Bulletin du cancer
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Colorectal cancers have been the first cancers to benefit from an efficient anti-angiogenic treatment, represented by bevacizumab, which has been approved for first-line metastatic treatment in combination with reference chemotherapies and which is under study in the adjuvant setting. Other gastro-intestinal malignancies appear less responsive to anti-angiogenic therapy, but inhibitors of the VEGF receptors (sorafenib, sunitinib, axitinib) are in development with encouraging results. The safety profile of anti-angiogenic agents is quite different from that of classical chemotherapy and may require a modification of treatment strategies.
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In 2003, there was 147,000 deaths attributed to cancer in France, 88,000 in men and 59,000 in women. Cancer mortality rates have been decreasing since 1987 in the male population and since the late 60's in the female population, the decrease is larger for the male population. This decrease is observed for most sites of cancer at least in recent years, however lung and bladder cancer mortality are increasing in the female population, pancreatic and skin cancer mortality are increasing both for men and for women, and myeloma is more or less stable. Among children aged 0 to 14, the incidence of cancer is stable and the mortality is decreasing markedly, the decrease being largest for leukaemia and lymphoma because of chemotherapy.
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Secondary lymphedema occurs in 14 to 28% after breast cancer treatment. Many studies have defined risk factors of lymphedema. ⋯ Others factors have been described such as type of surgery (mastectomy/tumorectomy), overweight at time of cancer, weight gain after surgery, skin puncture, reduction of physical activity. Risk of lymphedema and its complications (cellulitis, psychological and aesthetic discomfort) may be reduce by improvement in radiotherapy methods, sentinel lymph node biopsy, weight control, maintain of level physical activity after treatment and avoidance of skin puncture on ipsilateral arm.
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The unique genetic demography of the French Canadian population of Quebec, Canada, has provided a means to study the contribution of BRCA1 and BRCA2, the breast-ovarian cancer susceptibility genes. Here we review BRCA1 and BRCA2 in the context of French Canadian cancer families, a well-characterized founder population known for its contributions to medical genetics. Pathogenic BRCA1 and BRCA2 mutations contribute to a significant proportion of hereditary breast and/or ovarian cancer families of French Canadian descent. ⋯ This effect has been attributed to common founders in the French Canadian population of Quebec who emigrated from France in between 1608 and 1759. It is possible that novel highly penetrant cancer susceptibility genes account for a fraction of the 60 % of BRCA mutation-negative French Canadian cancer families. The continued genetic analysis and phenotypic characterization of French Canadian cancer families is warranted given the large family structure of these families are amenable for classical genome-wide linkage analysis for novel breast and ovarian cancer susceptibility genes.
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Comparative Study
[Pathological characteristics in screening versus clinically-detected breast cancer].
We report pathological characteristics of screen detected breast cancers versus breast cancers diagnosed outside the official breast screening program. The breast cancer screening program was organised in the county of Haute-Vienne and a pathological record was established in the Association de dépistage des cancers du sein (ADCS 87). ⋯ No difference in ductal carcinoma in situ or histological type was noted but tumor size and lymph node involvement presented significantly more favorable prognosis in screen detected breast cancers. This study confirms the potential benefit of screening in breast cancer.