Дисертації з теми "Cancer du sein – Études longitudinales"
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Ruiz, de Azua Unzurrunzaga Garazi. "La vie professionnelle après un cancer du sein : le devenir des femmes après la reprise du travail." Electronic Thesis or Diss., Sorbonne université, 2023. https://accesdistant.sorbonne-universite.fr/login?url=https://theses-intra.sorbonne-universite.fr/2023SORUS577.pdf.
The number of women that survive breast cancer is increasing and it includes a high number of survivors that are at a working age. This emphasizes the significance of considering cancer and treatment effects on daily life and return to work. Work provides financial stability, independence, and mental health. Furthermore, it is important to stress the societal importance of work for cancer survivors, which has gained prominence in media coverage and political discussions. Cancer survivors, across various types, face challenges in maintaining stable employment after diagnosis. Although factors associated with return to work have been largely investigated, studies on what happens once survivors return to work are scarce. Using data from the CANTO cohort, a large and prospective cohort including women diagnosed with stage I-III breast cancer in metropolitan France, we were able to study the proportion of women in our cohort that reported discriminations from their employer after they had returned to work and the determinants associated, and the proportion of women in our cohort that worked continuously after they had returned to work and the factors associated. For the latter, we specified discontinuation as having periods of sick leave, unemployment, early retirement of disability after they had returned to work. In the first study included in this manuscript we found that 26% of breast cancer survivors included in the analysis (n=2130) reported perceived discrimination. The fully adjusted model revealed several significant associations. Reporting perceived discrimination was positively associated with the number of months worked in the past 12 months, having workplace accommodations, returning to work due to fear of losing their job if they did not, and negatively associated with working for a small company of less than 50 employees, working in the public sector, having a better overall quality of life. In the second part of this thesis, we found that among the 1811 included in the study that had already returned to work, 77% worked continuously three years after diagnosis. Multivariable analyses indicated that sick leave was mainly associated younger age, tumour characteristics , fatigue, and workplace accommodations influenced, while younger age , working for private or smaller companies, and having fixed-term contracts were associated with unemployment. The findings presented in this PhD thesis emphasize that returning to work should be seen as an ongoing process rather than a final goal. Breast cancer survivors and individuals recovering from other types of cancer should receive continuous support to ensure they are not subjected to discrimination and can maintain uninterrupted employment if they so desire. It is crucial to provide clear guidance and best practices for all parties involved, including cancer survivors, companies and occupational health therapists. However, it is noted that there is currently a shortage of substantial evidence to support these stakeholders, highlighting the need for further research in this area
Savard, Marie-Hélène. "Bouffées de chaleur et cancer de sein: Facteurs de risque et relation avec les perturbations du sommeil." Thesis, Université Laval, 2010. http://www.theses.ulaval.ca/2010/26867/26867.pdf.
Domaison, Sophie. "Étude longitudinale du fonctionnement des familles confrontées au cancer de la mère." Thesis, Toulouse 2, 2012. http://www.theses.fr/2012TOU20135.
Any serious illness occurring in a patient threatens and alters the balance of their family group. The objective of this study is to identify the impact of breast cancer on a mother's nuclear family, when young children are present, with the longitudinal assessment of family functioning, psychological distress and adaptation strategies, through the perspective of different members of the group: the sick mother, the father and child(ren).Method: 39 parents (23 mothers and 16 fathers) of children aged between 6 and 12 completed self-assessment questionnaires as well as 22 children participated in research interviews at four evaluation times: the first (T1), the third (T2) and fifth (T3) of the mother’s chemotherapy, and two months after the end of chemotherapy (T4).Results: Family functioning as perceived by the family’s members is typical and stable over time. Spouses perceive more difficulties within the family than the patients and the children. The temporal evolution of variables highlights the T3 as a respite for the nuclear family. Levels of psychological distress are not pathological, but are different depending on the member’s place in the family. Women are more distressed than their spouses and children, and have more use of coping strategies focused on problem solving and seeking social support. The level of depression, hostility and the use of coping strategies focused on emotion in mothers explain their perception of family functioning. By contrast, the psychological state and the mode of adaptation of spouses and children do not affect their perception of family functioning.Conclusion: These results show the importance of combining qualitative and quantitative longitudinal methodology to analyse the views of all members of the family and improve the understanding of their experiences with the disease of the mother
Ansquer, Yan. "Cancer du sein et gène BRCA1 : études cliniques et expérimentales." Paris 7, 2005. http://www.theses.fr/2005PA077001.
