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Duflos C.,Paris West University Nanterre La Défense | Plu-Bureau G.,Unite de Gynecologie Endocrinienne | Thibaud E.,Unite de Gynecologie Pediatrique | Kuttenn F.,Paris West University Nanterre La Défense
Endocrine Development | Year: 2012

Fibroadenomas and breast growth disorders are the most common breast diseases in adolescent women. Assessment of breast disorders in this age group generally involves clinical evaluation through history and physical examination and when is needed ultrasonography. Due to the absence of breast cancer in adolescent women, it is easy to reassure women at the first consultation. Breast growth disorders can lead great psychological and physical embarrassment. Treatment consists of surgical procedures when the cosmetic defect is severe. According to the ANDI classification, small fibroadenomas are normal, clinical fibroadenomas are a mild aberration of the normal processes, and giant or multiple fibroadenomas are placed to the disease end of the spectrum. Fibroadenomas can be treated conservatively provided diagnosis is confident. Giant fibroadenomas are treated by surgical enucleation. Breast abscess is mainly due to the duct ectasia. In adolescence, ectasia has been described as an exaggeration of sinus duct development and can be considered as a variant of normality. Diseases of the adolescent breast are usually benign and their management are simple using medical strategy and more rarely surgical therapy. Copyright © 2012 S. Karger AG, Basel.


Plu-Bureau G.,Unite de Gynecologie Endocrinienne | Plu-Bureau G.,University of Paris Descartes
Revue du Praticien | Year: 2010

Estrogens are still the main option for the treatment of climacteric symptoms, especially hot flashes. Their effectiveness is also demonstrated in the prevention of osteoporosis. If the results of the Women's Health Initiative showing an unfavorable risk/benefit balance of hormone replacement therapy with long-term use, the recent results of epidemiological studies analyzing transdermal estrogenotherapy suggest a best tolerance. Regarding venous thrombosis risk, many biological and epidemiological data suggest a safe tolerance of transdermal estrogens use. On the contrary, the risk of breast cancer and arterial does not appear to be modified by the route of administration of estrogens. Recent studies on colorectal cancer risks seem quite favorable to the transdermal route. These data are fundamental to assess the short term risk-benefit balance that appears on the current available data favorable to the transdermal route of administration.


Gompel A.,Unite de Gynecologie Endocrinienne
Climacteric | Year: 2012

It is well established that progestogens protect the endometrium against the proliferative effects of estrogens in postmenopausal women receiving hormone replacement therapy (HRT). Therefore, micronized progesterone and progestogens are recommended as part of combined HRT in women with an intact uterus. The protective effect of progestogens against hyperplasia and endometrial cancer does not appear to differ with different progestogens (micronized progesterone or progestogens), but appears to be affected by the regimen and thus the dose, with continuous combined treatment conferring better protection. However, the protective effect of progestogens seen in the endometrium is not replicated in the breast. Progestogens combined with estrogens are generally associated with a small increase in the risk of invasive breast cancer, which is believed to be due to a promoter effect. However, all progestogens are not equivalent in their effects on the breast and breast cancer risk. Micronized progesterone does not increase cell proliferation in breast tissue in postmenopausal women compared with synthetic medroxyprogesterone acetate (MPA). Experimental evidence suggests that the opposing effects of MPA and micronized progesterone on breast tissue are related to the non-specific effects of MPA, including glucocorticoid activity and differences in the regulation of gene expression. Therefore, for women with an intact uterus, micronized progesterone may be the optimal choice as part of combined HRT. © 2012 International Menopause Society.


PubMed | Unite de Gynecologie Endocrinienne
Type: | Journal: Climacteric : the journal of the International Menopause Society | Year: 2012

It is well established that progestogens protect the endometrium against the proliferative effects of estrogens in postmenopausal women receiving hormone replacement therapy (HRT). Therefore, micronized progesterone and progestogens are recommended as part of combined HRT in women with an intact uterus. The protective effect of progestogens against hyperplasia and endometrial cancer does not appear to differ with different progestogens (micronized progesterone or progestogens), but appears to be affected by the regimen and thus the dose, with continuous combined treatment conferring better protection. However, the protective effect of progestogens seen in the endometrium is not replicated in the breast. Progestogens combined with estrogens are generally associated with a small increase in the risk of invasive breast cancer, which is believed to be due to a promoter effect. However, all progestogens are not equivalent in their effects on the breast and breast cancer risk. Micronized progesterone does not increase cell proliferation in breast tissue in postmenopausal women compared with synthetic medroxyprogesterone acetate (MPA). Experimental evidence suggests that the opposing effects of MPA and micronized progesterone on breast tissue are related to the non-specific effects of MPA, including glucocorticoid activity and differences in the regulation of gene expression. Therefore, for women with an intact uterus, micronized progesterone may be the optimal choice as part of combined HRT.


PubMed | Unite de gynecologie endocrinienne
Type: Journal Article | Journal: La Revue du praticien | Year: 2010

Estrogens are still the main option for the treatment of climacteric symptoms, especially hot flashes. Their effectiveness is also demonstrated in the prevention of osteoporosis. If the results of the Womens Health Initiative showing an unfavorable risk/benefit balance of hormone replacement therapy with long-term use, the recent results of epidemiological studies analyzing transdermal estrogenotherapy suggest a best tolerance. Regarding venous thrombosis risk, many biological and epidemiological data suggest a safe tolerance of transdermal estrogens use. On the contrary, the risk of breast cancer and arterial does not appear to be modified by the route of administration of estrogens. Recent studies on colorectal cancer risks seem quite favorable to the transdermal route. These data are fundamental to assess the short-term risk-benefit balance that appears on the current available data favorable to the transdermal route of administration.

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