Cancer screening in adults with down syndrome, a proposal.

Background: The specific distribution of cancers in Down syndrome (DS) calls into question the validity of screening policies for cancer surveillance as implemented for the general population.

Methods: We performed a literature review of cancer screening opportunities for adults with DS, taking account of the tumor profile in this specific population.

Results: In DS, solid tumors in adults are at most half as common as in the overall group of persons with intellectual disabilities, who have a frequency similar to that of the general population.

[Chateaubriand and contemporary medicine].

The author reviews the situation of medicine in the time of Chateaubriand, then his attitude toward this art and its practitioners, then his own pathology, psychological as well as somatic.

[Not Available].

In France, people with intellectual disability (ID) account approximately for 2.5 % of the total population. Life expectancy of ID increased over the last years, and this raised the risk of cancers developing in this group of patients.

Harm Reduction or Harm Introduction? Prevalence and Correlates of E-Cigarette Use Among French Adolescents.

Purpose: Electronic cigarettes are marketed as a tool to give up or reduce cigarette smoking, and their use has risen sharply in recent years. There is concern that use is increasing particularly among adolescents and that they are not being used as a cessation tool but as a novel experience in their own right.

Methods: The present research assessed prevalence and sociodemographic correlates of e-cigarette use and standard cigarette use and also explored the extent to which e-cigarettes appear to be used as a cessation tool.

CaPSCA: Evaluation of a Brief Cancer Prevention Education Programme to Promote Balanced Diet in French School Children.

This study examined the effectiveness of two cancer prevention interventions in improving balanced diet among French children aged 12-14 years. The educational techniques used were taken from the taxonomy of behaviour change techniques (BCTs; Abraham & Michie, 2008). Allocation to intervention group (intervention versus control) was randomised at the school-level, the intervention group received two interventions, each of 1-h duration, containing BCTs including advocated attitude, anticipated success/regret, behaviour modelling and barrier identification.

[Organized colorectal cancer screening].

Organized colorectal screening in France was extended to the whole of the country in 2008. People aged from 50 to 74 years are offered fecal occult blood tests (FOBT) every two years. Patients with individual or familial risk factors for colorectal disease are excluded from the program.

[Organized breast cancer screening].

Breast screening programs are increasingly controversial, especially regarding two points: the number of breast cancer deaths they avoid, and the problem of over-diagnosis and over-treatment. The French national breast cancer screening program was extended to cover the whole country in 2004. Ten years later it is time to examine the risk/benefit ratio of this program and to discuss the need for change.

Predictors of intentions to eat healthily in 8-9-year-old children.

One thousand two hundred seventy-two French children aged 8-9 years old participated in a study aimed at identifying predictors of healthy eating intention. We used a survey based on the Theory of Planned Behavior (TPB). Regression analyses were performed to assess the extent to which the extended TPB variables explained intention to eat healthily.

[How to reduce the incidence of breast cancer].

The incidence of breast cancer is rising in all industrialized countries. In France, with 41,000 new cases and 11,000 deaths per year, breast cancer is still the first cause of death from cancer in women. Genetic familial breast cancer is rare (only-2% due to mutated BRCA1/2 genes).

[Screening for occult malignancies (breast, colorectum, prostate) beyond the usual age limits].

The utility of screening for occult malignancies in very elderly people is controversial. Indeed, the following factors must be taken into account: increasing life expectancy, better efficacy and tolerability of cancer therapies, the cost of screening, and medico-legal issues. The dilemma is between missing a curable cancer and over-diagnosing and over-treating a vulnerable patient.

Response to neoadjuvant chemotherapy in lobular and ductal breast carcinomas: a retrospective study on 860 patients from one institution.

Background: We compared the impact of neoadjuvant chemotherapy on pathologic response and outcome in operable invasive lobular breast carcinoma (ILC) and invasive ductal breast carcinoma (IDC).

Patients And Methods: We extracted from our database all patients with pure invasive lobular (n=118, 14%) or pure invasive ductal carcinomas (n=742, 86%). Their treatment included neoadjuvant chemotherapy, adapted surgery, radiotherapy and adjuvant hormonal treatment.

A phase III randomized trial comparing adjuvant concomitant chemoradiotherapy versus standard adjuvant chemotherapy followed by radiotherapy in operable node-positive breast cancer: final results.

