Xerography of the Breast

Abstract

Xerograms of the breast have the following advantages over film mammograms: (a) they are easier to interpret; (b) they require less radiation to produce than Eastman Kodak “M” film mammograms; (c) they afford greater detail; (d) they are probably more accurate; (e) xerography is a dry process; (f) the finished product is obtained more quickly and with greater ease. The most important feature is that they are easier to interpret. Properly set-up xerograms could probably be read in a screening program at the rate of 4–5 cases per minute, whereas in a similar program film mammograms were read at a rate of 15–20 cases per hour (16). An additional advantage of xerography is that all parts of the breast are clearly shown with one image. Some workers in mammography believe that two x-ray films of different densities are required to delineate all structures (17, 18). It is my opinion that xerograms are more accurate, although I have not conducted a carefully controlled study to prove this (10, 13). The essential part of xerography is the “plate,” which consists of a sheet of aluminum, 10 × 17 inches, coated with a thin layer of selenium and encased in a wooden “cassette,” complete with a dark slide to protect it from light. The plate is used as one would an x-ray film insofar as performance of the examination is concerned. Review of the Literature Investigators at St. Vincents Hospital, New York City, have published three papers on xerography of the breast (4, 10, 13). The first was a description of the early experience with a small number of patients. The second paper was more complete and explained in detail the xerographic principle and the equipment available. The technic was discussed, together with some shortcomings that had become apparent. The last paper from this group summarized the experience gained from 463 breast examinations. When results were compared, xerography and roentgenography were exactly the same in accuracy of diagnosis of malignant disease. Other papers on xeroradiography, describing its use in aspects of radiology other than mammography, include two by Roach and Hilleboe. Their first article, which was of an introductory nature, explored the use of the procedure in the event of an emergency created by the explosion of an atomic bomb. They also discussed the physical aspects of the procedure and the results of early clinical testing (11). Their second article called attention to the relatively slow “speed” of xeroradiography in comparison with conventional roentgenography performed with “fast” film and intensifying screens (12).

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