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A Gorins

Publications and source records attributed to A Gorins.

At least 19 recordsLinked to original sources
PubMed1996

[Breast cancer during pregnancy. Epidemiology--diagnosis--prognosis].

The association "breast cancer and pregnancy" is rare. The hypervascularisation of the pregnant breast, the role of hormones, the immunological factors have been incriminated. The rate of diagnosis is often too late because of the changes in the pregnant breast. Among the investigations, besides mammogram, the interest of ultrasound examination especially cyto-punction is underlined. Prognosis appears more severe because the delay in diagnosis and the young age of patients. However that is true for N+ patterns, and not for N- cases. We detail the experience of the Centre des Maladies du Sein de l'Hôpital Saint-Louis which concerns 15 cases.

Adult↗
PubMed1996

Quality of life.

Explore the source record for details and available documents.

Breast Neoplasms↗
PubMed1995

[Effects of progesterone and progestational hormones on the mammary gland].

The growth of the mammary gland during the active genital period depends on a delicate balance between the action of the two major female sex steroid hormones, estradiol and progesterone. The regulation of growth and maturation of the gland primarily depends on the combined action of estradiol and progesterone. Breast epithelial proliferation is maximal during the luteal phase of the menstrual cycle. While estrogen appears to be the major impetus to the proliferation of mammary cells, the effect of progestin is subject to debate. Progestins have either a positive, modest or no growth effect or may even inhibit growth. Progestins could stimulate the development of malignant cells in contrast to normal or non-malignant cells. It is difficult to extrapolate in vitro results to the human breast. There is presently no direct evidence that progestins regulate the concentration of estrogen receptors (ER) in normal breasts. Furthermore, it is possible that each type of progestin may have different effects. Most studies suggest that progestins are effective in the treatment of premenstrual syndrome and benign breast disease. The therapeutic basis for the use of progestins is the suppression of pituitary-ovarian function the reduction of the effect of estrogen on breast tissues. Whether progestins give protection against breast cancer is less clear. If they do, the mechanism is not the same as that of the endometrium [down-regulation of ER, increase of 17 beta-hydroxysteroid dehydrogenase activity (E2DH)]. High doses of oral synthetic progestins are effective in the treatment of breast cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

Breast↗
PubMed1994

[2d and 3d line hormonal therapy in postmenopausal metastatic breast tumor. Comparison of medroxyprogesterone acetate and aminoglutethimide in tamoxifen-resistant patients].

In order to evaluate the effectiveness of second and third line hormone therapy for postmenopausal (spontaneous or surgical) women with metastatic tamoxifen-resistant breast cancer, 293 women aged 36 to 91 (mean 63.6) were divided into two groups submitted to a multicenter study of two treatment schedules: a) Aminoglutethimide (AG; 500 mg daily plus hydrocortisone 40 mg daily); b) Medroxyprogesterone (MPA; 1,000 mg daily per os). Of the 293 patients receiving second line hormone therapy, only 161 were available for third line treatment. In phase 1, 153 patients were treated with AG: 36% had objective responses (complete or partial); of 140 patient receiving MPA, 33% had objective responses (p = 0.045, significant). In the AG-treated group, duration of response was 11.3 +/- 8.4 months as against 8.3 +/- 5.6 months in the MPA group (p = 0.07, significant). In phase 2, 87 women previously treated with MPA received AG, and 74 previously AG-treated patients were given MPA. There were no significant differences in the results obtained. In conclusion, there were no significant differences in the results obtained by AG and MPA treatment as far as toxicity and survival was concerned but there was a statistically significant advantage for AG as second and third line management both as to objective responses and mean time until renewed progression of the disease.

Adult↗
PubMed1993

[High-dose progestational contraception: side effects].

Progestational contraception (CMP) is rarely used. In France, its indications are not clearly defined. The prescription is justified when there is a contra-indication to estrogen use (uterus fibroids, endometrial hyperplasia, endometriosis, fibro-cystic disease of the breast). The side effects are menstruation disorders (metrorrhagias, amenorrhea), weight gain, atherogenic metabolic changes. Actually, nor-pregnane derivatives, which correctly block ovulation, do not seem to have a deleterious effect on glucide and lipid parameters. At last, it is not sure that CMP may be prescribed to a patient previously treated for a breast cancer.

Arteriosclerosis↗
PubMed1992

Second and third line hormonotherapy in advanced post-menopausal breast cancer: a multicenter randomized trial comparing medroxyprogesterone acetate with aminoglutethimide in patients who have become resistant to tamoxifen.