Hervouet, Séverine. "Le rôle de l'hormonothérapie dans le développement de la dépression chez les hommes atteints d'un cancer de la prostate : une étude longitudinale." Thesis, Université Laval, 2010. http://www.theses.ulaval.ca/2010/27107/27107.pdf.
Jabagi, Marie Joëlle. "Risque d'hémopathies malignes après cancer du sein : Études à partir des données du SNDS." Thesis, université Paris-Saclay, 2020. http://www.theses.fr/2020UPASS113.
An indirect consequence of the improved long-term survival seen in patients with breast cancer is the increased risk of hematologic malignant neoplasms. These treatment related complications although rare are very aggressive. This work focuses on the evaluation of the occurrence of different types of hematological malignancies after breast cancer in the context of current care, at the scale of the French population, using the French National Health databases. Overall, 439 704 women diagnosed with incident primary breast cancer between 2006 and 2015 were included in our studies. Results from the first study aiming to estimate the incidence of various types of hematologic malignant neoplasm in breast cancer survivors showed that acute myeloid leukemia, myelodysplastic syndrome, acute lymphoblastic leukemia and multiple myeloma occur more in breast cancer survivors compared to the general population. The second study aiming to analyze the role of postoperative treatment for breast cancer in the development of subsequent hematological malignancies reveals that breast cancer survivors who received chemotherapy at an early age were most likely to develop acute myeloid leukemia, myelodysplastic syndrome, and acute lymphoblastic leukemia. Patients who received radiation therapy were at higher risk of developing acute myeloid leukemia and lymphomas. The third study aiming to analyze the risk of these hematologic malignancies associated with the use of granulocyte colony-stimulating factors (G-CSFs) with chemotherapy for breast cancer showed that only the risk of acute lymphoblastic leukemia seems to increase with the use of hematopoietic growth factors. The work carried out within the framework of this thesis, using real-life data in the general population, aims to better inform the therapeutic decision, in particular for patients suffering from the disease at an early stage who have a low risk of recurrence and are treated with curative intent. Since the treatments are constantly evolving it is important to continue to monitor trends in the occurrence of hematological malignancies after cancer in the future
Martel, Lyne-Mélanie. "Dix ans d'évolution des rôles des directions des ressources humaines au sein de la fonction publique québécoise : impacts sur l'attraction et la rétention de la main d'œuvre." Master's thesis, Université Laval, 2011. http://hdl.handle.net/20.500.11794/22648.
Lozano-Magnetto, Sandrine. "Taxoïdes et cancer du sein : études des mécanismes de résistance et de potentialisation par les bisphosphonates." Lyon 1, 1999. http://www.theses.fr/1999LYO1T127.
Porro, Bertrand. "Identification des principaux freins et leviers du retour à l'emploi, dans l'année suivant le début des traitements de cancer du sein : quels apports des variables psychosociales ? Une étude longitudinale et prospective en psychologie de la santé." Thesis, Montpellier 3, 2017. http://www.theses.fr/2017MON30023/document.
