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Abstract: Mammographic density is a risk factor for breast cancer and it reflects variations in the tissue composition of the breast. It is notably influenced by body mass index and by endogenous hormones as well as hormone replacement therapy (HRT). The pathways that are responsible for the increase in mammographic density following exposure to hormones and those that increase risk of breast cancer are probably not the same. Careful clinical and mammographic follow-up is appropriate in women undergoing HRT because an increase in density is not only a risk factor for breast cancer but it also reduces screening sensitivity. We present a case in which mammographic density decreased after menopause, then dramatically increased after HRT and finally, surgical biopsy allowed the diagnosis of an infiltrative breast carcinoma. We discuss appropriate HRT changes in case of increasing mammographic density. [Copyright &y& Elsevier]

The results from pilot experiments and breast cancer screening programmes have shown that it was possible to obtain a similar efficiency using a procedure adapted to our health system. The objective of the new protocol is to have an increasing homogeneity in medical breast care practice, extending the breast cancer screening to the whole of France. This protocol has kept some bases from the previous ones: a decentralised system based on private and public existing structures, quality assurance, training and evaluation. Changes concern the role of the radiologist who adds clinical examination to the two mammographic incidences and is allowed to perform complementary examination in the same session, in the case of a positive test. This experience which does not exist anywhere else will be certainly of interest for european countries with a liberal medical activity. We hope to obtain favourable results without excessive costs. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Identification of women who survived infiltrative breast cancer and subsequently conceived and determination of the rate of pregnancy, the time from diagnosis to pregnancy, the outcome of breast cancer and of subsequent pregnancies. Patients and methods: Women treated for breast cancer at the Gynaecology and Obstetrics Unit of the University Hospital of Strasbourg between 1993 and 2007 who subsequently conceived were prospectively registered and followed yearly. Results: Twenty pregnancies subsequent to surgery for breast carcinoma were observed in 598 patients. This association accounted for 3.3% of the cases of infiltrative breast carcinoma in potentially fertile women under 45. Six pregnancies were observed less than two years after breast cancer diagnosis (four abortions and two live births) and 17 pregnancies occurred after two years (three abortions, three miscarriages, one extra-uterine pregnancy and 10 live births). Two patients who developed distant metastases after pregnancy (less than one year and more than five years after diagnosis respectively) died. One patient, whose pregnancy occurred three years after the diagnosis, is still alive with a lung cancer and brain metastases. One patient was treated for local breast cancer recurrence. The overall prognosis was good, 18 patients (90%) being alive with a mean follow-up of 105 (S.D. 43) months. Discussion and conclusion: Pregnancy is more likely to occur in patients with a prolonged survival and no evidence of disease. Maternal prognosis is mainly related to initial stadification of breast cancer and not to its hormonodependence. [Copyright &y& Elsevier]