Diabetic fibrous breast disease.

Women with long-standing insulin-dependent diabetes mellitus (IDDM) and radiographically dense mammary glandular tissue can have benign breast masses clinically resembling cancer. The authors have identified 36 patients, aged 20-54 years, with this little-known condition, which the authors call diabetic fibrous breast disease (DFBD). For a diagnosis of DFBD, the patient must fulfill certain stringent requirements: a long-term history of IDDM; radiographically dense glandular tissue; and one or more hard, irregular, easily movable, discrete, painless, palpable breast masses with strong ultrasonographic acoustical shadowing and firm resistance to the back-and-forth motion of the needle used for fine-needle aspiration cytology (FNAC). Patients meeting all criteria can be monitored with serial FNAC procedures to prevent them from undergoing multiple surgical biopsies. During an average of 6 years of monitoring these 36 women, breast cancer did not develop in any mass fulfilling all requirements for DFBD.

Use of special mammographic views to maximize radiographic information.

Additional x-ray views can offer helpful information in both symptomatic patients (better evaluating the area of clinical abnormality) and screening patients (often preventing unnecessary biopsies). A wide variety of views have been devised to help solve specific problems raised by either suspected clinical or mammographic abnormalities. We have found those views described above to be most useful.

Focal spot size and scatter suppression in magnification mammography.

The improved image quality using magnification in film-screen mammography is related to a complicated interplay between focal spot size, x-ray tube output, detector resolution and sensitivity, air gap size, and target dimensions. Preliminary clinical evaluation of magnification mammography indicates that accuracy of diagnosis has been considerably enhanced. Additional technical and clinical evaluations are continuing, as suggested by mathematical modeling, in order to determine the best possible magnification protocols. While a small focal spot (less than 300 micrometers) is highly recommended for both contact and magnification with the film-screen systems, the smallest focal spot sizes (150 micrometers and smaller) may neither be necessary nor the best in all situations of reduced dose magnification mammography.

Increased incidence of breast carcinoma in patients with irradiation for post-partum mastitis: a screening situation.

In Rochester, New York, 606 women were treated with ionizing radiation for post-partum mastitis, mostly between 1940 and 1955. Two-thirds of all breasts were treated, the average dose per breast being 377 rads (at 2.5 cm breast depth). Mammographic examinations were performed on 265 of these women still residing in this vicinity. Two nonpalpable carcinomas (with no axillary node metastases) were found in the twelve breast lesions that have been biopsied. Some of the biopsies revealed premalignant changes. It is recommended that women in this high-risk category have close medical supervision, as well as periodic mammographic evaluation, and that the importance of periodic breast self-examinations should be emphasized.

A study of T and B lymphocytes and chromosomes in breast irradiated mastitis patients.

Proportions and absolute numbers of T, B and "Null" lymphocytes, percent of abnormal cells and chromosomal breaks were determined in breast irradiated mastitis patients and control subjects. No significant difference was observed at these values between controls and irradiated patients.

Improved liquid cholesterol ester crystal thermography of the breast.

The infrated detection apparatus used in breast thermography is relatively costly and therefore is not widely available to less populated areas in the country. The use of liquid cholesterol crystals, applied to the breast (applied over a water-base black dye) has already been described in the literature as an effective substitute for infrared instrument thermography. This method, however, has been hampered by the time and troublesome effort necessary for removal of the substances upon completion of the study. The object of this study was to devise a feasible method of cutaneous breast thermography using liquid cholesterol esters, as in prior studies, but by applying them to an easily removable black base. As a result the length of the examination has been shortened, and patients have found the examination to be aesthetically more acceptable. With this improved method, liquid crystal thermography of the breast (and other areas) should become more widely applicable.