Introduction : The breast cancer diagnosis, the symptoms and the side effects of the treatments, lead to multiple physical and psychological deficits that can have effects on the professional life. Indeed, with a median age of 63 years at the time of diagnosis, half of the women are still of working age. However, after the diagnosis, all women do not return to work. In order to explain this phenomenon, numerous studies have addressed the sociodemographic, occupational and medical determinants that impact the patients’ return to work ; but these factors alone are not sufficient to explain women's non-return to work. It appears that a number of psychosocial factors may also account for the return to work.Aims : The main objective of this study is to identify the main psychosocial determinants of the return to work of women with breast cancer during the year following the start of their adjuvant treatments. A secondary objective is to understand the impact of changes in these psychosocial determinants on the return to work.Method : We performed a longitudinal and prospective study of 68 patients with a mean age of 46.97 (SD = 6.92), employed at the time of diagnosis of breast cancer, recruited at the Montpellier Institut du Sein (MIS). The women were encountered during an initial measurement, by interindividual maintenance, at the beginning of adjuvant treatments (T0). Subsequently, they were followed by telephone at 3, 6 and 12 months after T0 (T1, T2 and T3, respectively). Socio-demographic, occupational and medical data, precariousness (EPICES score), neuroticism (Neo-PI r), quality of life (QLQ-C30), fatigue (MFI 20), post traumatic development social distress (SDI) and perceived social support (SSHSC) were assessed at T0. At T1, T2 and T3 we observed : being in a couple, providing or not supporting children's studies, collecting toxicities related to medical treatment and returning to work. At T2 and T3 we also assessed : quality of life, post-traumatic development, fatigue, social distress and perceived social support.Results : At T1, 50.0% of patients returned to work ; at T2, 60.7% were back to work ; at T3, 74.5% of them were back to work. Results of logistic regression analyzes indicate that a strong perception of negative support at T0, OR = 0.74 [0.56 - 0.97] and at T3, OR = 0.59 [0.39-0.90], a high sensation of physical fatigue at T3, OR = 0.55 [0.36 - 0.80] and high precariousness, OR = 0.94 [0.89 - 0.99] brake the return to work at T3. On the other hand, a good physical state at T0, OR = 1.17 [1.02 - 1.33] and a good cognitive state at T2, OR = 1.06 [1.01 - 1.11] are levers for returning to work at T3. Otherwise, we observed that overall good health, OR = 1.10 [1.001 - 1.20] and good cognitive status, OR = 1.08 [1.02 - 1.15] at T2, are levers for returning to work at the same time, while an increase in mental fatigue between T0 and T2 decreases the chances of returning to work at T2, OR = 0.13 [0.02 - 0.80]. Finally, the results of our study show that good overall health at T0 is a return to employment lever at T1, OR = 1.05 [1.01 - 1.10].Conclusion : Psychosocial determinants, including social support, precariousness, quality of life and fatigue, can play an important role in predicting the return to work of women with breast cancer. This confirms the interest of a multidisciplinary care of cancer and encourages the emergence of a theoretical model of the job retention, taking into account the socio-demographic, professional, medical, social, physical and psychological characteristics of the patients
Barberi-Heyob, Muriel. "Études biologiques et cliniques des anabolites du 5-fluorouracile et modulation par le dipyridamole." Nancy 1, 1993. http://www.theses.fr/1993NAN12442.
Antoni, Florent. "Conception & études de biodistribution de liposomes ciblant CD44 dans un modèle de cancer du sein." Thesis, Sorbonne Paris Cité, 2019. http://www.theses.fr/2019USPCC063.
This project aimed to study the in vivo biodistribution of liposomal nanoparticles targeting CD44, and particularly to evaluate the effect of the targeting agent (anti-CD44 aptamer grafted on the surface of liposomes) on their tumor accumulation. Fluorescent and radiolabeled anti-CD44 liposomes for Positron Emission Tomography imaging were designed. The method we developed has the advantage of being applicable to any type of liposomal nanoparticle, regardless of the targeting agent. The biodistribution results obtained in mice bearing CD44 overexpressing breast cancer xenografts showed that CD44-targeting liposomes had greater tumor accumulation than liposomes without a target antigen, and that this difference was related to the specific Aptamer-CD44 interaction. This confirms the interest of liposomes functionalized with the anti-CD44 aptamer as therapeutic agents (after loading in drugs) in tumor types overexpressing CD44. Finally, the nanoparticles that we have developed are good "companion imaging" agents, making it possible to verify by isotopic imaging the tumor accumulation of the therapeutic counterparts before their administration in patients
Hartmann, Anne. "Étude longitudinale de la qualité de vie et des stratégies d'ajustement des patientes avec un cancer du sein et de leur « accompagnant-référent »." Phd thesis, Université Rennes 2, 2007. http://tel.archives-ouvertes.fr/tel-00267588.
