The value of palpation findings and mammography in 596 patients with primary breast cancer was investigated. The most frequent symptom (86.1%) was the lump. The primary tentative diagnosis came from the patient in 63.4% of the cases, from the physician in 28.9% of the cases, and only after mammography in 7.7% of the cases. False-negative palpation findings and false-negative mammography findings were observed in 9.9% and 5.0% of cases respectively. There was a clear dependence on the tumor stage. Carcinomas that were first diagnosed by means of mammography manifested a five-year survival rate of 82.6% and a recurrence rate of 15.2%. Carcinomas that were first discovered by the patient or the physician reached a five-year survival rate of 67.7% and 70.6% respectively. Here, too, the recurrence rate was higher, at 26.2% and 22.1% respectively. The data show that the carcinomas that were first suspected mammographically were smaller and manifested lymph node metastases more rarely. In order to reduce the number of false-negative findings the physician performing a mammography or assessing X-ray films should himself submit the breast in question to a thorough palpatory examination.
The article reports on first experiences with the stereotactic diagnosis device "Mammotest" in the diagnosis of diseases of the breast. Preoperative stereotactic carbon marking of non-palpable changes requiring clarification via mammography was successful in 94% of the cases. With the stereotactic cytological clarification by means of Nordenström's cannula the high rate of cellular material which could not be clarified, was unsatisfactory. Stereotactic histological punch biopsy in case of unclear mammographic findings enables exact localisation of the punch and histological examination of the punch biopsy. Mammographic follow-up did not yield any false negative finding to date.
Primary bilateral malignant lymphoma of the breast was diagnosed in these women. All were of the lymphoblastic type of high malignancy. Two patients were pregnant and all died of generalised malignant lymphoma. Survival time between initial or early manifestation in the breast and death was two to four months.
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