Incidence and Mortality in Breast Cancer: Are We Doing Better?

Breast cancer in women is a major health problem: each year, more than 1 million new cases are diagnosed worldwide. One in 8 women will be confronted with breast cancer during her lifetime. The objective of this review is to present an overview of the epidemiology of breast cancer i.e. the incidence and mortality rate of breast cancer. In other words, how often does breast cancer occur and how often it is lethal? The geographical variation and the evolution over time are discussed - are we now doing better than 10 or 20 years ago? Possible ways of preventing breast cancer are also presented

Effect of the INTER-ACT lifestyle intervention on maternal mental health during the first year after childbirth:A randomized controlled trial

We assess whether the INTER-ACT postpartum lifestyle intervention influences symptoms of depression and anxiety, sense of coherence and quality of life during the first year after childbirth. A total of 1047 women of the INTER-ACT RCT were randomized into the intervention (n = 542) or control arm (n = 505). The lifestyle intervention consisted of 4 face-to-face coaching sessions, supported by an e-health app. Anthropometric and mental health data were collected at baseline, end of intervention and 6-months follow-up. We applied mixed models to assess whether the evolution over time of depressive symptoms, anxiety, sense of coherence and quality of life differed between the intervention and control arm, taking into account the women's pre-pregnancy BMI. There was no statistical evidence for a difference in evolution in anxiety or quality of life between intervention and control arm. But an improvement in symptoms of depression and sense of coherence was observed in women who received the intervention, depending on the mother's pre-pregnancy BMI. Women with normal/overweight pre-pregnancy BMI, reported a decrease in EPDS between baseline and end of intervention, and the decrease was larger in the intervention arm (control arm: -0.42 (95% CI, -0.76 to -0.08); intervention arm: -0.71 (95% CI, -1.07 to -0.35)). Women with pre-pregnancy obesity showed an increase in EPDS between baseline and end of intervention, but the increase was less pronounced in the intervention arm (control arm: +0.71 (95% CI, -0.12 to 1.54); intervention arm: +0.42 (95% CI -0.42 to 1.25)). Women with a normal or obese pre-pregnancy BMI in the intervention arm showed a decrease in sense of coherence between baseline and end of intervention (-0.36) (95% CI, -1.60 to 0.88), while women with overweight pre-pregnancy showed an increase in sense of coherence (+1.53) (95% CI, -0.08 to 3.15) between baseline and end of intervention. Receiving the INTER-ACT postpartum lifestyle intervention showed improvement in depressive symptoms, in normal weight or overweight women on the short run, as well as improvement in sense of coherence in women with pre-pregnancy overweight only

Simple ultrasound rules to distinguish between benign and malignant adnexal masses before surgery: prospective validation by IOTA group

Objectives To prospectively assess the diagnostic performance of simple ultrasound rules to predict benignity/malignancy in an adnexal mass and to test the performance of the risk of malignancy index, two logistic regression models, and subjective assessment of ultrasonic findings by an experienced ultrasound examiner in adnexal masses for which the simple rules yield an inconclusive result

AURORA : bariatric surgery registration in women of reproductive age : a multicenter prospective cohort study

Background: The expansion of the obesity epidemic is accompanied with an increase in bariatric procedures, in particular in women of reproductive age. The weight loss induced by the surgery is believed to reverse the negative impact of overweight and obesity on female reproduction, however, research is limited to in particular retrospective cohort studies and a growing number of small case-series and case-(control) studies. Methods/design: AURORA is a multicenter prospective cohort study. The main objective is to collect long-term data on reproductive outcomes before and after bariatric surgery and in a subsequent pregnancy. Women aged 18-45 years are invited to participate at 4 possible inclusion moments: 1) before surgery, 2) after surgery, 3) before 15 weeks of pregnancy and 4) in the immediate postpartum period (day 3-4). Depending on the time of inclusion, data are collected before surgery (T1), 3 weeks and 3, 6, 12 or x months after surgery (T2-T5) and during the first, second and third trimester of pregnancy (T6-T8), at delivery (T9) and 6 weeks and 6 months after delivery (T10-T11). Online questionnaires are send on the different measuring moments. Data are collected on contraception, menstrual cycle, sexuality, intention of becoming pregnant, diet, physical activity, lifestyle, psycho-social characteristics and dietary supplement intake. Fasting blood samples determine levels of vitamin A, D, E, K, B-1, B-12 and folate, albumin, total protein, coagulation parameters, magnesium, calcium, zinc and glucose. Participants are weighted every measuring moment. Fetal ultrasounds and pregnancy course and complications are reported every trimester of pregnancy. Breastfeeding is recorded and breast milk composition in the postpartum period is studied. Discussion: AURORA is a multicenter prospective cohort study extensively monitoring women before undergoing bariatric surgery until a subsequent pregnancy and postpartum period