Villeneuve, Sara. "Professions, expositions professionnelles aux solvants et cancer du sein analyse de deux études épidémiologiques sur les cancers du sein chez l'homme et chez la femme." Phd thesis, Université Paris Sud - Paris XI, 2011. http://tel.archives-ouvertes.fr/tel-00639294.
Bayet-Robert, Mathilde. "Potentialisation de la chimiothérapie par docétaxel par la curcumine dans les cancers du sein métastatiques : études expérimentales et clinique." Clermont-Ferrand 1, 2009. http://www.theses.fr/2009CLF1PP06.
Chemotherapy is mainly used in metastatic breast cancer (MBC) treatment. Among chemotherapeutics, docetaxel is the most effective agent indicated as a first line monotherapy in MBC. However, as only 5% of complete responses are reported in treated patients and 30% of them would have metastatic relapse; efficacy of chemotherapy has to be improved. The aim of our work was to optimize therapy of MBC in expanding knowledge on the tumor cell response to docetaxel. The new approach nutritherapy consisting in the use of phytochemicals properties was applied to potentiate docetaxel chemotherapy. Curcumin was selected because of its pleiotropic effects, mostly in cancer cells. First, the metabolic variations of human MCF-- breast cancer cells were studied in response to docetaxel and curcumin separately, and to the combinaison of both agents. Metabolomic analysis using proton NMR based-spectroscopy was performed to generate hypotheses in order to characterize time-and dose-dependent phenotypic variations in response to each treatment. Second, a phase I clinical trial was conducted to evaluate feasibility and tolerability of docetaxel/curcumin association in MBC patients. Promising clinical data in terms of antitumor and anti-angiogenic efficacy led us to initiate a comparative phase II clinical trial in order to evaluate the efficacy of such combinaison
Joyeux, Christian. "Induction de l'acide gras synthétase par les progestatifs dans les cancers du sein en culture : mécanismes de régulation et premières études cliniques dans le sein et l'endomètre." Montpellier 2, 1989. http://www.theses.fr/1989MON20193.
Grelier, Gaël. "Dicer, Enzyme clef de l'interférence ARN : études de son intérêt dans les cancers du sein et implication dans la réponse au stress réplicatif." Lyon 1, 2008. http://www.theses.fr/2008LYO10290.
Breast cancers are the first cause of mortality in occidental women population. Breast tumours can show various forms which are frequently resistant to therapeutics and prone to late relapse. Thus, the current clinical challenge consists in refining individual therapeutics management by employing tools provided by the study of molecular basis of mammary tumorigenesis. Besides, chromosomal instability (CIN) is a hallmark of breast cancer and recent data showed that Dicer, a key ribonuclease of the RNA interference mechanism, could be a regulator of chromosomal stability in human cells. We thus hypothesized that alteration of this protein could be associated with mammary tumorigenesis. In order to test this hypothesis, we assessed dicer transcription and expression in breast cancer cell lines and tissues corresponding to different phases of tumor progression. We further investigated the consequences of dicer knock-down on cell cycle and response to replicative stress. Our results show that dicer expression has an independent prognostic value for metastatic relapse prediction and is correlated with hormonal receptors expression. Furthermore, cells harbouring dicer inactivation presented defects in cell cycle and DNA breaks response pathways. Altogether, our data indicate that dicer inactivation could favour CIN during mammary tumorigenesis and this feature could represent a useful tool in breast cancer management
Lemamy, Guy-Joseph. "Le récepteur humain du mannose-6-phosphate/IGFII : développement d'anticorps et premières études dans les cancers du sein." Montpellier 1, 1998. http://www.theses.fr/1998MON1T026.
El, Roz Ali. "Récepteur nucléaire LXR et cancer du sein : coopération avec les macrophages : études in vitro sur les modèles MCF-7 et THP-1." Nantes, 2013. http://archive.bu.univ-nantes.fr/pollux/show.action?id=474dfa68-d12e-44cc-847a-15b10424985a.
