogenic risks of the radiation exposure, along with passivity on the part of the medical community in defending the procedure and the program. Disappointment in this occurrence spurred us to explore physician's knowledge of and attitudes toward breast cancer and mammography. The results confirmed our suspicions that a significant number of physicians lack accurate knowledge of breast cancer and of the extremely high benefit-to-risk ratio of mammography as a means of early detection.

Attitude of Health Personnel↗
PubMed2004

Clinical assessment of a radiolucent cushion for mammography.

PURPOSE: To determine whether use of a radiolucent cushion could significantly decrease pain during screening mammography without compromising image quality or other technical factors. MATERIAL AND METHODS: 838 patients presenting for routine screening mammography were evaluated. The radiolucent cushions were placed on the compression surfaces of the mammographic equipment and were used while imaging the right breast. No pads were used while imaging the left breast. Patient age, hormonal status, compression force, and radiation dose values were collected on all patients. Each subject completed a visual analog pain scale (VAS) rating the degree of pain experienced with and without the cushions. All mammographic images obtained (CC and MLO views) were compared, side by side (cushioned versus non-cushioned) by the readers. RESULTS: Use of radiolucent cushions reduced pain by 10% or more in 66% (555/838) of women. Patients in this "benefited group" experienced an average pain reduction of 53%. No compromise of image quality was observed. Compression force and radiation dose values were highly correlated between the cushioned and non-cushioned sides. CONCLUSION: Two-thirds of women experienced a significant reduction of pain when the radiolucent cushions were used during mammography. Pain reduction was accomplished without any clinically significant change in compression force, radiation dose values, or image quality.

Humans↗
PubMed1989

Attitudes, beliefs, and knowledge about mammography among women over forty years of age.

In this study, the relative impact of health beliefs and physician request in predicting previous mammography experience among women over age 40 was examined. Responses from a sample of 201 women were analyzed using multiple regression techniques. The variable that accounted for the largest proportion (56%) of variance between women who had a mammogram or intended to and those who had not had the test and did not intend to was physician request for mammography. Women's perceptions about the benefits of mammography and perceived barriers were also significant, but the relative strength of these variables was low. Among women who had been asked by a physician to have a mammogram, 89.6% had done so, while only 10.4% of women who had not been asked to have a mammogram had done so. Implications for cancer education are discussed.

Adult↗
PubMed1995

Mammography usage and knowledge about breast cancer in a Michigan farm population before and after an educational intervention.

The purpose of this study was to identify factors associated with the use of mammography screening in a farm population, before and after a community-based educational intervention. The educational intervention included sending individual mailings containing information about breast cancer risk and community sources for screening, and providing information and screening at local county fairs and agricultural community fairs. The authors used multivariate analytic methods to analyze the responses, reported by 1,545 women, to discern the roles of sociodemographic, attitudinal, and knowledge variables in this population's breast cancer screening practices. Results showed that the rural participants in both the intervention and the control communities demonstrated significant changes in knowledge and attitudes about breast cancer. Mammography usage was significantly higher among women who had higher scores on the knowledge and awareness assessments. Education--rather than income, insurance coverage, or family history of breast cancer--emerged in multivariate analyses as the most significant predictor of knowledge and awareness score levels associated with greater use of mammography. Implications of this study include support for education that emphasizes the benefits of early detection of breast cancer for all women.

Adult↗
PubMed1998

Mammography use among women attending an inner-city clinic.

BACKGROUND: Low-income, minority, and inner city women have breast cancer screening rates that are below those of the general population. METHODS: The authors surveyed women who received primary care at Seattle's county hospital about their mammography behaviors in early 1995. Data were analyzed within the context of the PRECEDE framework. RESULTS: Only half (48%) of the women were obtaining regular screening. Breast cancer and mammography beliefs differed by racial group. The following factors differentiated between inner-city women who were and were not regular users: mammography beliefs concerning early detection of disease, pressure from the machine causing breast cancer, and cost (these were less important among white women than members of other racial groups); previous physician discussions, concerns about appointment scheduling, and transportation problems; and social support from physicians, family, and friends. CONCLUSION: Interventions to encourage regular screening among inner-city women should address predisposing, enabling, and reinforcing factors.

Black or African American↗
PubMed2002

Message framing and mammography screening: a theory-driven intervention.

Although the rising incidence of breast cancer has prompted a surge of intervention strategies aimed at increasing women's use of mammography screening, the majority of patient-directed interventions have not been driven by relevant theoretical work on persuasive health communication. The authors evaluated an intervention derived from prospect theory that was designed to increase women's adherence to recommendations for annual mammography screening. They sent 1 of 3 reminder letters (positive frame, negative frame, or standard hospital prompt) to 929 randomly selected women who were due for mammography screening and had been identified as having either a positive or negative family history of breast cancer. The primary hypothesis that women with a positive history would be more responsive to negatively framed messages, whereas women with a negative history would be more responsive to positively framed letters, was not confirmed. The lack of support for predictions derived from prospect theory raises important questions about the generalizability of laboratory research to natural settings.

Adult↗
PubMed2002

Routine screening mammography: how important is the radiation-risk side of the benefit-risk equation?

The potential radiation hazards associated with routine screening mammography, in terms of breast cancer induction, are discussed in the context of the potential benefits. The very low energy X-rays used in screening mammography (26-30 kVp) are expected to be more hazardous, per unit dose, than high-energy X- or gamma-rays, such as those to which A-bomb survivors (from which radiation risk estimates are derived) were exposed. Based on in vitro studies using oncogenic transformation and chromosome aberration end-points, as well as theoretical estimates, it seems likely that low doses of low-energy X-rays produce an increased risk per unit dose (compared with high energy photons) of about a factor of 2. Because of the low doses involved in screening mammography, the benefit-risk ratio for older women would still be expected to be large, though for younger women the increase in the estimated radiation risk suggests a somewhat later age than currently recommended--by about 5-10 years--at which to commence routine breast screening.

Adult↗