Management of estrogen deficiency after breast cancer

peer reviewedThe prevention and the treatment of oestrogen deficiency induced by breast cancer treatments are crucial in the management of patients. The impacts of this deficiency must not be neglected: quality of life impairments inducing eventually premature withdrawal of hormonotherapies, and excess of bone and cardio-vascular morbidities and mortalities, especially in good prognosis young women. Management strategies of short and long term effects of this deficiency are reviewed and discussed here

Breast cancer in Belgium: why are we the first in Europe?

peer reviewedBreast cancer incidence in Belgium is on the top of European countries, with 9.697 new cases in 2008 and 106/100.000 women/year. The explanation of this high incidence in our country is probably the accumulation of risk factors (many of them are linked to lifestyle), and the impact of screening and registration of cases. The relative impact of each of theses factors is less clear because we don't have powerful statistical studies. Belgium is slightly above the European mean for breast cancer mortality, with 19,4/100.000 women/year and an all stages 15-year survival of 75%. Breast cancers are responsible for around 3% of all-cause mortality in Belgian women. This article discusses the causes of this high Belgian incidence and of current decrease of incidence in western countries, and reviews known and less known risk factors of breast cancers, with a special focus on menopause hormonal treatments

Prevention of Prematurity in the French Community at the Approach of the Year 2000

peer reviewedThe actual results confirm the dominating influence of psychosocial factors on prematurity and low birth weight. The study performed in Liege indicates that these factors must be taken into account for better care of the future mother. The systematic use of a prenatal questionnaire on psychosocial factors draws attention towards the personal situation of the future mother. Detection of some organic or psychosocial risk factors must prompt prophylactic measures even in the absence of any sign of pathologies. Prevention of prematurity has, over the last 30 years, been the primary objective of prenatal follow-up. Its importance must be further emphasized

Bilateral prophylactic mastectomy for women at very high risk for breast cancer: beyond the technique

peer reviewedBilateral prophylactic mastectomy is the most efficient risk management strategy for women at very high risk for breast cancer. Different methods can be used. The implementation of such a strategy must respond to the request of a well informed patient

Mild hemolytic disease of the newborn due to

peer reviewedUne femme de type caucasien, de phénotype A+ CCD.ee K neg, sans antécédent transfusionnel accouche d’un premier enfant présentant une anémie légère. Les hématies du nouveau-né de groupe A+ CCD.ee K neg présentent une réaction à l’antiglobuline fortement positive, de type IgG. Durant la grossesse et à l’accouchement, la recherche d’anticorps irréguliers (RAI) chez la mère s’est toujours avérée négative. Toutefois, à la naissance, en utilisant une collection de globules rouges de phénotype rare (antigènes privés) décongelés, le laboratoire met en évidence dans le sérum de la mère un anticorps de spécificité anti-Wra. L’activité de l’anticorps maternel de titre 16 est totalement inhibée par le dithiothréitol indiquant la nature IgM de l’anticorps circulant. La présence de l’antigène Wra à la surface des hématies du bébé et du père est ensuite confirmée. La concentration des IgG anti-Wra sur les hématies de l’enfant est démontrée par la mise en évidence aisée de l’anticorps dans l’éluat. Ce cas clinique illustre les difficultés à mettre en évidence les anticorps dirigés contre les antigènes privés présents à la surface des hématies des nouveau-nés, responsables de maladies hémolytiques du nouveau-né. En effet, les panels standards d’érythrocytes utilisés pour la recherche d’anticorps irréguliers n’expriment généralement pas ces antigènes privés.A Caucasian woman, with a A+ CCD.ee K neg erythrocyte phenotype and no history of blood transfusion, delivered a first child who developed mild anemia. The direct antiglobulin test performed on the newborn red blood cells belonging to the A+ CCD.ee K neg group, was strongly positive for IgG. During the pregnancy and after the delivery, the woman had a negative irregular antibody screening test, using standard red blood cells. However, at birth, using a collection of thawed red blood cells with rare phenotypes (private antigens), the lab showed an antibody anti-Wra in the maternal serum. The activity of the maternal antibody, with a titer of 16, was completely inhibited by dithiothreitol, indicating the nature IgM of the circulating antibody. The presence of the antigen Wra on the surface of the newborn and its biological father red blood cells was confirmed. The concentration of IgG anti-Wra on baby erythrocytes was demonstrated by the presence of the antibody anti-Wra in the eluate. This case illustrates the difficulties to detect antibodies against private antigens on baby erythrocytes, responsible of hemolytic diseases of newborn. Indeed, standard red blood cell panels used for irregular antibodies screening test do not express generally those private antigens

Benefits and Limitations of Mammography

peer reviewedThe literature on screening mammography provides ample opportunity for doubt (the sceptics) and dogma (the screening zealots), and can be interpreted to prove both benefit and harm. The benefit of mammography screening, if any, is modest and the balance between beneficial (potentially, a 20% relative reduction in breast cancer mortality with no significant benefit on all-cause mortality) and harmful (physical and psychological morbidity related to the 15-40% missed cancers and the 80-90% false-positive diagnoses) effects is still delicate. The mammogram alone is a modest weapon. Concurrent clinical breast examination is mandatory. Women that are concerned about breast cancer should be fully informed of the potential benefits and risks of screening mammography. These women should benefit from mammography with concurrent clinical breast examination, and possible whole-breast ultrasound in heterogeneously dense and extremely dense breast patterns

Purification, expansion, and multiple fluorochrome labeling of cord blood hemopoietic precursors: preliminary results.

CD34-positive cells were isolated from a total of 23 cords using CellPro Ceprate columns. AIS MicroCellector flasks, and panning. The cells were (1) expanded in serum-free culture supplemented with a variety of combinations of cytokines and (2) immunophenotyped using multiple fluorochrome labeling. The results indicated that the avidin column produced the highest purity of CD34-positive cells, and that immature blast cells could be expanded in serum-free culture. Preliminary results suggested that the four fluorochrome labeling technique may provide useful information on the lineage commitment of cord blood precursor and blast cells

Apport des techniques nouvelles d'imagerie médicale en gynécologie : sénologie interventionnelle, possibilités diagnostiques et thérapeutiques

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Prise en charge diagnostique d'un amas de calcifications atypiques par la méthode MIBB

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