Purpose: To compare concomitant and sequential adjuvant chemoradiotherapy regimens in node-positive, operable breast cancer patients.

Methods And Materials: This was a randomized, French, multicenter, phase III trial enrolling 638 eligible women with prior breast surgery and positive axillary dissection. Patients in Arm A received 500 mg/m2 5-fluorouracil, 12 mg/m2 mitoxantrone, and 500 mg/m2 cyclophosphamide, with concomitant radiotherapy (50 Gy +/- 10-20-Gy boost).

[FDG (18 fluorodeoxyglucose) positron emission tomography and breast cancer].

Positron emission tomography (PET) is a metabolic radionuclide imaging method in which a tracer labeled with a positron emitter is detected with a dedicated system. 18F-fluorodeoxyglucose (FDG) accumulates in tumor cells because of their increased glycolytic activity, and is thus widely used as a tracer in oncology. This increased metabolic activity precedes morphologic modifications, making FDG-PET a very useful tool for detecting and staging cancer.

Life-threatening sepsis associated with adjuvant doxorubicin plus docetaxel for intermediate-risk breast cancer.

Context: Adjuvant chemotherapy with new cytotoxic agents for breast cancer must be properly assessed for toxicity.

Objective: To describe adverse events associated with adjuvant chemotherapy for breast cancer, which led to premature termination of a clinical trial.

Design, Setting, And Patients: We conducted a prospective randomized multicenter study (Reposant sur des Arguments Pronostiques et Predictifs [RAPP]-01) to compare the effectiveness of 2 chemotherapy regimens.

[Opinion of the French National Academy of Medicine on the legislative framework for the application of the European Directive on biomedical research in humans].

The French National Academy of Medicine considers that biomedical research in humans is a necessity for Public Health. This research is indispensable to medical progress and public health. It must respect medical ethics, scientific rigor, and should be implemented within a legislative framework.

[Cost of treatment and follow up of breast cancer: a retrospective assessment in a comprehensive cancer centre].

Context: Breast cancer is one of the major causes of premature death for women. Its cost management is important for both the national health insurance and the individual health care providers.

Objective: The objective of this study was to assess the global medical cost of breast cancer from diagnosis to follow up in one French medical centre: centre René-Huguenin, Saint-Cloud (92).

Nonlinear discriminant analysis and prognostic factor classification in node-negative primary breast cancer using probabilistic neural networks.

Background: We used non-linear kernel discriminant analysis (KDA) to predict the outcome of 134 axillary node-negative primary breast cancer patients not treated with adjuvant therapy in a non censored database.

Material: Posterior probabilities of relapse at 5 years were estimated using probabilistic neural networks (PNN) and a cross-validation (leave-one-out) technique to avoid overfitting the data. A stepwise method was used to construct the models to define the best combination of risk factors among eleven prognostic factors: age, menopausal status, Scarff-Bloom-Richardson grade, clinical tumor size, pathological tumor size, estrogen and progesterone receptor status, urokinase-type plasminogen activator, p53 protein level, c-erbB-2 protein and epidermal growth factor receptor.

[Survivorship of breast implants used in breast reconstruction. 949 implants].

The authors present from a series of 949 implants their method to calculate the life span of a mammary implant in the framework of breast reconstruction after cancer. In this statistical study, they have calculated the median life span of breast implants (loss of half of staff) by distinguishing it according to each type of implant (content, brand, indication..

[Initial medical treatment for breast cancer].

Rationale for primary medical treatment of breast cancer relies on experimental data showing that the incidence of metastatic disease is dependent on the primary tumour mass and tumoral angiogenesis. Although this concept may be applied to both chemotherapy and hormonotherapy, only the first was extensively explored for patients with locally advanced breast cancer, and more recently in smaller tumours. Despite high clinical +/- radiological response rates, only pathologic information, carefully assessed in both the primary and axillae lymph nodes, stands out as the major source of prognostic information on patients' outcome.

[Treatment of breast cancer after 70 years of age. Report of 1143 cases].

Study Aim: Breast cancer is the most frequent type of cancer in women, increasing in frequency with the elderly. In Europe, a third of new breast cancers occur in women over 70 years of age. The aim of this retrospective study was to analyse the tumoural lesions and therapeutic results in a female population over 70, treated in the same medical centre over a 15-year period.