Lipid nutrients are involved in the modulation of cancer by interaction with their nuclear receptors. Among these receptors, we chose to investigate the role of Liver X Receptor (LXR) in a breast cancer in vitro model (MCF-7). LXR is known to play an essential role in lipid homeostasis, particularly in reverse cholesterol transport, allowing the transport of this lipid from peripheral tissues to the liver. On the other hand, conjugated linoleic acids (CLA), found in foods such as dairy products and ruminant meat, and whose anti-tumor effects are well documented, were recently presented as potential activators of LXR. Our work has confirmed that activation of LXR pathway by synthetic (T0901317) and sterolic [22(R)-HC] agonists and by t9,t11-CLA, is important to inhibit cell proliferation and induce apoptosis in MCF-7 breast cancer cells. We showed that macrophagic apolipoprotein E secreted after LXR activation is involved in the anti-proliferative effects. We suggest that the increased cholesterol efflux after LXR activation, associated with cholesterol membrane deprivation, could be responsible for the observed anti-proliferative effects. We propose in this work a new therapeutic research area and a new pharmacological and nutritional approach using CLA for the prevention against breast cancer
Delrieu, Lidia. "Activité physique dans le cancer du sein métastatique : faisabilité et résultats d’une intervention (études ABLE et MUST) et lien avec la survie (étude StoRM)." Thesis, Lyon, 2018. http://www.theses.fr/2018LYSE1242.
Approximately 5% of patients are diagnosed with metastatic breast cancer each year and 20 to 30% of localized breast cancers become secondarily metastatic. Benefits of physical activity during treatment in patients with localized breast cancer have been widely demonstrated, but the literature is limited in metastatic breast cancer. This thesis work assessed the potential effects of physical activity in patients with metastatic breast cancer through three studies.The StoRM observational study showed an association between the level of physical activity collected by questionnaire with an improvement of survival for HER2 patients. The ABLE intervention study highlighted the feasibility of a physical activity intervention with an activity tracker in this population with an excellent adherence rate (96%), patients' interest and willingness to participate in physical activity programs and functional improvements. The intervention contributed to maintaining quality of life, fatigue and physical activity levels despite treatment and disease progression. Potential biomarkers predictive of tumor progression have been identified. The MUST study showed that the antioxidant SOD and quadriceps isometric extension force appear to prevent sarcopenia and an association between sarcopenia status and toxicity risk was confirmed. This thesis work represents a first step in analyzing the effects of physical activity on patients with metastatic breast cancer. Physical activity appears to be beneficial in this population, but these results need to be confirmed in a larger scale study. These preliminary results highlight the importance of providing appropriate physical activity interventions for patients with metastatic breast cancer at the time of diagnosis in order to maintain an active lifestyle as long as possible
Quesnel, Catherine. "Efficacité d'un traitement cognitif-comportemental pour l'insomnie auprès de femmes ayant été traitées pour un cancer du sein non métastatique." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/MQ55791.pdf.
Doat, Solène. "Rôle de la consommation d'Anti-inflammatoires Non Stéroïdiens (AINS) dans la survenue du cancer de la prostate, du sein, et colorectal en France." Thesis, Université Paris-Saclay (ComUE), 2017. http://www.theses.fr/2017SACLS550/document.
