Hormonothérapie du cancer du sein

in Revue Médicale de Liège (2011), 66(5-6), 367-371

Actualites therapeutiques en gynecologie: pathologies organiques

in Revue Médicale de Liège (2007), 62(5-6, May-Jun), 414-22

Over the last ten years, progress in evidence-based medicine coupled with technological and surgical breakthroughs have deeply changed the management of our patients. Uterine bleeding is the first cause ... [more ▼]

Over the last ten years, progress in evidence-based medicine coupled with technological and surgical breakthroughs have deeply changed the management of our patients. Uterine bleeding is the first cause of gynaecological consultation and the intrauterine progestin delivery system as well as new hysteroscopic procedures have optimized the therapeutic approach to this problem. Introduction of magnetic resonance imaging and interventional procedures have improved breast disease diagnosis and management; likewise sentinel node localization, introduction of aromatase and growth factors inhibitors, new radiotherapy procedures and pharmacogenomics, have helped to ameliorate breast cancer treatment. Pelvic surgery has been switching more and more towards laparoscopic procedures not only in the field of benign lesions (eg endometriosis), of surgery of prolapse and incontinence with new prosthetic materials, but also for an improved management of gynaecological cancers. [less ▲]

Interet et limites du depistage de masse du cancer du sein par mammographie seule (mammotest)

in Revue Médicale de Liège (2003), 58(5), 331-7

The 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 ... [more ▼]

The 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. [less ▲]

Hystéroscopie opératoire ou hystérectomie dans le traitement des lésions utérines bénignes. Que choisir en 1998?

in Revue Médicale de Liège (1998), 53(12), 756-61

In the past, the treatment of benign uterine lesions required, in many instances, a hysterectomy. These days, most cases can be successfully treated by hysteroscopy. To be reliable, this technique must ... [more ▼]

In the past, the treatment of benign uterine lesions required, in many instances, a hysterectomy. These days, most cases can be successfully treated by hysteroscopy. To be reliable, this technique must lead to a significant reduction in the number of hysterectomies performed for benign uterine lesions. The electroresection technique is preferred to that using the Nd-YAG laser because of its lower cost and its equivalent efficacy. By using the uterine perfusion pump device, the risk of resorption syndrome can be reduced to its minimum. Submucosal myomas < 1 cm, benign endometrial hyperplasia and adenomyosis are the commonest benign lesions treated. Dysfunctional uterine bleeding can also be treated by an endometrectomy. A preoperative workup includes a transvaginal ultrasound and a biopsy. This ensures that only benign lesions that are accessible to a hysteroscopy will be submitted to this technique and that no cases of endometrial cancer or atypical hyperplasia would be ignored. This study presents 270 cases of operative hysteroscopy with a follow-up to 4 years. 82.8% of myomatous lesions were treated with success. The results for patients with benign endometrial polyps or benign endometrial hyperplasia are also excellent with only 4.6% and 5.6% rate of secondary surgery respectively. Adenomyosis does not appear to be a good indication for hysteroscopy as only 37% of patients did not need a definitive hysterectomy. Rates of operative complications (post-operative bleeding, uterine perforation, resorption syndrome and difficulty of access) are acceptable and get less frequent as the surgeon experience increases. [less ▲]

Approche thérapeutique du cancer épithélial de l'ovaire au CHU Sart Tilman : Conclusions de la réunion interdisciplinaire du 22 mars 1995

in Revue Médicale de Liège (1995), 50

Notre but est de définir une approche multidisciplinaire permettant d'offrir les meilleures chances de guérison ou de survie prolongée aux patientes. Nous nous sommes basés sur notre expérience ... [more ▼]

Notre but est de définir une approche multidisciplinaire permettant d'offrir les meilleures chances de guérison ou de survie prolongée aux patientes. Nous nous sommes basés sur notre expérience personnelle et les données actuelles de la littérature, tout en intégrant les approches innovatrices (ex : chimiothérapie intrapéritonéale précoce). Pour certaines patientes, le pronostic reste trop sombre avec un traitement standard et il nous semble important de leur proposer un traitement potentiellement plus efficace. [less ▲]