Reactive stroma and trastuzumab resistance in HER2-positive early breast cancer

We investigated the value of reactive stroma as a predictor for trastuzumab resistance in patients with early HER2-positive breast cancer receiving adjuvant therapy. The pathological reactive stroma and the mRNA gene signatures that reflect reactive stroma in 209 HER2-positive breast cancer samples from the FinHer adjuvant trial were evaluated. Levels of stromal gene signatures were determined as a continuous parameter, and pathological reactive stromal findings were defined as stromal predominant breast cancer (SPBC; >= 50% stromal) and correlated with distant disease-free survival. Gene signatures associated with reactive stroma in HER2-positive early breast cancer (N = 209) were significantly associated with trastuzumab resistance in estrogen receptor (ER)-negative tumors (hazard ratio [HR] = 1.27 p interaction = 0.014 [DCN], HR = 1.58, p interaction = 0.027 [PLAU], HR = 1.71, p interaction = 0.019 [HER2STROMA, novel HER2 stromal signature]), but not in ER-positive tumors (HR = 0.73 p interaction = 0.47 [DCN], HR = 0.71, p interaction = 0.73 [PLAU], HR = 0.84; p interaction = 0.36 [HER2STROMA]). Pathological evaluation of HER2-positive/ER-negative tumors suggested an association between SPBC and trastuzumab resistance. Reactive stroma did not correlate with tumor-infiltrating lymphocytes (TILs), and the expected benefit from trastuzumab in patients with high levels of TILs was pronounced only in tumors with low stromal reactivity (SPBCPeer reviewe

Epidemiology and Outcome of Fungemia in a Cancer Cohort of the Infectious Diseases Group (IDG) of the European Organization for Research and Treatment of Cancer (EORTC 65031)

In a prospective cohort study of 145 030 admissions of cancer patients from 13 European Organisation for Research and Treatment of Cancer centers fungemia occurred in 0.23%. Candida albicans was the predominant pathogen. Fungemia was associated with substantial mortality. Antifungal prophylaxis and remission of cancer predicted better surviva

Sleep apnea syndrome in a young cosmopolite urban adult population: Risk factors for disease severity

Purpose: The purpose of this study is to investigate the risk factors for obstructive sleep apnea (OSA) in young patients from an urban European city with many migrants. Methods: The medical data of 2,343 patients referred for polysomnography from January 2007 till September 2009 were retrospectively reviewed in order to identify patients younger than 40 years with OSA and assess their characteristics. Results: One hundred twenty-one of the 2,093 patients (6%) referred for diagnostic polysomnography were younger than 40 years and had OSA. There were 17 women and 104 men. The race was Caucasian in 55% (67/121) and African in 42% (51/121). The median apnea-hypopnea index (AHI) was 39 in men and 23 in women (p < 0.01), 30 in Caucasians and 39 in Africans (p = 0.03). BMI was positively correlated to the AHI (correlation of 0.19, p = 0.04). Multiple regression modeling showed that African origin (p = 0.01), current smoking (p = 0.05), and neck circumference (p < 0.01) were predictors of AHI, independently of BMI, but not the presence of upper airway abnormalities (p = 0.75). Co-morbidities were frequent (hypertension, 20%; diabetes, 13%; hypercholesterolemia, 27%; depression, 13%; reflux and gastric ulcer, 13%; hypothyroidism, 5%; asthma, 9%), and were related to BMI (p = 0.02), nocturnal desaturation time (p = 0.02), and African origin (p = 0.024). Conclusions: In patients aged <40 years and suffering from OSA, disease severity was associated with high BMI, large neck circumference, male sex, and African origin. After adjustment for BMI, African origin, tobacco use, and neck circumference remained predictors of high AHI. Neither upper airway abnormalities nor co-morbidities were found to be a risk factor for higher AHI in this group of young patients from a European city. © 2010 Springer-Verlag.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Surgical treatment for periacetabular metastatic lesions.

Periacetabular bone metastasis present with severe pain and functional loss leading to a poor quality of life. Surgical treatment remains challenging.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

PRODIGE 7 should be interpreted with caution

SCOPUS: le.jinfo:eu-repo/semantics/publishe