Detection of breast cancer local recurrences.

Background: Early detection of locoregional recurrences of breast cancer is possible with a variety of diagnostic methods. A combination of palpation, sonography and aspiration cytology is probably as accurate and certainly simpler, faster and cheaper compared to other more complicated and costly tests (computerized tomography, magnetic resonance imaging, lymphoscintigraphy). Retrospective studies have estimated that periodic observation may anticipate the detection of local symptomatic recurrences of about 3 months time with respect to their symptomatic onset.

Trends in cervical cancer incidence in the district of Florence.

The trend in cervical cancer incidence in the District of Florence from 1975 to 1989 was investigated. Tuscany Cancer Registry data were available since 1985. Incidence data from 1975 to 1985 were obtained through a retrospective survey of all the Departments of Pathology and Gynaecology in the district.

Performance of fine-needle aspiration cytology of the breast-multicenter study of 23,063 aspirates in ten Italian laboratories.

Aims And Background: The aim of this study was to assess the performance of routine breast cytology in a group of Italian laboratories, as a basis for interlaboratory quality control.

Methods: A multicenter retrospective consecutive series of 23,063 aspirates from breast lesions (5,130 invasive carcinoma, 247 intraductal carcinoma, 2,386 benign lesions [histological], 13,144 benign lesions [follow-up], 2,156 other [no follow-up]) was reviewed. Standard accuracy measurements (inadequacy rate, sensitivity, specificity, predictive value) were determined, as well as the contribution of diagnostic tests such as physical examination and instrumental diagnostic procedures (mammography, sonography).

Independent double reading of screening mammograms.

Objective: To evaluate the cost effectiveness of independent double reading of screening mammograms.

Setting: Prospective study of 18,817 women undergoing first or repeat screening in a population based programme in the Florence district.

Methods: Mammograms were independently double read by experienced radiologists.

[Comparison between 2 techniques of screening for prostatic carcinoma. Rectal exploration and transrectal ultrasonography vs. prostate specific antigen].

We report the results of two pilot studies for the early detection of prostatic carcinoma in resident men aged 60-75 years, using combined digital rectal examination (DRE) and transrectal ultrasonography (TRUS) versus prostate-specific antigen (PSA; cutoff: 4 ng/ml) as screening tests. Both screening protocols exhibited high cancer detection rates (DRE + TRUS = 1.82%, PSA = 1.

Comparative analysis of results of guaiac and immunochemical tests for faecal occult blood in colorectal cancer screening in two oncological institutions.

The performances of three faecal occult blood tests, rehydrated Hemoccult (HOR), Hemoccult sensa (HOS) and Hemeselect (HSEL) on 3 days were compared in 1,725 subjects consecutively recruited in two oncological institutions in Milan and Florence. Significant differences between the results were evident as far as HOR positivity rates (7.5% vs 4.

[The diagnostic role of breast echography].

The authors reviewed a consecutive series of 4,160 breast lesions (511 carcinomas and 3,649 benign lesions) studied with 10-MHz US in 1990-1991. US sensitivity was 72.6%, specificity was 97.

Assessment of lesions detected at mammographic screening: performance at first or repeat screening in the Florence programme.

Objective: To evaluate the assessment criteria and the results achieved in the detection of breast lesions at mammographic screening.

Setting: Review of cases assessed in the last screening round of Florence city (FC--first screening round: 29,522 subjects) and Florence district (FD --repeat screening round: 13,268 subjects) programmes.

Methods: Referral and biopsy rates, predictive values, and prevalence of cancers detected by screening were determined, as well as the frequency of the diagnostic procedures used at assessment, and their contribution to the final diagnosis according to the mammographic appearance of the suspected lesion.

[The mammographic aspect and the prognosis of breast carcinoma].

The authors report on 354 consecutive cases of invasive breast carcinoma followed up 3 to 13 years. The prognostic value of the mammographic appearance of cancer, determined according to Broberg, was studied, as well as that of other indicators, such as pT, pN and estrogen receptor content. An association was found between the mammographic appearance and the other prognostic indicators, but such an association was at the limits of statistical significance (pT p = 0.

Intensive diagnostic follow-up after treatment of primary breast cancer. A randomized trial. National Research Council Project on Breast Cancer follow-up.

