I063 VULVAR PATHOLOGY IN CHILDHOOD

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<ul><li><p>S176 Invited presentations and presentations by organisations and societies / International Journal of Gynecology &amp; Obstetrics 119S3 (2012) S161S260</p><p>medical instructions, technique protocols). In the meantime,</p><p>the continents scientic societies should issue clear and strict</p><p>guidelines in this area. Additionally, the accreditations of</p><p>ultrasound practitioners may be a prerequisite.</p><p> A health system should be implemented that allows ultrasoundsto be extended to rural areas, and at the same time their excessive</p><p>use in certain urban communities should be curtailed.</p><p>I061</p><p>IMPACT OF REPRODUCTIVE GENETIC TESTS ON LOW-RESOURCE</p><p>COUNTRIES</p><p>E. Castelazo Morales</p><p>The impact of reproductive genetic testing in women of</p><p>underdeveloped countries is not known, because it is not available</p><p>to the greater part of the population. Despite wide historical,</p><p>political, social and ethno-cultural differences among the people</p><p>in developing countries, it is expected that the judicious use of</p><p>reproductive genetic testing will be possible when other aspects</p><p>of health and quality of life are resolved, in addition it is also</p><p>anticipated that for the majority of the population, reproductive</p><p>genetic tests constitute an accepted way to prevent suffering and</p><p>death as a result of genetic diseases. The incorporation of these</p><p>techniques must always bear in mind the rights of individuals to</p><p>make their own decisions regarding reproduction with complete</p><p>and adequate respect for human dignity.</p><p>On the basis of what has been commented, the importance is</p><p>manifest of what all these scientic breakthroughs and progress</p><p>mean for society and its traditional development. Today, respect</p><p>for dignity and self-determination of each individual are perceived</p><p>as values that awaken a special sensitivity in the social community</p><p>and that also reect from the legal vantage point. On the contrary,</p><p>being aware that the scientic discoveries in human genetics should</p><p>invite the entire community not just the actors, the scientists </p><p>to reect upon such important steps for humanity and then adopt</p><p>in consequence, within this framework, complete respect for the</p><p>individual and for timely policy, social and legal decisions.</p><p>I062</p><p>NEWS IN BREAST CANCER MEDICAL TREATMENTS</p><p>M. Castiglione. Breast Center and Oncogynecology, University</p><p>Hospital, Geneva, Switzerland</p><p>Breast cancer continues to be the most frequent malignancy in</p><p>Western women and its incidence is constantly increasing in most</p><p>of the European countries and in the US.</p><p>During the last few years knowledge on biology of tumor diseases</p><p>and also of breast cancer has performed tremendous steps allowing</p><p>for the understanding of some of the cellular pathways leading to</p><p>malignancy.</p><p>In breast cancer the discovery of the human epidermal growth</p><p>factor receptor (HER) family of receptors has allowed the</p><p>development of targeted treatments in patients with the subtype</p><p>of breast cancer showing these characteristics. Some drugs as</p><p>Trastuzumab and Lapatinib are already widely used in the adjuvant</p><p>setting as well as in the metastatic situation, whereas other drugs</p><p>are just ready to enter wide clinical use (Pertutumab, TDM1). Many</p><p>more are in different phases of clinical development.</p><p>Most breast cancers are hormone dependent but in the course of the</p><p>disease nearly all develop an endocrine resistance and some, despite</p><p>expression of hormone receptors, are primarily hormone-resistant.</p><p>Understanding the mechanism of resistance development is one of</p><p>the targets of research in breast cancer. Cross-talk between the es-</p><p>trogen receptor (ER) and the phosphoinositide-3-kinase (PI3K)/Akt/</p><p>mammalian target of rapamycin (mTOR) pathways is a mechanism</p><p>of resistance to endocrine therapy, and blockade of both pathways</p><p>enhances antitumor activity in preclinical models. Preclinically,</p><p>everolimus, an oral inhibitor of mTOR, has been shown to reverse</p><p>resistance to tamoxifen. Results from clinical trials using this</p><p>compound together with tamoxifen or aromasin will be presented.</p><p>Angiogenesis has been shown to be implicated in tumor growth.</p><p>Bevacizumab has been shown to have a certain activity in breast</p><p>cancer but at the price of high toxicity. New compounds targeting</p><p>this mechanism of tumor development are in the pipeline and will</p><p>also be discussed.</p><p>Great progress is ongoing in the understanding of cellular</p><p>mechanisms of malignancy and this knowledge should allow</p><p>pursuing the development of new treatments, more targeted and</p><p>possibly more effective and less toxic than the classical chemo- and</p><p>hormonal therapies for breast cancer.</p><p>I063</p><p>VULVAR PATHOLOGY IN CHILDHOOD</p><p>A. Caussade</p><p>The objective of this review is to remember the most common</p><p>vulvar disorders in children.</p><p>Many pediatricians and family practitioners often practice the</p><p>palpation of testes during examination of boys during the exam in</p><p>infancy, but it is different, with the vulvar exam in girls. Sometimes</p><p>little girls just could be examined when they grow, and go to the</p><p>gynecologist during the rst pelvis exam. This practice, precludes</p><p>an early detection in vulvar problems.</p><p>Pruritus and itching, is the most common symptom in little children</p><p>and frequently manifest important diseases that could be early</p><p>treated.</p><p>We will review, the most common vulvar disorders, including</p><p>vulvovaginitis, dermatitis, lichen sclerosus, labial adhesions, and</p><p>other common problems. The etiology and treatments can be very</p><p>different in children, so the dosage and their management, are</p><p>different and therefore, very important.</p><p>I064</p><p>MENSTRUAL PROBLEMS IN ADOLESCENTS AND IMPROVING</p><p>QUALITY OF LIFE: THE PANASIAN EXPERIENCE</p><p>S.S.C. Chan</p><p>Menarche represents a developmental milestone of puberty in girls.</p><p>While some regard menarche and menstruation as natural, some</p><p>do not and may even have negative feelings on them. Cultural belief</p><p>and education plays a role on it.</p><p>Menstrual disorders are the most common gynecological problem</p><p>of adolescents. The reported prevalence of dysmenorrhea was</p><p>6090%, abnormal menstrual cycle length was 6090% in rst year</p><p>of menstruation and in 1015% persists for 3 to 5 years; and men-</p><p>orrhagia was 1020% in different Asian populations. The prevalence</p><p>of different menstrual disorders is similar to the ndings in many</p><p>other regions of the world. Some important causes of amenorrhea</p><p>or oligomenorrhea include polycystic ovarian syndrome, excessive</p><p>stress and weight loss, eating disorder and premature ovarian</p><p>failure; apart from certain types of congenital genital tract anomaly</p><p>for primary amenorrhea. Most of the dysmenorrhea is primary</p><p>dysmenorrhea, but some suffer from endometriosis or pelvic</p><p>infection. While menorrhagia is mostly due to dysfunctional uterine</p><p>bleeding, bleeding disorders have to be ruled out.</p><p>Although menstrual disorders are so common, only 615% of</p><p>adolescents seek medical advice; despite their daily activities,</p><p>school attendance, concentration at school and quality of life</p><p>are being affected. Obstacles in health-seeking include inadequate</p><p>knowledge on menstruation, anxiety about embarrassing questions,</p><p>and opinion of family member.</p><p>Education to adolescent girls on managing menstrual symptoms</p><p>and the benet of available effective treatment may improve their</p><p>quality of life. And education should also be extended to parents</p><p>and school peer leaders.</p></li></ul>