Bilateral Mammograms Research Articles

As Mammography Use Increases, Are Some Providers Omitting Clinical Breast Examination?

To explore use of clinical breast examination (CBE) among women receiving mammography. A retrospective cohort analysis of 100 women aged 50 years or older with at least one bilateral mammogram. Chart review documented demographic information, severity of illness, and performance of CBE (from 1 year prior to 18 months after the mammogram). The mean age of the 100 women was 63 years. They were predominantly unmarried (60%), nonwhite (58%), and not currently employed (57%). Three quarters (76%) had mammography and CBE (comprehensive screening), while the remaining 24% had mammography only. Sociodemographic factors did not differ for women with and without comprehensive screening (P>.1). However, patients of female providers were more likely to receive comprehensive screening than patients of male providers. Specifically, 95% of women seen by female attending physicians or fellows had comprehensive screening vs 67% for male attending physicians or fellows and 61% for residents (P=.008). Mammography may be replacing CBE especially among patients of male providers. Interventions targeted to these providers could help improve the use of CBE and mammography.

Is breast size a predictor of breast cancer risk or the laterality of the tumor?

The relationship of breast size both to breast cancer risk and to the laterality of the tumor was studied among 261 women diagnosed with breast cancer and 291 control subjects who were enrolled in the United States' Breast Cancer Detection and Demonstration Project from 1973 to 1980. Standardized measures of breast area were obtained by applying planimetry to bilateral screening mammograms taken four years before breast cancer was diagnosed in case subjects. The left breast was larger in 53 percent of women with breast cancer and in 60 percent of women in the control group; the difference in breast area by laterality was significant only among controls (P = 0.01). To assess breast cancer risk, breast area was categorized by quartiles, with the lowest quartile being the referent group. Risk was increased minimally among women with the largest breast area (odds ratios = 0.9, 0.9, 1.2); however, the point estimates were not statistically significant and there was no evidence of a linear trend. Left-sided diseased was diagnosed in 51 percent of women in the case group. Although the mean area of the breast with the malignancy did not differ significantly from the opposite breast, cancer developed in the larger breast of 57 percent of women with left- and 46 percent of women with right-sided disease. Breast size was associated with cancer of the left breast but not the right. However, these size differences were small since the area of the larger breast was less than 10 percent greater than the smaller breast among half of the case subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Bilateral breast cancer after cured Hodgkin's disease

Three patients developed bilateral breast cancer at 10 to 24 years after mantle irradiation for locally or systemically advanced Hodgkin's disease (HD). Four of the six cancers in the three patients were detected only by mammography. Pathologically, five of the cancers were intraductal carcinomas (four with an invasive component) with one being a lobular carcinoma. Five of the six lesions were Stage I pathologically without evidence of axillary nodal involvement. It is recommended that female patients with Hodgkin's disease who have received mantle irradiation as part of the therapy for their Hodgkin's disease and who are observed for 10 or more years after completion of mantle irradiation be considered at risk for the development of breast cancer. Such patients should be monitored appropriately by routine bilateral mammograms to increase the early detection of early stage lesions.

Tinnitus, Enophthalmos, And Transient Thrombocytopenia As Symptoms Of Metastatic Breast Cancer Without Local Disease

A 57 year old woman with a past medical history of oculopharyngeal muscular dystrophy presents with tinnitus, thrombocytopenia, and enophthalmos. She then develops subcutaneous skin nodules on her abdomen. Initial biopsies of the cutaneous nodules revealed adenocarcinoma of unknown origin. CT imaging of her chest, abdomen, and pelvis reveal atypical peritoneal carcinomatosis and possible diffuse bone marrow infiltration. CA -125, CEA and CA-19 are negative. Upper and lower endoscopies are normal along with bilateral mammograms of the breast. Repeat biopsy of the skin nodules and bone marrow biopsy reveals lobular carcinoma of the breast. She is treated with hormone modifying therapy for approximately one year but subsequently passes away.