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International audience; Patients frequently ask about the cause of their breast cancer. To answer, physicians refer to breast cancer risk factors based on medical reports. We aim to assess these risk factors for the point of view of survivors, a point of view which seems to differ from that of medical references. We ran a survey with open- and closed-ended questionnaires on patients' opinions about risks factors both for women in general and for their own case. We also collected data on their sources of information on this subject. Most patients had no opinion. The most frequently cited risk factors were stress, then genetic causes, and poor diet. Internet was the leading source of information for patients, followed by physicians and magazines. Our study highlights the mismatch between breast cancer risk factors as perceived by scientists and by survivors. Survivors tend to focus on non-controllable risk factors. Taking into account attribution theories of life events, an awareness of patient opinion may be valuable for psychological support of survivors, and it may be informative to record the way in which patients attribute causality for life events such as breast cancer and, more generally, all type of cancer.

Introduction: Lung cancer is the leading cause of cancer deaths in the United States and worldwide. Biomarker testing is critical to personalized therapy in lung adenocarcinoma and has been extensively investigated in whites and Asians. However, little information addresses the underlying genetic changes among Caribbean and African Caribbean patients. In this study, we identified targetable biomarkers in Caribbean patients with lung adenocarcinoma. Methods: DNA extracted from lung adenocarcinoma specimens collected from 157 patients in whom primary lung adenocarcinoma was diagnosed from 2013 to 2015 in the University Hospital of Martinique was tested for mutation of the epidermal growth factor receptor gene (EGFR), Kirsten rat sarcoma viral oncogene homolog gene (KRAS), B-Raf proto-oncogene, serine/threonine kinase gene (BRAF), phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha gene (PIK3CA), ROS proto-oncogene 1, receptor tyrosine kinase gene (ROS), and MMNG HOS Transforming gene (MET). Clinical characteristics of our patients have been retrospectively gathered and correlated with mutational status. Results: Mutations in EGFR were identified in 57 cases (36%). Women accounted for 68% of patients with mutations versus 38% of those without mutations (p < 0.001). Eighteen percent of patients with mutations were smokers versus 62% of patients without mutations (p < 0.001). Sex, smoking habit, and age were significantly associated with differences in mutational status in univariate analysis, and the difference remained statistically significant in multivariate analysis (p = 0.0411, p = 0.001, and p = 0.0483, respectively). After the analysis was restricted to patients born in the French West Indies, the mutation rates reached 41%. Conclusion: Patients in Martinique, and specifically those of African descent, show very high levels of EGFR mutation as opposed towhat can be found inmainland France or in African Americans. These findings may be ascribed to low tobacco consumption aswell as togenetic factors. Systematic screening in patients of African Caribbean origin should be prescribed.

A clinicopathologic study was conducted to assess the implication of HTLV-I infection, Strongyloides stercoralis (Ss) infection, and P53 overexpression in the development, response to treatment, and evolution of non-Hodgkin's lymphoma (NHL) in Martinique, French West Indies. Two groups of patients, with 22 and 41 participants with B-cell and T-cell lymphoma, respectively, were analyzed. HTLV-I antibodies were detected in 24 (59%) patients with T-cell lymphoma of whom 19 (46%) fulfilled diagnostic criteria of adult T-cell leukemia/lymphoma (ATLL). By comparison with other T-cell lymphomas, patients with ATLL were significantly younger (52 versus 63 years; p = .03), had a significantly higher incidence of hypercalcemia (60% versus 0%; p = .0001), a trend for higher incidence of digestive tract localization (21% versus 4%; p = .1) and significantly shorter median survival (6 versus 17 months; p = .03). Similar results were observed when all 24 HTLV-I-infected patients with T-cell lymphoma were compared with the 17 seronegative patients. Strongyloidiasis was diagnosed in 11 of 34 patients tested for Ss infection. All 4 Ss-infected (Ss-positive) ATLL patients treated with combination chemotherapy achieved complete remission (CR) versus only 2 of 7 Ss-negative ATLL patients (p = .04). In addition, survival of Ss-positive patients with ATLL was better than that of the uninfected patients: 27 versus 5 months, p = .04, respectively). P53 expression was assessed by immunohistochemistry on lymph node biopsies from 37 patients including 18 B-cell lymphomas, 14 ATLL, and 5 other T-cell lymphomas. P53 overexpression (P53-positive) was observed in 6 samples that corresponded in all 6 patients with ATLL. All P53-positive ATLL patients had stage IV disease with elevated lactate dehydrogenase (LDH) levels. By comparison with other ATLL patients studied for p53 expression, P53-positive ATLL were characterized by a lower response rate to combination chemotherapy (CR: 0 of 6 versus 4 of 6; p = .04) and a shorter survival (2 versus 9 months, p = .04). Our results suggest that ATLL represents almost 50% of T-cell lymphomas in Martinique; Ss infection during ATLL seems to be linked with a high response rate to chemotherapy and prolonged survival; and P53 overexpression is observed in almost 50% of aggressive ATLL from Martinique and, even in advanced clinical subtypes, is associated with resistance to chemotherapy and short-term survival.

Introduction En Martinique, le cancer du poumon, bien que 5 e cause de cancer chez l’homme et 6 e chez la femme, reste respectivement la 2 e et 3 e cause de deces par cancer [1] . L’avenement des inhibiteurs de la tyrosine kinase a permis une amelioration de la survie des patients mutes EGFR [1] . Cette mutation est retrouvee chez 10,5 % des patients presentant un carcinome non a petites cellules non epidermoides. Nous avons recherche dans cette etude la frequence des mutations EGFR, dans les adenocarcinomes pulmonaires des patients diagnostiques en Martinique, population essentiellement afro-caribeenne peu tabagique, jusqu’ici non etudiee. Methodes Analyse retrospective des mutations EGFR retrouvees dans les carcinomes bronchiques non a petites cellules, non epidermoides, diagnostiques au CHU de Martinique entre janvier 2013 et mai 2015. Cette etude concerne les patients ayant beneficie d’une recherche de mutation theranostique. Resultats Quatre-vingt-onze cas d’adenocarcinome pulmonaire ont ete diagnostiques pendant cette periode et ont beneficie de la recherche de mutation EGFR. Trente-cinq (38 %) patients etaient porteurs d’une mutation de l’EGFR, contre 49 patients indemnes et 7 dont les prelevements n’etaient pas contributifs. Parmi les tumeurs mutees, 20 presentaient une deletion sur l’exon 19 et 11 autres presentaient une mutation ponctuelle l858r de l’exon 21. Soixante-deux pour cent des patients mutes etaient des femmes contre 33 % dans le groupe non mute ( p = 0,006). Il n’y a pas de difference d’âge entre les 2 groupes ( p > 0,05). Conclusion Notre population, principalement antillaise, presente, en particulier chez les femmes, un taux de mutation EGFR tres superieur a celui releve usuellement chez les caucasiens. Ces patients doivent beneficier d’une therapie ciblee par inhibiteurs de tyrosine kinase. Il importe de poursuivre l’analyse des facteurs cliniques associes a la mutation.