Background – Prostate, breast, and colorectal cancers are among the most common cancers in developed countries. Many risk factors have been identified over the years but could explain only a part of the new cases. Chronic inflammation is highly suspected to play a role in the carcinogenesis of those cancers and the presence of inflammatory infiltrate in tumoral tissue, considered as precancerous lesions, reinforced this hypothesis. In this context, several epidemiological studies have investigated the potential role of Non-steroidal anti-inflammatory drugs (NSAIDs) in cancer occurrence. Indeed, NSAIDs such as aspirin and non-aspirin NSAIDS including selective inhibitors of cyclo-oxygenase 2 (COX-2) may decrease the incidence of those cancers.Objectives – The main objective of the thesis was to investigate the role of NSAIDs use including aspirin, non-aspirin NSAIDs and selective inhibitors of COX-2 in the occurrence of prostate, breast and colorectal cancers.Population and methods – This work was based on the General Sample of health insurance Beneficiaries (EGB) for the three localizations of cancer and on the data of a population-based case-control study carried out in the département of Herault (EPICAP) for prostate cancer. In the EGB study, a cohort of 426 410 persons present in the database in January 1st, 2007 allowed to identify incident cases between 2008 and 2012 based on different algorithms. Exposure to NSAIDs was determined from January 1st, 2005 until the end of the follow up defined as either cancer incident date, date of death, or censure date fixed as December 31st, 2012. A latency of at least one year between the beginning of exposure to NSAIDs and the cancer occurrence was taken into account. For the EPICAP study, 819 incident prostate cancer cases and 879 population-based controls, frequently matched by age to the cases, were face-to-face interviewed using a standardized questionnaire, specifically on their NSAIDs use.Results – From the EGB cohort, preliminary results showed a positive association between all NSAIDs use and prostate or breast cancer occurrence (RR=1,30 [1,17-1,46], RR=1,29 [1,14-1,46], respectively), while no association was found with colorectal cancer occurrence (RR=0,92 [0,82-1,05]). These associations became negative associations when a latency of six years was taken into account in prostate and colorectal cancer (RR=0,85[0,74-0,96], RR=0,77 [0,66-0,90], respectively). In the EPICAP study, NSAIDs use was negatively associated with prostate cancer (OR=0,77 [0,61-0,98]). This association was more pronounced with daily intake (OR=0,75 [0,33-0,92]) or more than once a day (OR=0,38 [0,18-0,79]), and for a duration of five to ten years (OR=0,55 [0,33-0,92]). The negative association was reinforced for preferential anti-COX-2 NSAIDs (OR=0,48 [0,28-0,79]), and for patient with high grade prostate cancer (Gleason score, GS=7 (4+3) or GS>7 : OR=0,62 [0,41-0,95]).Conclusion – This work showed that NSAIDs use was negatively to prostate and colorectal cancer occurrence. For prostate cancer, this thesis was based on two different databases (a medical and administrative database and a case-control study) and used two different methodologies, allowing comparison about strengths and limits of both
Filion, Myriam. "Comparaison de la survie des patientes atteintes d'un cancer du sein ayant participé à un ou des essai(s) clinique(s) par rapport à celles qui n'y ont pas participé." Thesis, Université Laval, 2012. http://www.theses.ulaval.ca/2012/29435/29435.pdf.
Walker, Valentin. "Étude du risque de cardiotoxicité radio-induite précoce chez des patientes traitées par radiothérapie pour un cancer du sein à partir de la cohorte prospective BACCARAT Early Detection of Cardiovascular Changes After Radiotherapy for Breast Cancer: Protocol for a European Multicenter Prospective Cohort (MEDIRAD EARLY HEART Study) Early Detection of Subclinical Left Ventricular Dysfunction After Breast Cancer Radiation Therapy Using Speckle-tracking Echocardiography: Association between Cardiac Exposure and Longitudinal Strain Changes (BACCARAT Study)." Thesis, université Paris-Saclay, 2020. http://www.theses.fr/2020UPASR003.
Radiation therapy (RT), an adjuvant treatment for breast cancer, is associated with an increased risk of cardiovascular disease several years after RT. Identifying early signs of cardiotoxicity and their relationship to the dose of ionizing radiation absorbed by the heart could help predict the occurrence of cardiovascular disease and improve prevention in patients at risk.This thesis is based on the BACCARAT cohort that included a hundred of patients treated with breast RT without chemotherapy and followed during 24 months post-RT. An individual reconstitution of the doses absorbed by the heart, the left ventricle (LV) and the coronary arteries was performed.Early signs of cardiotoxicity were defined by subclinical cardiac dysfunctions evaluated by echocardiography and by changes in the concentrations of a panel of circulating biomarkers potentially involved in cardiotoxicity.With an intermediate follow-up of 6 months, the analysis of data showed a dose-response relationship between subclinical left ventricular dysfunction characterized by a >10% decrease in the myocardial contractility index (longitudinal strain) and the average dose absorbed by the LV. The alteration of fibrinogen levels at the end of RT, combined with the LV dose, improved risk prediction (based on longitudinal strain)
Cordina-Duverger, Emilie. "Facteurs de risques hormonaux et anthropométriques dans le cancer du sein de la femme : étude CECILE." Thesis, Paris 11, 2015. http://www.theses.fr/2015PA11T015/document.
