Mammography Surveillance Following Breast Cancer

Background. To describe when women diagnosed with breast cancer return for their first mammography, and to identify factors predictive of women returning for mammographic surveillance. Methods. Women who underwent mammography at facilities participating in the National Cancer Institute's Breast Cancer Surveillance Consortium (BCSC) during 1996 and who were subsequently diagnosed with ductal carcinoma in situ or invasive breast cancer were included in this study. Data from seven mammography registries were linked to population-based cancer and pathology registries. Kaplan–Meier curves were used to depict the number of months from the breast cancer diagnosis to the first mammogram within the defined follow-up period. Demographic, disease and treatment variables were included in univariate and multivariate analyses to identify factors predictive of women returning for mammography. Results. Of the 2503 women diagnosed with breast cancer, 78.1% returned for mammography examination between 7 and 30 months following the diagnosis. Mammography facilities indicated that 66.8% of mammography examinations were classified as screening. Multivariate analyses found that women were most likely to undergo surveillance mammography if they were diagnosed at ages 60–69 with Stage 0, I or II breast cancer and had received radiation therapy in addition to surgery. Conclusions. While the majority of women return for mammographic surveillance following breast cancer, some important subgroups of women at higher risk for recurrence are less likely to return. Research is needed to determine why some women are not undergoing mammography surveillance after a breast cancer diagnosis and whether surveillance increases the chance of detecting tumors with a good prognosis.     

Success rate of Orlistat in primary-care practice is limited by failure to follow prescribing recommendations: the referral letter content vs clinical reality

Numerous referrals to our Obesity Unit state that 'treatment with Orlistat did not work'. This surprised us, since Orlistat has been well documented to result in long-term sustained moderate weight loss. A simple questionnaire to 70 such patients, however, revealed that in many cases the referral physician had not observed basic rules and regulations, nor given appropriate information on Orlistat use.     

Permeability of thermally damaged skin II: immediate influences of branding at 60°C on hairless mouse skin permeability

Dry heat burns of incrementally increased duration (15–960 seconds) have been administered to freshly sacrificed mice with a thermostated branding iron maintained at 60°C. The association between extent of burn damage (shallow to deep tissue damage) and permeability was studied using water, methanol, ethanol, butanol, hexanol, and octanol as permeants. Thermal effects were measured as the ratio of a burned surface permeability to a normal skin section permeability in the same animal. Branding for brief times produced similar effects as scalding at 60°C for equivalent durations, 1–5 to 2-fold increases for water, methanol, and ethanol and 3-to 4-fold increases for the higher alkanols. There appears to be a gradual, steady increase in permeability with duration of burning. Permeability alteration was both qualitatively and quantitatively analogous to that seen previously with burns inflicted with 60°C water, indicating that at this temperature the method of burning is not a principal factor in altering permeability of the tissue.     

Reasons for smoking among extremely heavy smokers

Four factors describing reasons for smoking were identified in 200 heavy smokers. When these four factor scores were correlated with other variables, the Addictive/Habitual Needs factor correlated most often with increased use of tobacco, alcohol, and coffee. The Pleasure factor was associated with obesity and the Stress Reaction factor with more perceived stress. The Stress Reaction factor was consistently correlated with more unfavorable ratings on psychological adjustment. Persons who smoked to alleviate stress or for addictive/habitual needs had tried to stop more often, whereas those who smoked for pleasure had little motivation to stop smoking. Findings suggest that there are individual differences in reasons for smoking among extremely heavy smokers and that these need to be taken into account in trying to help such individuals.