In order to evaluate the efficacy of two different sequences of second and third line hormonotherapy in advanced post-menopausal breast cancer, 257 women aged 36-91 years (mean age: 63.6 years) who had become resistant to tamoxifen (TAM), entered into a multicenter randomized trial comparing two different regimens: 1) Aminoglutethimide (Ag) 500 mg/day with hydrocortisone supplementation from 30 to 60 mg/day; and 2) oral medroxyprogesterone acetate (MPA) 500 mg twice a day. 250 patients were evaluated following second line hormone therapy and, after cross-over, 128 following third line hormonotherapy. No significant difference was observed, during either second or third line therapies, for toxicity, survival, or response rate; however, in both second and third line therapies the median time to progression was significantly longer with Ag therapy.

Adult↗
PubMed1991

[Breast cysts].

The mammary cyst is part of the fibro-cystic disease. Only cysts with a diameter of more than 3 mm would have a pathological significance. Its clinical symptomatology is well known. The clearing puncture is the essential diagnostic and therapeutic act. Mammography, sustained by cystography, furnishes highly worthy information. Thermography and ultra-sonography may also be useful. Its pathogeny is still being very much discussed. Hormonal factors are incriminated: hyperestrogenemia, luteal deficiency, dysprolactinemia are inconstant. They are neither necessary nor sufficient to induce the cystic disease. The titration of TeBG may perhaps open an interesting path for research. The study of intracystic steroids (among which DHEAS) furnishes instructive results. Intracystic glycoproteins, proteins and electrolytes are also the objects of promising research. Recently, the interest lying in the study of EGF, its possible relation to DHEAS and the intracystic Na/K ratio were emphasized. It is also important to notice the presence of cysts with a flat wall or with a hyperplastic wall, of the apocrine type. The psychogenic factors seem to be determining in the cystic flare-ups. The relations with breast cancer remain the fundamental problem. Although the cyst itself only exceptionally degenerates into cancer (cyst-epithelioma), the very presence of a macrocytic disease multiplies by 3 or 4 the risk of cancer. The treatment is composed of psychotherapy, tranquillizers and a clearing puncture of the strained cysts. The administration of phlebotonics, anti-prostaglandins, colostrum extracts, can give substantial results. The author gives details about the part of hormonal treatment as a function of the titrations and the severity of the case. If it appears necessary to block the gonadotropic function, Danazol is a very effective agent. Surgery has but a small place. Indication of subcutaneous mastectomy will rest upon a very severe case-selection.

Adolescent↗
PubMed1991

[When must a mastopathy at risk be operated on? The viewpoint of the clinician, the radiologist, the surgeon, and the anatomopathologist].

The mastopathy is said to be truly "at risk" only when an anatomopathological examination has singled out certain criteria. At present, there is no medical treatment, particularly a hormonal one, capable of preventing the evolution towards a breast cancer. The indication for an operation could be based on a real score taking into account the age, the family history, the pregnancies, the fatness, the endogenous hormonal balance and the exogenous hormonal supply. In fact, above all considerations is the local mammary state, "the major mastoses", where a joint analytical study of: the clinical state, the mammography, the thermography and the cytopuncture is essential. The possibility of carrying out micro-biopsies under local anaesthesia is also underlined. Finally, we retain two big types of indication: of necessity. A lesion for which a doubt exists must be operated upon. The radiological location constitutes a considerable progress. Of principle. Namely in women with a heavy family history of breast cancer, a fortiori if the mammographies reveal dense, heterogeneous aspects, difficult to follow. Finally, the women for whom a previous biopsy has revealed lesions with an evolution potential (lobe neoplasia, extensive atypical epitheliosis). In conclusion, the indications are not often easy and is usually the object of a study of each case individually.

Adult↗
PubMed1991

[Contraception and breast cancer].

The role of oral contraceptives in the development of breast cancer has given rise and still gives rise to many debates, accentuated by the economic and social impact of contraception. Several problems can the brought forward: can oral contraceptives (OC) play a role in the development of breast cancer? Can they aggravate it? Can they prevent it? We have various means at our disposal to help us in answering those difficult questions: fundamental studies, mechanisms of action of steroid hormones in the development of the mammary gland, comprehension of the mechanisms of carcinogenesis, epidemiological studies which enable us to define the notion of relative risk. At present, there is no emergence of the notion of an aggravation of the risk of breast cancer linked with the intake of oral contraceptives. However, it must be reminded that the use of oral contraceptives is still recent if we take into account the existence of a latency period before an eventual harmful effect appears and the fact that the oestro-progestative compositions have been greatly modified in those last few years. However, the present studies are centred on the populations said to be "at risk". The results of studies on women who have taken an OC before their first pregnancy or before the age of 25 still remain contradictory. Those of women with a family history of breast cancer or hyperplastic lesions are reassuring but need to be confirmed. Finally, a protective effect of a contraceptive composition is yet to be demonstrated.

