[Breast cancer mass screening in the Province of Liege. Results after 8 years]. / Depistage systematique du cancer du sein en province de Liege. Bilan apres 8 ans de fonctionnement.

Breast cancer mass screening by mobile units started in 1992 in the Province of Liège (Belgium). This project is developed for rural areas and interests all women between 40-69 years old not regularly X-rayed in traditional breast cancer diagnosis centers. Despite lots of efforts population participation is low (25%). Nevertheless, the experiment results are encouraging: in a series of 31,443 women, 213 cancers were diagnosed, corresponding to a rate of 6.9/1000, 75% of which are of good prognosis. After an 8 years experiment, it is hoped that the population concerned becomes more sensitive to this mass screening project and one should expect a better collaboration with the other actors in the field of breast diseases diagnosis.

[Screening for breast cancer: the time of decision]. / Dépistage du cancer du sein: l'heure des choix.

The purpose of this review article is to propose the basic rules of a scientifically correct breast cancer mass screening. It might give to the different authorities arguments to make a choice between an organized screening and some trials currently used in our country.

[Preliminary results of a screening programme by mobile units in the province of Liege]. / Résultats préliminaires d'une expérience de dépistage du cancer du sein par unités mobiles en Province de Liège.

The goal of the mass screening of breast cancer undertaken under the authority of the Province of Liège is to focus the action on rural communities. For this reason, mobile vans equipped with X-Ray dedicated units are used. The main difficulty of this programme is to reach a massive participation of the population. It varies up to now from 45% to 20% in the different visited villages. During the 42 first months of functioning, 16,207 mammographies were carried out in women aged from 40 to 69; 69 cancers were discovered in apparently healthy women plus 10 cases of epithelial hyperplasia with atypias. These first results are quite encouraging. The main task of this continuing programme will be to reach a better participation of the population.

[ Radiological anatomy of the breast]. / Anatomie radiologique du sein.

The macroscopic anatomy of the breast is often not well understood; it is the reason why the radiologic images formation of this organ needs to be explained. This work is based upon anatomical-radiological confrontations, which allow to separate the two main compartments of the gland, the fibroglandular tissue and the adipose tissue, and to study the limits of these two components. Their different proportions are at the origin of different patterns leading to a simple classification of non-pathologic breast X-rays. This classification makes easier the diagnosis of abnormalities, especially of tumoral origin.

Esophageal cancer.

The authors invited eminent Belgian specialists to report on their experience in esophageal cancer. A summary is given of the most striking features of their reports.

[Evaluation of diagnostic efficacy in radiology. Literature review]. / Evaluation de l'efficacité diagnostique en radiologie. Revue de la littérature.

The recent development of new imaging procedures has lead the radiologists to assessing the diagnostic efficacy of the available examination techniques in order to reduce medical care costs. In cooperation with epidemiologists and statisticians, several methods of statistic analysis of the diagnostic efficacy of the procedures such as sensitivity and specificity evaluation, ROC analysis, disease prevalence, predictive value of tests, etc... have been developed. Benefit-cost and cost-efficiency analyses have also been performed, with a view to improving the quality of long-term medical care for the patient at a lower cost both for himself and the society.

Mammography: the gold standard of breast mass screening.

The rationale and results of breast mass screening are presented. The data available suggest that annual or biannual mammography reduce breast cancer mortality and should be recommended especially to women aged 50-65.

Rectal cancer: a summary.

The authors summarize the most important conclusions of a multicentric multidisciplinary review on rectal cancer in Belgium.

Diagnostic accuracy of new imaging techniques in breast diseases.

During the last decade, the hypothetical carcinogenic effects of mammography have lead to new technical developments in X-ray diagnosis and to the use of other imaging techniques such as ultrasonography (US), transillumination, magnetic resonance imaging (MRI). Many preliminary studies were published but few clinical trials are really convincing. According to the definition of a diagnostic tool, none of these new modalities is supposed to supplant mammography in the diagnosis of breast cancer. Improvements are expected by digital mammography in the near future.

Mach bands in mammography.

The radiologic appearance of tissue surrounding a tumor often influences the characterization of a cancerous lesion. An example is the radiolucent halo that is sometimes seen around breast cancers. Mammograms of 108 malignant tumors (74 scirrhous tumors, 17 partially scirrhous nodular tumors, and 17 nodular tumors) and eight benign tumors that showed peritumoral fat were retrospectively evaluated. All the scirrhous and partially scirrhous nodular cancers were more or less surrounded by a 5-10-mm-wide hyperlucent halo; this corona sign was also found in 14 nodular cancers. The halo sign, a hyperleucent 1-mm band, was observed around all benign lesions and immediately adjacent to sharply delineated cancers. These radiologic findings are an optical illusion (Mach band, background contrast effect). Densitometric measures and isoluminous analysis did not demonstrate the presence of a true hyperlucent zone.

[Ovarian radiation dosage during hysterosalpingography]. / Dose délivrée aux ovaires lors de l'hystérosalpingographie.

Doses delivered to ovaries during a standardized hysterosalpingography is determined in 30 patients with LiF dosimeters placed on the anterior and the posterior wall of the lower abdomen. It varies between 0.1 and 0.6 rad and is essentially dependent on the thickness of traversed tissues. This work is based on rare-earth screens experience.