Objective: To evaluate the effectiveness of early detection of intrathoracic and bone metastases in reducing mortality in breast cancer patients.

Design: Randomized clinical trial allocating breast cancer patients to two alternative follow-up protocols (intensive vs clinical) for at least 5 years.

Setting: Twelve breast clinics (referral centers) in different areas in Italy.

[Mammographic screening. An analysis of the characteristics of interval carcinomas observed in the program in the province of Firenze (1989-1991)].

The authors evaluated 30 interval cancers consecutively observed from 1989 to 1991 and compared them to 98 screening-detected cancers observed in the same period. Interval cancers have a more advanced stage (stage I = 13 lesions, stage II + = 17 lesions) with respect to screening-detected cancers (stage 0 = 10 lesions, stage I = 61 lesions, stage II + = 27 lesions). This finding seems unrelated to an intrinsically higher aggressivity of interval cancers (length biased sampling) which do not differ significantly from screening-detected cancers as far as histopathologic characteristics of prognostic value are concerned.

Non-palpable lesions of the breast detected by mammography--review of 1182 consecutive histologically confirmed cases.

We report on 1182 consecutive histologically confirmed non-palpable breast lesions detected by mammography (infiltrating carcinoma 427, in situ carcinoma 121, benign 634). The proportion of cancer cases varied according to age (< 50 years = 33%; 50-59 years = 46%; > 59 years = 63%), mammographic pattern (regular opacities = 8%, parenchymal distortions = 20%, isolated calcifications = 42%, irregular opacities = 62%, stellate opacities = 73%), and calendar period (1970-1985 = 29%, 1986-1989 = 56%; 1990-1992 = 69%). A sharp decrease of the benign/malignant biopsy ratio was evident after routine fine-needle aspiration cytology (sonography-guided or stereotaxic) was introduced in 1986.

The contribution of ultrasonography to the differential diagnosis of breast cancer.

Overall consecutive breast abnormalities (259 carcinomas, 1820 benign) examined with breast ultrasonography (US) are reported. US sensitivity, specificity and positive predictive value were 67.6, 97.

Screening history of incident cases of invasive carcinoma of the cervix. Florence district 1988-1989.

Background: Incidence cases of carcinoma of the cervix may be assumed as failures of a population-based cytologic screening program. Monitoring such cases would provide an estimate of screening effectiveness, and evaluating the causes of the failures would improve screening performance.

Study Design: All incident cases of cervicocarcinoma registered in 1988 and 1989 in the Tuscany Tumor Registry were eligible for the study and were reviewed.

[Reference standards in the performance of a mammographic screening program. Results of the screening program in the province of Florence, 1992].

The authors report the results of the Florence District program for the year 1992. 11,033 subjects were examined. Attendance rate (64.

A prospective study of the value of mammographic patterns as indicators of breast cancer risk in a screening experience.

The association between mammographic parenchymal patterns and the risk of subsequent breast cancer was studied in a cohort of 17,911 women aged 40-70 years, enrolled in a mammographic screening program. The cohort was prospectively followed-up for 5 years after blind attribution of mammographic pattern. Incident cancers, either screen- or interval-detected, were monitored through the screening program and by the local cancer registry.

Cancer reoccurrence in the conserved breast - diagnostic features in a consecutive series of 102 cases.

Diagnostic features of 102 consecutive cases of cancer reoccurrence in the conserved breast are reported. The sensitivity of palpation, mammography, cytology or ultrasonography was 75.5%, 58.

Fine-needle aspiration cytology of nonpalpable breast lesions: US versus stereotaxic guidance.

The authors evaluated ultrasound (US)-guided fine-needle aspiration cytology (FNAC) in 270 patients with suspicious findings at mammography. FNAC with a 10-MHz transducer and real-time scanner was performed when a lesion seen mammographically was unequivocally depicted at US. The needle was inserted with variable obliquity to the scanning plane.

Prognostic value of proliferating cell nuclear antigen in lymph node-negative breast cancer patients.

Background: The prognostic value of proliferating cell nuclear antigen (PCNA) has been demonstrated in recent studies of human tumors including breast cancer.

Methods: PCNA immunoreactivity was assessed retrospectively in a consecutive series of 173 lymph node-negative primary breast cancer cases. The PCNA grade was determined according to estimated quartiles of nuclear immunostaining, and its association to disease-free and overall survival was studied.