Background: There is evidence that menopausal combined estrogen-progestagen therapy increases the risk of breast cancer, but the risk may vary depending on the types of progestagen used. Moreover, the role of progestagen-only therapy in breast cancer has been little studied. Because of French specificities in prescribing these treatments, we analyzed the risk of breast cancer based on these different types of hormone treatment prescribed among women in France.Overweight and obesity are associated with a reduced risk of premenopausal breast cancer, but increase the risk in postmenopausal period. The underlying mechanisms are not fully understood, and questions remain about the role of weight gain in different periods of life.Methods: This work relates on data from a case-control study in the general population in France, including 1232 cases and 1317 controls recruited among women in two departments of Ille-et-Vilaine and Côte d'Or, between 2005 and 2007. Detailed information on hormonal treatments use, on weight at different periods of life and various reproductive and medical characteristics were obtained during a face-to-face interview. Odds ratios and 95% confidence intervals after adjustment for breast cancer risk factors were calculated using logistic regression models. Analyzes of BMI trajectories between the age of 20 and the age at diagnosis were performed.Results: The risk of breast cancer was increased in users of synthetic progestagen combined or not combined with an estrogen. This risk was restricted to the recent use of the hormone treatment and increased with the duration of use. Conversely, the natural progesterone based treatment was not associated with an increased risk of breast cancer.In premenopausal women, higher BMI and a previous weight gain were associated with a decreased risk of breast cancer. In postmenopausal women, only weight gain in the period preceding the menopause (40 to 50 years) was associated with an increased risk of breast cancer. This association was stronger among women who were lean women at the age of 20 (IMC≤ 18.5 kg / m²), or in older women.Conclusion: This study confirms the carcinogenic effects of hormonal treatments with synthetic progestagen, and the absence of deleterious effects of natural progesterone on breast cancer risk. However, the use of natural progesterone must be evaluated according to the benefits and risks that may result. We could also clarify the relationship between weight gain and the risk of breast cancer, and suggested that weight gain during the period before menopause could be more favorable to the occurrence of breast cancer in post-menopausal
Gassama, Malamine. "Estimation du risque attribuable et de la fraction préventive dans les études de cohorte." Thesis, Université Paris-Saclay (ComUE), 2016. http://www.theses.fr/2016SACLV131/document.
The attributable risk (AR) measures the proportion of disease cases that can be attributed to an exposure in the population. Several definitions and estimation methods have been proposed for survival data. Using simulations, we compared four methods for estimating AR defined in terms of survival functions: two nonparametric methods based on Kaplan-Meier's estimator, one semiparametric based on Cox's model, and one parametric based on the piecewise constant hazards model. Our results suggest to use the semiparametric or parametric approaches to estimate AR if the proportional hazards assumption appears appropriate. These methods were applied to the E3N women cohort data to estimate the AR of breast cancer due to menopausal hormone therapy (MHT). We showed that about 9% of cases of breast cancer were attributable to MHT use at baseline. In case of a protective exposure, an alternative to the AR is the prevented fraction (PF) which measures the proportion of disease cases that could be avoided in the presence of a protective exposure in the population. The definition and estimation of PF have never been considered for cohort studies in the survival analysis context. We defined the PF in cohort studies with survival data and proposed two estimation methods: a semiparametric method based on Cox’s proportional hazards model and a parametric method based on a piecewise constant hazards model with an extension to competing risks. Using data of the Three-City (3C) cohort study, we found that approximately 9% of cases of stroke could be avoided using lipid-lowering drugs (statins or fibrates) in the elderly population. Our study shows that the PF can be estimated to evaluate the impact of beneficial drugs in observational cohort studies while taking potential confounding factors and competing risks into account
Bessaoud, Faïza. "Étude de facteurs de risque classiques et alimentaires du cancer du sein sur une population cas-témoins de l'Hérault et intérêt de la méthode de régression spline logistique." Montpellier 1, 2005. http://www.theses.fr/2005MON1T019.
