Background. Women with proliferative breast disease (PD) have been observed to have an increased risk of breast cancer. The authors evaluated the effect of PD on breast cancer risk in a case–control study among participants of the Breast Cancer Detection Demonstration Project (BCDDP). Methods. More than 280,000 women were screened in the BCDDP at 29 centers. Study subjects were selected from BCDDP participants who underwent biopsy that revealed benign breast tissue. There were five BCDDP centers for which histologic slides were available on more than 85% of the benign biopsy specimens. Case patients for this study were the 95 women from these five centers who had breast cancer develop during follow‐up. Two matched control patients who did not have breast cancer develop were selected for each case. The biopsy slides were reviewed by two pathologists who were blinded with regard to cancer outcome. Results. Women with atypical hyperplasia (AH) had 4.3 times the breast cancer risk of women without PD (95% confidence interval [CI], 1.7–11). In women with PD lacking AH, the relative risk was 1.3 (95% CI, 0.77–2.2). A family history of breast cancer (FH) increased breast cancer risk 2.4 times (95% CI, 1.4–4.3). The joint occurrence of FH and AH had a strong synergistic effect on breast cancer risk. Conclusions. AH is a reliable marker of increased breast cancer risk among women undergoing breast biopsy.

Women have a higher stress fracture rate than men in military studies, although the exact cause of this is not clear. Hyperpronation has been implicated as a potential risk factor for injury. In this prospective observational study, we measured subtalar joint range of motion in 101 women (ages 20-27 years) enrolled in Marine Corps Officer Candidate School in June 1994. The purpose of this study was to identify risk factors for injury in female Marine Corps officer candidates. The primary area of interest was the association between the amount of subtalar joint range of motion and stress reactions. Questionnaires were administered that explored previous physical activities, sports participation, and menstrual history. Anthropometric measurements were performed, including subtalar joint range of motion. During the 10 weeks of physical training, 11.5% of the women (N = 12) had stress reactions compared with 7% of the men (N = 10). There was no statistically significant difference in the means of subtalar joint range of motion in the stress reaction group compared with the non-stress reaction group. Differences in stress reaction rate across quartiles of subtalar joint range of motion were not significant. Those women who ran fewer miles (< or = 2.8 miles per session) before training had a higher rate of stress reactions (p < 0.04). Younger individuals (< 23 years) had a higher rate of stress reactions (p < 0.01). Women with fewer menstrual periods (< 10 per year) had a higher rate of stress reactions (p < 0.02). A narrow pelvis (< or = 26 cm) was associated with a higher rate of stress reactions (p < 0.09). We conclude that an increased subtalar joint range of motion is not a risk factor for stress reactions in women. However, further studies with a larger study population should be performed to confirm these findings.

No abstract

The desirability of obtaining written informed consent for low-risk radiologic procedures has been the subject of controversy. A group of 80 patients was studied to evaluate the effect of informed consent for excretory urograms on: (1) incidence of contrast reactions; (2) discomfort during the procedure; (3) level of patients' anxiety before and after the procedure; (4) patients' perception of the procedure; and (5) desirability of informed consent from the patients' viewpoint. Results revealed no statistically significant difference between the 2 groups in the incidence of reactions, discomfort, perception of the examination, or anxiety level prior to the procedure. The informed consent group had a statistically greater factual knowledge of the procedure evaluated objectively (P less than 0.01). Of the patients who received the written consent form, 83% regarded it as helpful and none viewed it as harmful or refused the examination. In the control group, 32% desired more information.

The purpose of this study was to evaluate the diagnostic virtues and limitations of the combined use of high frequency, real-time ultrasound scanning (US) using hand-held transducers and xeromammography (XM) in the evaluation of palpable breast masses. Seventy-one patients, who ranged in age from 14 to 88 years and who had histologically proved masses, were examined by both imaging modalities. US demonstrated the highest degree of accuracy in establishing the presence of cysts (96%) and fibroadenomas (89%). XM afforded better overall depiction of the breast and correctly identified seven carcinomas, five of which were prospectively diagnosed by sonography. When all types of breast masses were considered, the combined use of XM and US was more accurate (89%) than when either XM (70%) or US (85%) was used alone. For this reason, a combined approach using both modalities in the examination of most patients with palpable breast masses is advocated. The advantages and limitations of both XM and US in the evaluation of palpable masses are discussed and illustrated.