Die klinische Erkennung von 2511 Mammakarzinomen der Jahre 1977 bis 1986

Abstract

From 1977 to 1986, inclusively, 2511 patients with breast cancer were analysed. The following factors were evaluated: patients attitude toward screening programs, the method of cancer detection, the relation between tumor-size and axillary nodes metastases and efficiency of the currently in Germany used screening program. 65.9% of the patients underwent regular annual preventive physical examination, 15.2% irregular and 18.9% no examination. Only 12.7% of cancers were detected through the screening program, in 85% the patients discovered their tumors. Cancers up to 0.5 cm had in 25% lymph-nodes metastases and tumors up to 1.0 cm had in 27% of cases axillary nodes metastases. Breast cancers between 1.1 cm and 2.0 cm had a bad prognosis: the axillary metastases occurred in 34%-45%. Surprisingly, there were no differences in tumor size, percentage of residual tumor and frequency of axillary lymph-nodes metastases between patients who took regularly part in preventive physical examination and those never taking part. Women who irregularly participated in the program had the most unfavourable prognosis.

Moderne Diagnostik der Mamma

“…Daher wurden große Hoffnungen in die seit 1970 gesetzlich eingeführten Krebs-Früherkennungen gesetzt, deren Ergebnisse die Erwartungen jedoch nur teilweise erfüllt haben. In einer Studie von Leonhardt (1988) wurden bei 2511 Patientinnen mit Mammakarzinom Vorsorgeverhalten, Art der Karzinomentdeckung, Tumorgröße, Lymphknotenstatus und Effizienz der Krebs-Früherkennungsuntersuchungen analysiert. 65,9% der Frauen hatten regelmäßig, 15,2% unregelmäßig und 18,9% niemals an Krebs-Früherkennungs-Untersuchungen teilgenommen.…”

Prognostic Factors in Patients with Node-Negative Breast Cancer

“…Nevertheless, patients with negative nodal status may also de velop metastatic disease, and the recurrence rate among node negative patients in the control groups of studies was higher than initially supposed [7]. In the near future, the group of patients with node-negative breast cancer will gain in importance, because •small' mam mary carcinomas (clinically 'minimal occult' and occult carci nomas) measuring 1.0 cm or less in diameter and hence asso ciated with a smaller portion of axillary nodal involvement can increasingly be detected by mammographic screening and thin-needle aspiration and cytologic examinations [2][3][4][5][6]. In several randomized studies performed in patients with node-negative breast cancer, after up to 4 years of observation, the group of patients given adjuvant hormonal treatment and chemotherapy to date appears to benefit only by a prolonga tion of the relapse-free interval, but not by a significant impro vement in overall survival as compared with the untreated control group [7].…”