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Several recent papers have suggested the role of HRT in the development of breast cancers. From the data base of the Institut Curie we compared the clinical characteristics, histoprognosis factors and survival of a cohort of 6737 patients recorded between 1988 and 1999 in which 1482 declared having receive HRT for more than 6 months. Surgical procedure, locoregional recurrence, metastasis, disease free and global survival were compared bet the patient who received an HRT versus the patients who didn't receive this treatment Mammographic diagnosis was more frequent in the HRT group and the age at diagnosis was smaller (p < 10(-4)). Cancers diagnosed in the HRT group were smaller and had a more favourable biologic profile as well as there were more lobular carcinomas and the conservative treatment was more frequent (p < 10(-4)). Mean follow up was 97 months. Recurrence free survival was not different in the two groups but the metastasis free and global survival were better in the HRT group. HRT remained an independent prognostic factor in a multivariate analysis. In western countries the increasing incidence of breast cancer concerns pre as well as post menopausal women. HRT cannot be considered as the only responsible of this augmentation.

Aim: Evaluate bilateral reduction mammoplasty in the management of breast cancer in the lower quadrants., Patients and Methods: 60 patients were operated on between 1992 and 2003 mean age: 53 years (34-75) by a double team, oncologic and plastic, during the same operative procedure for a cancer in the lower quadrants (T1-2, N0-1a, M0). Radiation therapy was delivered in every patient with a boost in 30% of them., Results: Mean cancer size was 17,5 mm (5-20 m) with 10 N + patients. Mean weight of the lumpectomy was 220 g (80-900!). There was one local recurrence at three years. Cosmetic result was good in 75 % of the patients. Radiation side effects: fibrosis, induration, telangiectasias and vicious cicatrisation on the contro-lateral breast were responsible of the middle quality results., Conclusion: Bilateral reduction mammoplasty is a good technique for the management of cancers in the lower quadrants. A double team, with a good logistic organisation, gives a good oncoplastic result.

Sentinel node identification has gained its place in early breast cancer surgical management before the results of prospective randomized trials. Published results can be explained by teams configurations and technical aspects can create some confusion in results analysis. Logistic aspects confers a specificity for each team. Sentinel node technique should be reserved to experienced treatment center where it can be utilized routinely., (Copyright John Libbey Eurotext 2003.)