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• W2418133090 abstract "Despite advances in treatment, mortality rates from breast cancer remain high. Five-year relative survival rates have remained virtually unchanged from 1950 through 1969 (1). In an attempt to turn down the mortality curve and raise up the 5-year suniival curves, large scale screening studies to find smaller and yet smaller lesions utilizing mammography have been proposed. The ongoing prospective study of the Health Insurance Program of New York demonstrates that survival in screened patients is improved over the nonscreened group. In fact, Shapiro says only one death occurred among the 44 patients whose breast cancer was detected during screening through mammography alone (7). It is generally well accepted that the two most important correlates of prognosis in patients with carcinoma of the breast are size of the primary tumor, and the presence or absence of involved axillary lymph nodes (2, 8). While, generally speaking, lesions of 1 em or so in size, when limited to the breast, are considered as having a very favorable prognosis, Gallager and Martin have emphasized the concept of breast cancer (3). This includes carcinoma, lobular or ductal which is totally in situ, or invasive cancer less than 5 mm in diameter with no evidence of regional spread. Wanebos et al. (9) have reported that in 162 patients with minimal breast cancer whom they have treated, the 10-year crude survival rate is 95 %; i.e., no patient in that series had died either of, or with, cancer of the breast. It has already been amply demonstrated that, by an aggressive approach to screening, a high proportion of minimal breast cancers and Stage I carcinomas of the breast can be detected in self-referred patient populations (4-6). Nevertheless, despite these observations, one must consider the possibility that radiation-induced breast cancer may occur more frequently than cancer more amenable to cure. We feel at this time, that our data are sufficient to permit a reasonable preliminary assessment of risk-benefit ratios. There were 91,733 exposures recorded on all our Xerox processing units. This includes one machine which has been replaced, and three units currently in operation since the center was opened. Also metered are studies performed on consultation patients. The results of the latter group of patients are not included in the data reported in the screening study. Including consultations examined from August 1973 (but excluding those examined from 11/72 through 7/73) 19,442 mammographic examinations were performed. This would yield an average of 4.7 exposures/examination, or 2.35 exposures! breast/examination. During the first year of operation of the center, 26 % of the patients were called back for a repeat mammogram. Often, only one side, and not infrequently only a single view, were obtained. During the second year of our operation, only 11% of the patients being screened for the first time required an additional x-ray exposure. Therefore, we estimate that patients being screened for the flrsttlrne in our center will receive an average of 2.8 exposures per breast." @default.
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• W2418133090 date "2016-01-01" @default.
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• W2418133090 title "Breast Cancer Screening" @default.
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• W2418133090 doi "https://doi.org/10.1016/c2014-0-02059-x" @default.
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