[Predictive factors of concordance (5mm threshold) between MRI and histological sizes of invasive lobular breast cancer]. / Facteurs prédictifs de concordance (seuil 5mm) entre les tailles mesurées à l'IRM mammaire et les tailles histologiques dans les cancers infiltrants du sein de type lobulaire.

OBJECTIVE: The aim of this study was to search for predictive factors of concordance between MRI and histological sizes for invasive lobular breast cancer. MATERIAL AND METHODS: All women managed for an invasive lobular breast cancer (pure or associated to a component of invasive ductal carcinoma) between 1st january 2007 and 31th december 2016 were included to the study. Univariable and multivariable analysis were performed to determine clinical or histological predictive factors of concordance between MRI and histological sizes for invasive lobular breast cancer (threshold 5mm). RESULTS: During the study period 384 women were managed in our center for an invasive lobular carcinoma. We had access to the breast MRI of 246 of them. For a concordance witha threshold of 5mm, significant factors in univariate analysis were: menopausal status (OR 1.93[1.01-3.71], P=0.04), histological size (OR 0.97 [0.96-0.99], P<0.0001), lthe size of associated in situ component (OR 0.74 [0.32-1.71], P=0.01), multifocality (OR 0.56 [0.33-0.95] P=0.03) and the histological isolated invasive lobular carcinoma versus mixed ((OR 2.64 [1.01-6.91], P=0.03). In multivariate analysis, menopausal status, histological size and the histological isolated invasive lobular carcinoma versus mixed, were considered as independent predictive factors. CONCLUSION: This work identified independent predictive factors of concordance between MRI and histological sizes for invasive lobular breast cancer (threshold 5mm).

[Robotic surgery program in gynecology: Lessons from the first 100 procedures]. / Implantation d'un programme de chirurgie robotique gynécologique : leçons à retenir des 100 premières procédures.

INTRODUCTION: The objective of this work is to report the first 6 months of a robotic program in a surgical gynecological team, trained in advanced laparoscopy, in terms of operating times, complication rate, analgesic consumption and average duration of hospitalization. METHODS: This is a prospective observational study, intended to treat. RESULTS: During the study period, 98 women underwent laparoscopic robot assisted surgery. The average BMI was 27.2kg/m2 (±7). Malignant diseases accounted for 41% of operative indications. Comparing the first 30 procedures to the last 30 procedures, there is a significant decrease in docking times: 14.7min (±7.0) vs 8.9min (±5.0), P=0.009. There is also a trend towards a decrease in operative times for hysterectomy: 151.9min (±56.2) vs 113min (±51.4), P=0.08. The rates of complications were not significantly different at the beginning and end of inclusion during the study (10.0% vs 16.7%). CONCLUSION: The implementation of a robotic surgery program in a gynecological surgery department does not lead to an increase in complications for the patients, including for the first procedures. The learning curve mainly allows a reduction in the robot's installation time.