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See detailLe cancer du sein en Belgique: pourquoi sommes-nous les premiers en Europe?
DESREUX, Joëlle ULg; Gaspard, Ulysse ULg; BLERET, Valerie ULg et al

in Revue Médicale de Liège (2011), 66(5-6), 231-7

Breast 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 ... [more ▼]

Breast 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. [less ▲]

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See detailHormonothérapie du cancer du sein
LIFRANGE, Eric ULg; ANDRE, Chantal ULg; BLERET, Valerie ULg et al

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

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See detailL'observance au traitement de longue durée : le cas particulier de l'hormonothérapie adjuvante du cancer du sein
Bleret, Valerie ULg; Collignon, Joëlle ULg; Coucke, Philippe ULg et al

in Revue Médicale de Liège (2010), 65(5-6), 405-408

L'objectif de l'hormonothérapie adjuvante dans le cancer du sein est d'atteindre en pratique quotidiennee, une efficacité comparable à celle obtenue au cours des études cliniques. Malgré l'efficacité ... [more ▼]

L'objectif de l'hormonothérapie adjuvante dans le cancer du sein est d'atteindre en pratique quotidiennee, une efficacité comparable à celle obtenue au cours des études cliniques. Malgré l'efficacité démontrée de l'hormonothérapie, la compliance constitue un défi majeur et un problème multidimensionnel. Une meilleure compréhension des raisons de cette non-compliance aiderait à mieux identifier les patientes à risque et à développer des interventions capables d'améliorer l'adhésion à l'hormonothérapie adjuvante.C'est dans ce but que nous avons entrepris une revue de la littérature des six dernières années (Pub Med 2003-2006). [less ▲]

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See detailActualites therapeutiques en gynecologie: pathologies organiques
HERMAN, Philippe ULg; Lifrange, Eric ULg; Nisolle, Michelle ULg et al

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 ▲]

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See detailEnvironmental dichlorodiphenyltrichlorethane or hexachlorobenzene exposure and breast cancer: is there a risk?
Charlier, Corinne ULg; Foidart, Jean-Michel ULg; Pitance, François ULg et al

in Clinical Chemistry & Laboratory Medicine (2004), 42(2), 222-227

The carcinogenic potential of environmental xenoestrogens (i.e., organochlorines) is a matter of controversy. Their pathogenic role as promoters in breast cancer has been previously suggested. In Europe ... [more ▼]

The carcinogenic potential of environmental xenoestrogens (i.e., organochlorines) is a matter of controversy. Their pathogenic role as promoters in breast cancer has been previously suggested. In Europe, despite their prohibition since the '70s, residues persist in soil and rivers resulting in a widespread contamination of the general population. In this study, we have compared the serum levels of p,p'-1,1-dichloro-2, 2-bis (4-chlorophenyl) ethylene (DDE) and hexachlorobenzene (HCB) in 231 women at the time of breast cancer discovery and in 290 agematched healthy controls. p,p'-DDE was found in 76.2% of cases and in 71.1% of controls but HCB was present only in 12.6% of cases (29 from 231) and in 8.9% of controls (26 from 290). Even if taking all undetectable results (recorded as "0") into consideration, mean values were significantly different in cases when compared to controls. The serum level of p,p'-DDE was 3.46+/-3.48 ppb (0.58+/-0.58 mug/g lipid) in patients and 1.85+/-2.09 ppb (0.31+/-0.35 mug/g lipid) in controls (p<0.0001). The HCB serum level was 0.66+/-1.25 ppb (0.11+/-0.21 mug/g lipid) in patients and 0.20+/-1.02 ppb (0.03+/-0.17 mug/g lipid) in controls (p<0.0001). When considering p,p'-DDE and HCB as binary variables (1 if higher than the limit of quantification, 0 if lower), the presence of both residues was significantly associated with an increased risk of breast cancer development (OR 2.21, 95% CI 1.41-3.48 for p,p'-DDE and OR 4.99, 95% CI 2.95-8.43 for HCB). No excess was observed among parous women or when familial history of breast cancer was considered. In the cancer group, no differences in serum levels of p,p'-DDE or HCB were found in relation with estrogenreceptor (ER) status, Bloom stage or lymph node metastasis, but the HCB level was moderately correlated with tumor size (p=0.026). [less ▲]

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See detailInteret et limites du depistage de masse du cancer du sein par mammographie seule (mammotest)
Lifrange, Eric ULg; Bleret, Valerie ULg; Desreux, Joëlle ULg et al

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 ▲]

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See detailBreast cancer and serum organochlorine residues
Charlier, Corinne ULg; Albert, Adelin ULg; Herman, Philippe ULg et al

in Occupational and Environmental Medicine (2003), 60(5), 348-351

Background: Controversy still exists about the breast carcinogenic properties in humans of environmental xenoestrogens (organochlorines), justifying new investigations. Aims: To compare the blood levels ... [more ▼]

Background: Controversy still exists about the breast carcinogenic properties in humans of environmental xenoestrogens (organochlorines), justifying new investigations. Aims: To compare the blood levels of total dichlorodiphenyltrichloroethane (DDT) and hexachlorobenzene (HCB) in samples collected at the time of breast cancer discovery, in order to avoid the potential consequences of body weight change ( after chemotherapy or radiotherapy) on the pesticide residue levels. Methods: Blood levels of HCB and total DDT (we calculated total DDT concentrations by adding all DDT and DDE isomers) were compared in 159 women with breast cancer and 250 presumably healthy controls. Risk of breast cancer associated with organochlorine concentration was evaluated. Results: Mean levels of total DDT and HCB were significantly higher for breast cancer patients than for controls. No differences in serum levels of total DDT or HCB were found between oestrogen receptor positive and oestrogen receptor negative patients with breast cancer. Conclusions: These results add to the growing evidence that certain persistent pollutants may occur in higher concentrations in blood samples from breast cancer patients than controls. [less ▲]

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See detailHystéroscopie opératoire ou hystérectomie dans le traitement des lésions utérines bénignes. Que choisir en 1998?
Herman, Philippe ULg; Gaspard, Ulysse ULg; Foidart, Jean-Michel ULg

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 ▲]

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See detailAttitudes obstétricales: Consensus de Département ULg. Document des cours de troisième cycle, octobre 96
Biquet, G.; Brichant, Jean-François ULg; Dewandre, Pierre-Yves et al

in Revue Médicale de Liège (1997), 52(3), 142-8

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See detailApproche thérapeutique du cancer épithélial de l'ovaire au CHU Sart Tilman : Conclusions de la réunion interdisciplinaire du 22 mars 1995
Jerusalem, Guy ULg; Detroz, Bernard ULg; Herman, Philippe ULg et al

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 ▲]

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