Breast Neoplasms↗
PubMed1991

[What is mastopathy at risk? Epidemiologic and clinical basis].

One out of 11 women is destined to develop breast cancer. All women should be "under observation". Does a "normal" breast really exist? A discharge from a single orifice could suggest a papillomatosis, a real borderline lesion, the adenofibroma practically never degenerates, the essential problem is that of the fibrocystic disease, (or mastosis) which was the object of a recent detailed analysis (W. Dupont and D. Page), pre-menstrual mastodynia does not seem to be a risk factor. On the other hand, certain dystrophic lesions constitute a high risk, such as atypical epithelial hyperplasia, especially if it is associated with a direct family history of breast cancer. Recent studies on mammary cysts insist on their hormone and electrolyte content, the presence of EGF, as well as that of certain proteins (GCDFP 15). They also insist on the local tissue enzymatic activities, the importance of myoepithelial cells and of fibroblasts. On a practical level, the attention is drawn on: cysts whose diameter exceeds 5 mm, certain histological lesions found during the biopsies. The value of mammography and thermography in the assessment of the high risk is discussed. Finally, the present well-established notions are recalled: the family history, late pregnancies, the diet, the weight, certain pathological associations, the endogenous hormonal balance bearing on E2/P and the blood prolactin level, the exogenous hormone intake.

Breast Neoplasms↗
PubMed1986

[Pregnancy after treated breast cancer. Results of a case-control study].

Sixty-eight cases of pregnancy after carcinoma of the breast were collected during a survey conducted by the Société Française de Gynécologie: 27 patients had one or several pregnancies interrupted at an early stage; 41 patients had at least one uninterrupted pregnancy. The fate of these patients was compared to that of 136 controls similar in all respects, except for the absence of post-cancer pregnancy. There was no significant difference in survival curves: the 10-year survival rate in our 68 patients was 71% (90% in those with N- cancer; 71% in those with N+ cancer, with no significant difference between cases and controls in each group). The patients whose pregnancies were interrupted had the same prognosis as those who delivered at term. The survival of 14 patients who conceived within 6 months of the breast cancer treatment was not significantly different from that of the corresponding controls. Pregnancy after breast cancer does not seem to alter the prognosis of the disease. In women with good prognosis cancer, the survival rate is excellent whatever the delay between cancer and pregnancy, and women should not be discouraged from having children; in women with poor prognosis cancer (N+), the outcome is not modified by pregnancy, and it remains lethal in about 50% of cases.

Adult↗
PubMed1985

[Treatment of the menopause: estrogens and breast cancer].

The responsibility of oestrogens in the aetiology and development of cancer of the breast is critically discussed. There are in fact perfectly contradictory theoretical and clinical arguments. The work of epidemiologists and biologists results in no less heterogeneous results. It is possible that oestrogens may be incapable of inducing the development of cancer of the breast, but it is very probable that the oestrogens are capable of accelerating the development of a quiescent tumour of small volume. The lesion is clinically and radiologically undetectable.

Breast Neoplasms↗
PubMed1984

[Cancer of the breast. Influence of hormonal contraception].

Whether or not oral contraception encourages the development of breast cancer is a much debated problem. The large number or parameters involved makes evaluation extremely difficult. Several theoretical, experimental, clinical, epidemiological and biochemical data suggest that oestrogens may have a detrimental action on the breast, but none of these is very convincing , and there are even cases where oestrogens exert an unquestionably favourable effect on advanced breast cancer. Several progestogens have been accused of inducing malignant mammary nodules in several animal species, but the relevance of these findings to human breast cancers remains doubtful. Depending on dosage and time of administration, the same compound may have diametrically opposite effects on breast carcinogenesis. Pathological studies have shown no difference in breast cancer between users and non users of oral contraceptives. Retrospective and prospective statistical studies have cleared "the pill" of all suspicion, except perhaps in some women at "high risk" of breast cancer. The latest paper by Pike and al. suggests that breast cancer is more frequent in young women on oral contraceptives for more than 8 years and who did not bear children up to term before the age of 25. But this study is open to criticism on several grounds and has not been confirmed by other prospective studies. For the moment, therefore, no firm conclusion can be reached. But while the contra-indications of oral contraceptives must be strictly respected and their users carefully watched, it is equally important to reassure these women and prevent cancerophobia .

Adult↗