Is hysterosalpingo-foam sonography (HyFoSy) more tolerable in terms of pain and anxiety than hysterosalpingography (HSG)? A prospective real-world setting multicentre study.

BACKGROUND: In 60% of sterile couples a female factor is present, with these being tubal factors in 30-50% of cases. A tubal patency test is also required in women without a male partner undergoing fertility treatment. Thus, an accurate, safe and tolerable technique should be available. The aim of this study is to determine and to compare hysterosalpingo-foam sonography (HyFoSy) and hysterosalpingography (HSG) tolerability in terms of pain and anxiety. METHODS: This is a prospective real-world setting multicentre study conducted in two tertiary hospitals in Madrid. 210 infertile women/women without a male partner looking to get pregnant were recruited; 111 for the HyFoSy group and 99 for the HSG group. Tolerability was measured in terms of anxiety by the State Trait Anxiety Inventory (STAI) and pain by the Visual Analogue Scale (VAS). RESULTS: Median VAS score in HyFoSy group was 2 (P25; P75: 1; 3) versus 5 (4; 8) in HSG group, p < 0.001. The median State-STAI score in the HSG group was 18 points (10; 26) versus 10 (7; 16) in the HyFoSy group (p < 0.001); the median Trait-STAI score in the HSG group was 15 (11; 21) versus 13 (9; 17) in the HyFoSy group (p = 0.044). CONCLUSIONS: HyFoSy shows higher tolerability to both: pain and anxiety. It is related to less pain and less post-test anxiety than HSG.

Cribado radiológico de cáncer de mama en mujeres con alto riesgo / Radiological screening of breast cancer in women at high risk

Se han identificado numerosos factores de riesgo relacionados con el desarrollo del cáncer de mama. Las mujeres con alto riesgo deben someterse a un estudio intensificado para la detección precoz de lesiones sospechosas. Sin embargo, la definición de población de alto riesgo ha sufrido modificaciones durante las últimas décadas, apuntando actualmente a los antecedentes personales y familiares, basados en modelos predictivos, y a la herencia, valorada a través de un estudio genético, como los principales factores a tener en cuenta a la hora de seleccionar a las mujeres con mayor riesgo para efectuar el cribado. Así mismo, los protocolos en cuanto al tipo de estudios de imagen y la periodicidad de estos a la hora de realizar el cribado se están homogenizando, implementando el examen de resonancia magnética anual a partir de los 30 años en la mayoría de las recomendaciones. Esta actualización intenta resumir las recomendaciones de las principales sociedades científicas a nivel internacional, en cuanto a la selección de las mujeres con alto riesgo y las exploraciones radiológicas que deben realizarse para efectuar un seguimiento individualizado. (AU)

Numerous risk factors have been identified for the development of breast cancer. High-risk women should participate in an intensified study for the early detection of suspicious lesions. However, the definition of the high-risk population has changed in recent decades. Currently, the main factors to consider in the selection of women at highest risk of developing breast cancer are personal and family history, based on predictive models, and inheritance, evaluated through genetic study. Similarly, protocols for the imaging technique and their timing are being standardised, with the most widely made recommendation being the use of annual magnetic resonance imaging from the age of 30 years. This update attempts to summarise the recommendations of the main international scientific societies for the selection of high-risk women and the radiological examinations that should be performed to establish an individualised follow-up. (AU)