S176 Invited presentations and presentations by organisations and societies / International Journal of Gynecology & Obstetrics 119S3 (2012) S161–S260

medical instructions, technique protocols). In the meantime,

the continent’s scientific societies should issue clear and strict

guidelines in this area. Additionally, the accreditations of

ultrasound practitioners may be a prerequisite.

• A health system should be implemented that allows ultrasounds

to be extended to rural areas, and at the same time their excessive

use in certain urban communities should be curtailed.

I061

IMPACT OF REPRODUCTIVE GENETIC TESTS ON LOW-RESOURCE

COUNTRIES

E. Castelazo Morales

The impact of reproductive genetic testing in women of

underdeveloped countries is not known, because it is not available

to the greater part of the population. Despite wide historical,

political, social and ethno-cultural differences among the people

in developing countries, it is expected that the judicious use of

reproductive genetic testing will be possible when other aspects

of health and quality of life are resolved, in addition it is also

anticipated that for the majority of the population, reproductive

genetic tests constitute an accepted way to prevent suffering and

death as a result of genetic diseases. The incorporation of these

techniques must always bear in mind the rights of individuals to

make their own decisions regarding reproduction with complete

and adequate respect for human dignity.

On the basis of what has been commented, the importance is

manifest of what all these scientific breakthroughs and progress

mean for society and its traditional development. Today, respect

for dignity and self-determination of each individual are perceived

as values that awaken a special sensitivity in the social community

and that also reflect from the legal vantage point. On the contrary,

being aware that the scientific discoveries in human genetics should

invite the entire community – not just the actors, the scientists –

to reflect upon such important steps for humanity and then adopt

in consequence, within this framework, complete respect for the

individual and for timely policy, social and legal decisions.

I062

NEWS IN BREAST CANCER MEDICAL TREATMENTS

M. Castiglione. Breast Center and Oncogynecology, University

Hospital, Geneva, Switzerland

Breast cancer continues to be the most frequent malignancy in

Western women and its incidence is constantly increasing in most

of the European countries and in the US.

During the last few years knowledge on biology of tumor diseases

and also of breast cancer has performed tremendous steps allowing

for the understanding of some of the cellular pathways leading to

malignancy.

In breast cancer the discovery of the human epidermal growth

factor receptor (HER) family of receptors has allowed the

development of targeted treatments in patients with the subtype

of breast cancer showing these characteristics. Some drugs as

Trastuzumab and Lapatinib are already widely used in the adjuvant

setting as well as in the metastatic situation, whereas other drugs

are just ready to enter wide clinical use (Pertutumab, TDM1). Many

more are in different phases of clinical development.

Most breast cancers are hormone dependent but in the course of the

disease nearly all develop an endocrine resistance and some, despite

expression of hormone receptors, are primarily hormone-resistant.

Understanding the mechanism of resistance development is one of

the targets of research in breast cancer. Cross-talk between the es-

trogen receptor (ER) and the phosphoinositide-3-kinase (PI3K)/Akt/

mammalian target of rapamycin (mTOR) pathways is a mechanism

of resistance to endocrine therapy, and blockade of both pathways

enhances antitumor activity in preclinical models. Preclinically,

everolimus, an oral inhibitor of mTOR, has been shown to reverse

resistance to tamoxifen. Results from clinical trials using this

compound together with tamoxifen or aromasin will be presented.

Angiogenesis has been shown to be implicated in tumor growth.

Bevacizumab has been shown to have a certain activity in breast

cancer but at the price of high toxicity. New compounds targeting

this mechanism of tumor development are in the pipeline and will

also be discussed.

Great progress is ongoing in the understanding of cellular

mechanisms of malignancy and this knowledge should allow

pursuing the development of new treatments, more targeted and

possibly more effective and less toxic than the classical chemo- and

hormonal therapies for breast cancer.

I063

VULVAR PATHOLOGY IN CHILDHOOD

A. Caussade

The objective of this review is to remember the most common

vulvar disorders in children.

Many pediatricians and family practitioners often practice the

palpation of testes during examination of boys during the exam in

infancy, but it is different, with the vulvar exam in girls. Sometimes

little girls just could be examined when they grow, and go to the

gynecologist during the first pelvis exam. This practice, precludes

an early detection in vulvar problems.

Pruritus and itching, is the most common symptom in little children

and frequently manifest important diseases that could be early

treated.

We will review, the most common vulvar disorders, including

vulvovaginitis, dermatitis, lichen sclerosus, labial adhesions, and

other common problems. The etiology and treatments can be very

different in children, so the dosage and their management, are

different and therefore, very important.

I064

MENSTRUAL PROBLEMS IN ADOLESCENTS AND IMPROVING

QUALITY OF LIFE: THE PANASIAN EXPERIENCE

S.S.C. Chan

Menarche represents a developmental milestone of puberty in girls.

While some regard menarche and menstruation as natural, some

do not and may even have negative feelings on them. Cultural belief

and education plays a role on it.

Menstrual disorders are the most common gynecological problem

of adolescents. The reported prevalence of dysmenorrhea was

60–90%, abnormal menstrual cycle length was 60–90% in first year

of menstruation and in 10–15% persists for 3 to 5 years; and men-

orrhagia was 10–20% in different Asian populations. The prevalence

of different menstrual disorders is similar to the findings in many

other regions of the world. Some important causes of amenorrhea

or oligomenorrhea include polycystic ovarian syndrome, excessive

stress and weight loss, eating disorder and premature ovarian

failure; apart from certain types of congenital genital tract anomaly

for primary amenorrhea. Most of the dysmenorrhea is primary

dysmenorrhea, but some suffer from endometriosis or pelvic

infection. While menorrhagia is mostly due to dysfunctional uterine

bleeding, bleeding disorders have to be ruled out.

Although menstrual disorders are so common, only 6–15% of

adolescents seek medical advice; despite their daily activities,

school attendance, concentration at school and quality of life

are being affected. Obstacles in health-seeking include inadequate

knowledge on menstruation, anxiety about embarrassing questions,

and opinion of family member.

Education to adolescent girls on managing menstrual symptoms

and the benefit of available effective treatment may improve their

quality of life. And education should also be extended to parents

and school peer leaders.