Evaluation of beast adipose tissue magnetic resonance spectroscopy as a non invasive biomarker of the nutritional part of Beast cancer risk

La composition en acides gras du tissu adipeux mammaire est reconnue comme marqueur qualitatif de la consommation lipidique antérieure mais aussi de la part nutritionnelle du risque / pronostic du cancer du sein. Ceci ouvre la perspective d’individualiser dans la population générale, un groupe de personnes à risque, susceptibles de bénéficier d’une intervention nutritionnelle ciblée. L’approche du dépistage d’une population à risque par l’utilisation de la composition du tissu adipeux comme biomarqueur se heurte i) à l’aspect invasif que représente le prélèvement d’un fragment de tissu adipeux mammaire, et ii) à la lourdeur contraignante du conditionnement et de l’analyse systématique des acides gras du tissu adipeux. Les méthodes analytiques actuellement disponibles sont incompatibles avec la perspective d’un dépistage de masse. Cependant, les descriptions récentes de l’utilisation de la spectroscopie par résonance magnétique (SRM) pour décrire la composition lipidique des triglycérides du tissu adipeux permettent d’envisager de l’utiliser dans cet objectif. Ce travail de thèse présente: 1) l’évaluation de la SRM pour caractériser la composition en acides gras du tissu adipeux chez l’animal (le rat) suite à une intervention nutritionnelle, 2) l’évaluation du profil lipidique du tissu adipeux par SRM chez la femme sur une plateforme clinique 3T, 3) l’étude des liens entre la composition en acides gras du tissu adipeux et la présentation du cancer du sein, et 4) la comparaison des données de la SRM in vitro (11.7T) et in vivo (3T) du tissu adipeux chez des patientes prises en charge pour un cancer du sein avec les données de la chromatographie gazeuse.Fatty acid composition of the white adipose tissue remains the most reliable qualitative biomarker of previous dietary intake of fatty acids and may provide information on the nutritional part of the risk or evolution of breast cancer. This opens the prospect of individualization of women at high nutritional risk of breast cancer that may benefit from a targeted nutritional intervention but 1) the need for biopsy and 2) subsequent time-consuming biochemical analyses hamper any application of this approach. Proton magnetic resonance spectroscopy (1H-MRS) of adipose tissue lipids represents an appealing, non-invasive approach, which could circumvent these limitations. This manuscript reports: 1) an assessment of feasibility of (1H-MRS) to evaluate the consequences of a nutritional intervention in a rat mammary tumor model on the adipose tissue fatty acid composition, 2) an assessment of the feasibility of in vivo measurement of the fatty acid composition of breast adipose tissue by (1H-MRS) on a clinical platform, 3) an assessment of the relation of specific patterns of composition of adipose tissue fatty acids with the presentation of breast cancer, and 4) a comparison with gas chromatography of (1H-MRS) data acquired on breast adipose tissue in vitro (11.7T) and in vivo (3T) on patients managed for breast cancer

Sécurité carcinologique de la mastectomie avec conservation de l'étui cutané (une étude cas-témoin)

TOURS-BU Médecine (372612103) / SudocSudocFranceF

Faut-il opérer toutes les lésions de métaplasie cylindrique avec atypies diagnostiquées sur macrobiopsie mammaire ?

TOURS-BU Médecine (372612103) / SudocSudocFranceF

Place et performance de l'imagerie par résonnance magnétique au cours des chimiothérapies néo adjuvantes pour cancer du sein localement avancé

TOURS-BU Médecine (372612103) / SudocSudocFranceF

Quel est l'impact de l'hystérectomie sur la survie des patientes atteintes de tumeur borderline de l'ovaire ?

TOURS-BU Médecine (372612103) / SudocSudocFranceF

Evaluating the clinical impact of the 2023 FIGO staging for endometrial cancer: Complexities and considerations

International audienc

Fallopian tube prolapse after hysterectomy: a systematic review.

BACKGROUND:Prolapse of the fallopian tube into the vaginal vault is a rarely reported complication that may occur after hysterectomy. Clinicians can miss the diagnosis of this disregarded complication when dealing with post-hysterectomy vaginal bleeding. OBJECTIVES:We performed a systematic review in order to describe the clinical presentation, therapeutic management and outcome of fallopian tube prolapse occurring after hysterectomy. SEARCH STRATEGY:A systematic search of MEDLINE and EMBASE references from January 1980 to December 2010 was performed. We included articles that reported cases of fallopian tube prolapse after hysterectomy. Data from eligible studies were independently extracted onto standardized forms by two reviewers. RESULTS:Twenty-eight articles including 51 cases of fallopian tube prolapse after hysterectomy were included in this systematic review. Clinical presentations included abdominal pain, dyspareunia, post- coital bleeding, and/or vaginal discharge. Two cases were asymptomatic and diagnosed at routine checkup. The surgical management reported comprised partial or total salpingectomy, with vaginal repair in some cases combined with oophorectomy using different approaches (vaginal approach, combined vaginal-laparoscopic approach, laparoscopic approach, or laparotomy). Six patients were initially treated by silver nitrate application without success. CONCLUSIONS:This systematic review provided a precise summary of the clinical characteristics and treatment of patients presenting with fallopian tube prolapse following hysterectomy published in the past 30 years. We anticipate that these results will help inform current investigations and treatment

Quilting Suture of Mastectomy Dead Space Compared with Conventional Closure with Drain

International audiencePURPOSE: This study was designed to compare conventional closure with a drain and quilting suture of mastectomy dead space for preventing wound seroma. METHODS: Consecutive patients undergoing mastectomy for breast cancer were included in this retrospective observational study. Patients received conventional closure with drainage or quilting suture for wound closure. Propensity score (PS) matching was performed based on potential confounders to minimize selection bias. The primary outcome was the rate of type 2 or 3 wound seroma according to the common terminology criteria for adverse events (CTCAE) definition. RESULTS: A total of 119 patients were included (quilting suture n = 59; conventional closure n = 60). Type 2 or 3 seroma was observed in 6.8 % of the quilting suture group and 21.7 % of the conventional closure group (crude odds ratio 0.26; 95 % confidence interval 0.08-0.86; p = 0.03). The overall seroma rate was 15.2 % in the quilting suture group and 51.7 % in the conventional closure group (p < 0.001). Persistent pain at days 15-21 was significantly less frequent in the quilting suture group than in the conventional suture group. PS matched analysis confirmed these findings, in particular the lower rate of type 2 or 3 seroma in the quilting suture group than in the conventional closure group (PS-matched odds ratio 0.16; 95 % confidence interval 0.04-0.72; p = 0.02). CONCLUSIONS: Quilting suture of the mastectomy dead space is associated with significantly less frequent seroma than conventional closure with drain

Flow chart of selection process.

<p>Flow chart of selection process.</p