Mammography

Most breast cancers diagnosed are small tumors (less than or equal to 2 cm), and disease is localized in all racial and ethnic groups. However, blacks and other minority women have proportionally more cases of disease diagnosed at more advanced stages compared with white women. This is thought to reflect access to and use of screening mammography and timely treatment. 

Initial work-up for a woman presenting with a lesion or symptoms suggestive of breast cancer should include a careful history, physical examination of the breast, three-dimensional mammography, and possibly other breast imaging techniques such as ultrasound. Most (80% to 85%) breast cancers can be visualized on a mammogram as a mass, a cluster of calcifications, or a combination of both. Breast biopsy is indicated for... 

Breast cancer has a very high incidence in women. Breast cancer frequently develops into (or is) a systemic disease. The best way to reduce risk due to breast cancer is early tumor detection and surgical removal. The increase in detection rate of breast tumors that are < 1 cm in diameter over the past 10 years can be mostly attributed to improvements in the sensitivity and utilization of mammography. The main utility of CA 15-3 in breast cancer is to monitor patients after mastectomy (14). 

Zahl, Per-Henrik, Jan Msehlen and H. Gilbert Welch, The Natural History of Invasive Breast Cancers Detected by Screening Mammography , Annals of Internal Medicine 168, no. 21 (2008) 2311-16... 

Many women first detect some breast abnormalities themselves, but it is increasingly common for breast cancer to be detected during routine screening mammography in asymptomatic women. 

Initial workup for a woman presenting with a localized lesion or suggestive symptoms should include a careful history, physical examination of the breast, three-dimensional mammography, and, possibly, other breast imaging techniques such as ultrasound. 

Chlebowski RT, Hendrix SL, Langer RD et al. (2003) Influence of estrogen plus progestin on breast cancer and mammography in healthy postmenopausal women. J Am... 

J.M. Boone, T.R. FeweU and R.J. Jennings, Molybdenum, rhodium and tungsten anode spectral models using interpolated polynomials with application to mammography, Med. Phys. 24(12) (1997) 1863-1874. 

Optical mammography Brain imaging Sequential and/or parallel detection of light at selected points reconstruction of 2D, 3D images Reflected or Breast tumours transmitted light, fluorescence Brain perfusion, stroke... 

Williams RR, Feinleit M, Connor RJ, et al. Case-control study of anti-hypertensive and diuretic use by women with malignant and benign breast lesions detected in a mammography screening program. J Natl Cancer Inst 1978 61 325-7. 

Karlsson YA, Malmstrom PO, Hatschek T, et al. Multimodality treatment of 128 patients with locally advanced breast carcinoma in the era of mammography screening using standard polychemotherapy with 5-fluorouracil, epirubicin, and cyclophosphamide prognostic and therapeutic implications. Cancer 1998 83 936-947. 

Brody H, Cullen M. 1957. Carcinoma of the breast seventeen years after mammography with thorotrast. Surgery 42 600-606. 

Detection bias occurs in convenience-cohort studies when any measure of substance exposure is correlated with differences in medical scrutiny. For example, the positive relationship between reser-pine (a blood pressure medication) and breast cancer might be attributable to the fact that women under treatment for high blood pressure are more likely to have breast exams, which detect otherwise silent breast cancers (Feinstein 1988, 1261). The same might be true of the relationship between alcohol intake and breast cancer, because alcohol could be a surrogate for income and more frequent breast cancer screening and mammography (Feinstein 1988, 1261). 

Another approach to the study of the effects of hormone replacement therapy on the breast is to examine breast density, using mammography and the Wolfe classification. In a randomized study of 166 menopausal women, using this technique, there was increased breast density after 6 months of treatment eight times more commonly in those who took estradiol and norethisterone acetate than in those who took tibolone (186). The significance of this increased density is not clear, but it should for the present be regarded as undesirable,... 

Persson I, Thurfjell E, Bergstrom R, Holmberg L. Hormone replacement therapy and the risk of breast cancer. Nested case-control study in a cohort of Swedish women attending mammography screening. Int J Cancer 1997 72(5) 758-61. 

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