Background. Mammography is widely known to reduce morbidity and mortality from breast cancer, but a population‐based assessment of mammography use and follow‐up of mammography findings has not been reported previously. Methods. An observational, population‐based, follow‐up study was conducted of all women having mammograms in the Greater Lansing, Michigan, metropolitan area, between June 1987 and June 1988. A total of 17,811 Greater Lansing women participated. The adherence of women to mammography screening guidelines was estimated, and mammography's utility to detect breast cancer was assessed through follow‐up review of breast biopsy results. Results. Thirty‐seven percent of the expected number of women 35 years of age and older had mammograms. Adherence to screening guidelines declined with age, and less than 5% (302 of 6700) of women 55 years of age and older reporting having annual mammograms. Seventy‐six percent of women reported that their physicians prompted the examination. The predictive value of a positive mammogram was 21.9% for women without symptoms and 32.4% for women with symptoms. Mammography's sensitivity and specificity for breast cancer detection were 71% and 98%, respectively. Conclusions. The study highlights the need to target mammography to women 50 years of age and older, underscores the importance of physicians in promoting mammography, and demonstrates the analytic value and limitation of mammography in clinical decision‐making.

The reimbursement of breast biopsies must be improved in order to guarantee nationwide care of the population using the breast biopsy methods recommended in the S 3 guidelines and to avoid disincentives with respect to breast biopsy indications.

Weiden und Pappeln, wenig beachtet, oft übersehen, dennoch nützlich und heilsam Zusammenfassung Die Familie der Weidengewä chse (Salicaceae) umfasst die Gattungen Salix (Weiden) und Populus (Pappeln). Beide sind seit der Antike als wirtschaftlich wichtige Pflanzengruppen bekannt, die jedoch auch medizinisch verwendet werden. Das in Weiden und Pappeln vorkommende Salicin zerfä llt im Darmtrakt in Saligenin und D-Glukose. Resorbiert wird das Saligenin, das sich durch Oxidation zur therapeutisch wirksamen Salicylsäure wandelt. Mit der Entwicklung synthetischer Salicylsäurederivate galten Produkte aus der Weidenrinde (Cortex Salicis) oft als ü berholt. Hier trat ein Wandel ein. So greift man bei leichten fieberhaften Erkrankungen, rheumatischen Beschwerden und Kopfschmerzen häufig wieder auf die Weidenrinde zurü ck. Entsprechende Empfehlungen der Kommission E und der ESCOP liegen vor. Blä tter, Rinden und Knospen von Pappeln entfalten ebenfalls eine antiphlogistische, analgetische, antibakterielle und spasmolytische Wirkung, erhielten jedoch keine positive Monographie der Kommission E. Dennoch sollte man die gü nstige Wirkung bei Miktionsbeschwerden infolge einer Prostatahypertrophie sorgfä ltig weiter beobachten. Man vermutet, dass die Zimt-Lignane dafü r verantwortlich sind. Schlüsselwörter AbstractThe willow family (Salicaceae) comprises the genera Salix (willows) and Populus (poplar). Both genera have been known since Greco-Roman times as economically important plants, which can also be used for medicinal purposes. Salicin, which is present in willows and poplars, disintegrates into saligenin and glucose in the intestinal duct. Saligenin, which turns into the therapeutically effective salicylic acid by oxidation, is resorbed. With the development of synthetic salicylic acid derivatives, products from the willow bark (Cortex Salicis) were often considered to be out-dated. In this case, a change occurred. In the case of slightly feverish diseases, rheumatic discomforts and headache, people often fall back on willow bark again. Respective recommendations of the commission E and of ESCOP are available. Leaves, barks and buds of poplars also have an antiphlogistic, analgetic, antibacterial, and spasmolytic effect, but did not get a positive monograph of the commission E. Nevertheless, the favourable effect in the case of micturition difficulties as a result of a prostatic hypertrophy should be carefully observed further. It is suspected, that the cinnamon lignans are responsible for that.

No abstract