[Relevance of the sentinel lymph node biopsy in breast multifocal and multicentric cancer]. / Pertinence de la procédure du ganglion sentinelle dans les cancers du sein multifocaux et multicentriques.

OBJECTIVES: The sentinel lymph node biopsy is a gold standard in the management of breast cancer. Its role in multifocal or multicentric tumors is still evolving. The aim of this study is to assess the feasibility and pertinence of sentinel lymph node biopsy in multifocal and multicentric tumors based on a systematic review of literature. METHODS: A systematic review was conducted searching in the following electronic databases PubMed using "sentinel lymph node biopsy", "breast cancer", "multifocal tumor", "multicentric tumor" and "multiple tumor" as keywords. We included original articles published between 2000 and 2014, both French and English, studying feasibility of sentinel lymph node biopsy in invasive breast cancer, multicentric and/or multifocal tumors. The first end point was success rate and false negative rate. RESULTS: Twenty-six articles were included in this literature review, with 2212 cases (782 multifocal, 737 multicentric and 693 multiple tumors). Percentage of tumors whose stage was higher than stage T2 ranged from 0 to 86.3%. Success rate average was 83.1%. False negative average was 8.2%. False negative rate was less than 10% in 15 articles. Mean of sentinel lymph node biopsy was 2 (1-9). The average rate of sentinel lymph node positive was 50.6%. Axillary recurrence rate was 0.5%. CONCLUSION: Despite the methodological biases of the studies included in this review of literature, the false negative rate of sentinel node biopsy in multifocal and multicentric breast cancers are less than 10% with a low rate of axillary recurrence. Despite the lack of randomized study, this procedure can be routinely performed in accordance with rigorous technical process.

[Locoregional surgery for stage IV breast cancer patients]. / Place du traitement chirurgical locorégional chez les patientes présentant un cancer du sein métastatique d'emblée.

Three to 6% of women newly diagnosed with breast cancers have stage IV disease. Overall survival was improved during the last few years (16-45 months). The treatment of stage IV breast cancer has traditionally been palliative with surgical resection reserved for symptomatic wound complications. Since 2000, several retrospective studies have compared surgery versus no local therapy in women presenting with stage IV breast cancer with an intact primary tumor. All showed a survival advantage for the surgical cohort. However, these studies are limited by the fact that it is not possible to control for biases that led to surgical resection of the primary tumor. Several prospective randomized trials have been undertaken. We have partial results for two of them and they show no survival differences between patients who benefit from local surgery and patients who did not have surgery. However, breast surgery is at low risk of complication, if not considering psychological aspect of mastectomy, and can be proposed to patients with no progression after first chemotherapy. Conservative management can be an option, but surgery must be optimal with negative margins. No benefit of axillary surgery has been shown but this treatment can lead to complications and impact quality of life of patients. Therefore, axillary node resection is not recommended for stage IV breast cancer. Finally, radiotherapy can be an alternative option of local therapy associated or no to surgery in stage IV breast cancer.

Exploration of the cytotoxic effects of an insecticide, lambda cyhalothrine, on sexual exocrine function in the white rat.

Many xenobiotiques (solvents, pesticides, metals heavy.....) are suspected to be responsible for the fall of the male and female fertility. The purpose of this work is to study the insecticide impact, Lambda-cyhalothrine, managed by oral way during 7 days on the rat testicles histology. Wistar rats were given distilled water (controls) or containing 15,383 mg/kg or 23,075 mg/kg of Lambda-cyhalothrine. The exposure to this insecticide induced an increase in the diameters of the seminiferous tubes. The histological of the seminiferous tubes revealed deteriorations of the germinatif epithelium: blocking of the spermatogenesis, presence of the apoptotic cells and absence of the spermatozoids in certain lumens. All these histological alterations constitute a signs of cytotoxicity of Lambda-cyhalothrine on the male fertility in the Wistar rat.

The toxicological effects of the herbicide 2,4-DCPA on progesterone levels and mortality in Wistar female rats.

The effect of the ester butylglucol of 2,4-Dichlorophenoxyacetic acid (herbicide) on the rate of fertilization and on progesterone levels during gestation in rats, has been studied. The experiments consisted of four groups; one receiving the drug in the drinking water at a concentration of 125 mg/kg/day (the agriculture dose), the second and the third group received per os doses of 50 and 100 mg/kg/day of the herbicide, while the fourth group served as controls. The obtained results show that all treatments lead to a decrease in both indexes of females' fertility and in that of newborn mortality. On the other hand, the index of fertilization has been highly affected by the drug application, with a clear delay in fertilization in animals treated with 100 mg/kg/day and 125 mg/kg/day. Progesterone levels have also been suppressed in individuals receiving the herbicide at 50 and 125 mg/kg/day.