Usefulness of mammography and sonography in women less than 35 years of age

Article Abstract:

Mammography is an X-ray technique used to screen women for breast cancer. Most breast cancers occur in women over the age of 35. Consequently, younger women are not usually advised to undergo mammography unless they have symptoms or a family history suggestive of an increased risk for breast cancer. This study examined whether mammography is useful for screening women younger than 35 years. The cases of 1,016 women under the age of 35 who underwent mammography were randomly selected from the files of a clinic. For 454 of the women, mammography was performed because a mass was felt in the breast. Mammograms of 77 of these women showed abnormalities; three were found to have cancer after a biopsy was performed. A total of 237 women underwent mammography for screening purposes. No tumors were detected in any of these women. Breast ''lumpiness'' was the reason why 151 women had a mammogram. Although three mammograms showed abnormalities, no tumors were detected. The rest of the women had mammograms for various reasons, such as breast tenderness or discharge from the nipples. None of the mammograms of these women indicated the presence of a tumor. Overall, 19 of 1,016 mammograms showed suspicious results, of which 1 turned out to be cancerous. A total of six women were eventually diagnosed with cancer and for three of these women there was a delay in cancer diagnosis because mammographic findings were negative. Sonography was performed on 389 of the women, of whom 272 had breast masses. Sonographic results showed that of the 272 women with masses, 36 had cysts, 83 had solid masses, and 150 had no abnormalities. These results were useful in deciding who should undergo a biopsy. The study size was too small to fully evaluate the usefulness of mammography for women under the age of 35, but it did show that women with palpable breast masses may benefit from biopsy even if mammographic findings are negative. (Consumer Summary produced by Reliance Medical Information, Inc.)

Statistics, Diseases, Young women, Breast cancer, Mammography

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Endoluminal catheter-assisted transcervical US of the human embryo

Article Abstract:

Ultrasound (US) imaging, a technique that uses high frequency sound waves to produce images of tissues and organs, is increasingly being used in obstetrics. US can be used to estimate fetal age, to demonstrate fetal cardiac activity in early pregnancy, and to detect fetal abnormalities. Transvaginal US can detect some fetal abnormalities as early as the later part of the first trimester, but it can not clearly depict the anatomy of the early human embryo. A new US technique, endoluminal catheter-assisted transcervical (ELCAT) sonography, offers promise because of its ability to depict the anatomy of the early embryo. This could allow for very early detection of abnormalities. The technique involves placing a catheter into the uterus through which US can be performed. The procedure was performed on seven women about to undergo termination of first trimester pregnancies. The catheter was easily placed into the uterus in all seven women. The gestational sac was not damaged by the procedure in any of the cases. Fetal cardiac activity was detectable in six cases and fetal death was discovered in the other case. No definite anatomical structures were detectable in two cases, one involving the fetal death. In the other five cases, the heart was clearly identified. The neural tube was clearly distinguishable in one case. In another case, the head, neck, and part of the chest were clearly depicted. Image quality was best when the transducer was close to the embryo. These results indicate that ELCAT can accurately depict the anatomy of the embryo. Further studies are required to establish the safety of this procedure. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Innovations, Ultrasound imaging, Human embryo, Prenatal ultrasonography, Ultrasonics in obstetrics

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Frequency measurements in real-time US equipment: Variations from expected values

Article Abstract:

Measurements of the reflected frequency spectra of a variety of real-time clinical US probes were compared with the frequency values listed by manufacturers. The equipment tested was made by Labsonics, ATL, Diasonics, and Philips. The use of high-frequency transducers for ultrasonographic (US) breast imaging to increase clinical precision is now well established. While a number of high-frequency US units for breast imaging were being tested, several unexpected findings were discovered. First, marked differences in penetration were noticed when the same breast was being imaged with different units that were supposed to operate at the same frequency. Second, comparison of images of the same breast mass obtained within different high-frequency transducers did not show marked improvement of resolution with the more powerful 10-MHz instrument. Third, penetration depended more on targeting the area of interest than on the center frequency listed by the manufacturer. Two recommendations were made as a result of these studies: users of US equipment should not select probes only on the basis of the manufacturers' stated frequencies, and manufacturers should test probes for frequency response in reflectance mode as part of the US system. A spectrum analyzer should be available when US equipment is tested for acceptance. Since most clinics do not have access to such specialized equipment, and most US physicists are not trained to use it, users should place more emphasis on their own judgment of the resolution and penetration capabilities of each probe, which should be tested before purchase with both routine quality-control and clinical procedures.

Research, Evaluation, Medical equipment, Breast, Ultrasonic equipment, Mammary ultrasonography

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