BACKGROUNDAlthough there is evidence for a reduction in breast carcinoma mortality with mammographic screening, some doubts have been expressed, and there is still uncertainty regarding the age specific effects.METHODSThe authors report on a randomized, controlled trial of mammographic screening for breast carcinoma that was conducted among 51,611 women (21,650 women who were invited to a screening [the study group] and 29,961 women in a control group) ages 39–59 years in Gothenburg, Sweden. Among women in the study group, the screening interval was 18 months. The screening phase of the trial took place in 1982–1991, and follow‐up for breast carcinoma mortality continued until December 31, 1996. Mortality from breast carcinoma was analyzed using a Poisson regression model. Overall and age specific effects of invitation to mammography screening on breast carcinoma mortality were calculated. Three mortality effects were estimated: the effect on deaths from breast tumors diagnosed during the screening phase of the trial, as assessed by an independent Endpoint Committee (the EPC evaluation model); the effect on deaths from breast carcinoma diagnosed during the screening phase of the trial, as determined by data from the National Cancer Registry and the National Cause of Death Register (the SCB evaluation model); and the effect on deaths from all breast carcinomas diagnosed up to December 31, 1996, as determined by the National Cancer Registry and the National Cause of Death Register (the SCB follow‐up model).RESULTSA nonsignificant, 21% reduction in the rate of mortality from breast carcinoma with invitation to screening was observed using the EPC evaluation model (relative risk [RR], 0.79; 95% confidence interval [95% CI], 0.58–1.08; P = 0.14); and a borderline significant, 23% rate reduction was observed using the SCB follow‐up model (RR, 0.77; 95% CI, 0.60–1.00; P = 0.05). Age specific analyses yielded greater mortality rate reductions for the groups of women ages 39–44 years, 45–49 years, and 55–59 years, but there was no mortality rate reduction in the group of women ages 50–54 years. The effects of invitation to mammographic screening on the incidence of lymph node‐positive disease closely paralleled the effects of invitation on breast carcinoma mortality. The effect on breast carcinoma mortality was consistent with the effect on all‐cause mortality, suggesting no bias in classification of cause of death. Breast carcinoma incidence in the study group was almost identical to the incidence in the control group after trial by screening had ended in the control group (RR, 0.98; 95% CI, 0.88–1.09; P = 0.7).CONCLUSIONSThe current results support the commonly observed 20–30% reduction in breast carcinoma mortality with invitation to screening. The impression that screening is less effective in women younger than 50 years may be an oversimplification. Age specific effects should be a target for further research. Cancer 2003;10:2387–96. © 2003 American Cancer Society.DOI 10.1002/cncr.11361

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A dissection technique for the huamn prostate has been developed on about one hundred male autopsies, which makes it possible to delimit two dorsal, two lateral and two median lobes, each with separate ducts. It was found that both the dorsal lobesand the lateral lobes join dorsally to the ejaculatory ducts. The median lobes are situated below the medial parts of the seminal vesicles, and are closely apposed both ventrally and dorsally of the ejaculatory ducts. The ability to delimit the prostatic lobes in man may offer new opportunities to study the relation of prostatic diseases to different lobes as well as the hormonal dependency of the separate lobes.

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During a 27‐year period (1956–1982), 64 patients were treated surgically for pheochromocytoma. There was no kinship among any of these subjects. The true prevalence of C‐cell disease of the thyroid in this series was searched for by performing serum calcitonin determinations after provocation with pentagastrin. Postoperative follow‐up of the pheochromocytoma disease was performed by blood pressure measurement and determination of urinary excretion of catecholamines and metabolites. Ten individuals (15.6%) were found to have C‐cell disease indicating that they had multiple endocrine neoplasia type II (MEN II) syndromes. Seven of these patients had been diagnosed before the time of follow‐up evaluation, 4 because of symptoms and 3 because of the screening procedure. At the systematic follow‐up, 3 “new” cases of C‐cell disease were diagnosed. As a result of the screening procedure, we found 4 “new” MEN II kindreds. After unilateral adrenalectomy, 7 of the 10 MEN II patients have been followed for more than 7.7 years without signs of recurrent adrenal disease. Our results suggest that the prevalence of MEN II syndromes among pheochromocytoma patients is higher than previously reported. Removal of only grossly evident pheochromocytomas and careful follow‐up is a good alternative to routine bilateral adrenalectomy in MEN II patients with pheochromocytoma.