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Purpose of the research The main aim was to assess the effects of a spa treatment on the resumption of occupational and non-occupational activities and the abilities of women in breast cancer remission. A cost-effectiveness analysis (CEA) was also performed. Methods and sample A multicentre randomised controlled trial was carried out between 2008 and 2010 in the University Hospital of Auvergne and two private hospitals in Clermont-Ferrand, France. Eligible patients were women in complete breast cancer remission without contraindication for physical activities or cognitive disorders and a body mass index between 18.5 and 40 kg/m 2 . The intervention group underwent spa treatment combined with consultation with dietician whereas the control underwent consultations with the dietician only. Of the 181 patients randomised, 92 and 89 were included in the intervention and the control groups, respectively. The CEA involved 90 patients, 42 from the intervention group and 48 from the control group. Key results The main results showed a higher rate of resumption of occupational activities in the intervention group ( p = 0.0025) and a positive effect of the intervention on the women's ability to perform occupational activities 12 months after the beginning of the study ( p = 0.0014), and on their ability to perform family activities ( p = 0.033). The stay in a thermal centre was cost-effective at 12 months. Conclusions Spa treatment is a cost-effective strategy to improve resumption of occupational and non-occupational activities and the abilities of women in breast cancer remission.

International audience; BACKGROUND: Adipocytes in femoral areas are known to be metabolically 'silent'. Changes related to fat cell hypertrophy may be involved in the formation of cellulite. A mechanical massage technique, with circulatory and dermotrophic properties, has been shown to have an impact on clinical evaluations (i.e. changes in morphometric measurements) in cellulite areas. Whether this technique affected lipolytic responsiveness in subcutaneous adipose tissue of cellulite areas was not known. OBJECTIVE: Using a microdialysis technique in subcutaneous adipose tissue, a study was carried out to test the in situ incidence of a mechanical massage technique in terms of adipose tissue responsiveness to a lipolytic challenge. MATERIALS AND METHODS: Nine healthy women volunteers with cellulite (grade > or = 2) were included and treated with 12 sessions of mechanical massage technique (Endermologie). Microdialysis has been carried out in the femoral adipose tissue in order to assess lipolytic responsiveness via glycerol determination following perfusion of a lipolytic agent (0.1, 1 and 10 microm isoproterenol). Clinical evaluations (measurements of waist, thighs and skin fold) were carried out in parallel. All evaluations were performed before and after treatment. RESULTS: The studied intervention lowered resting dialysate glycerol levels in femoral adipose tissue. The lipid-mobilizing effect of isoproterenol was enhanced after 1 month of treatment. In addition, a clear decrease of morphometric measurements (mean decrease on thighs perimeter: 3.1 to 3.3 cm, P < 0.01) was observed. CONCLUSION: These results suggest an increase in the lipolytic responsiveness of femoral adipose tissue in women with cellulite having undergone 12 sessions of mechanical massage.