Firlej, Virginie. "Facteurs de transcription du groupe PEA3 et cancérogenèse mammaire : modèles d'inhibition de l'expression, études phénotypiques et recherche de gènes cibles." Lille 1, 2006. https://pepite-depot.univ-lille.fr/LIBRE/Th_Num/2006/50376-2006-Firlej.pdf.
Injectées en sous-cutané à des souris immunodéficientes, ces même cellules induisent la formation de tumeurs de taille réduite par rapport aux cellules contrôles, confinnant l'implication des facteurs du groupe PEA3 dans les événements conduisant à la cancérogenèse. La caracténsation de la régulation du gène bax par les facteurs du groupe PEA3 a permis de mettre en évidence un nouveau mode de régulation non encore décrit pour ces facteurs, impliquant une interaction avec le facteur USF-I sans liaison directe des facteurs PEA3 à l'ADN. Celle des deux autres gènes cibles cycline D2 et p55cdc est en cours. La modulation de leur expression a été confirmée dans les modèles cellulaires de répression de l'expression des facteurs Erm et Pea3. L'étude de leur région promotrice a permis de définir des sites de régulation dont la caractérisation reste à affiner. La mise au point des différents modèles dans lesquels l'expression des membres du groupe PEA3 est modulée nous a conduit à initier une recherche plus complète des cibles moléculaires des facteurs Erm et Pea3 par utilisation de micro-arrays (Applied Biosystems) avec pour but la corrélation avec les modifications phénotypiques liées à la modulation de l'expression des facteurs du groupe PEA3
Duroux, Roxane. "Inférence pour les modèles statistiques mal spécifiés, application à une étude sur les facteurs pronostiques dans le cancer du sein." Thesis, Paris 6, 2016. http://www.theses.fr/2016PA066224/document.
The thesis focuses on inference of statistical misspecified models. Every result finds its application in a prognostic factors study for breast cancer, thanks to the data collection of Institut Curie. We consider first non-proportional hazards models, and make use of the marginal survival of the failure time. This model allows a time-varying regression coefficient, and therefore generalizes the proportional hazards model. On a second time, we study step regression models. We propose an inference method for the changepoint of a two-step regression model, and an estimation method for a multiple-step regression model. Then, we study the influence of the subsampling rate on the performance of median forests and try to extend the results to random survival forests through an application. Finally, we present a new dose-finding method for phase I clinical trials, in case of partial ordering
Leung, Lisa. "Occupational exposures and cancers in women." Electronic Thesis or Diss., université Paris-Saclay, 2023. http://www.theses.fr/2023UPASR014.
Background: Evidence from migrant studies suggests that environmental risk factors may play a role in the pathogenesis of breast, ovarian, and lung cancers, yet the etiology of these cancers remains poorly understood. Women account for a significant proportion of the labour force worldwide, yet research on occupational hazards of female workers is limited. Few studies have examined occupations common to women and occupational risks in relation to female cancers.Objectives: The specific objectives of the thesis were: 1) to study the association between occupation, occupational exposures and ovarian cancer, 2) to study the association between occupational exposures and breast cancer, and 3) to study the association between occupation, occupational exposures and lung cancer in women.Methods: Data from three population-based case-control studies on women in Canada and France that collected occupational history information was used to achieve the objectives: the PROVAQ study on ovarian cancer (491 cases, 897 controls), the CECILE study on breast cancer (1,206 cases, 1,294 controls), and the WELCA study on lung cancer (731 cases, 751 controls). In all three studies, an industrial hygienist coded the occupation of each participant's job. Job codes were linked to the Canadian job-exposure matrix, thereby generating exposure estimates for many agents. The relationship between exposure to each of the most prevalent agents and cancer risk was assessed, specifically 29 agents for ovarian cancer, 49 agents for breast cancer, and 41 agents for lung cancer. For ovarian and lung cancers, prevalent occupations were additionally examined by comparing participants employed in an occupation for <10 years and ≥10 years vs. never employed in the occupation. Associations with cancer risk for occupations and occupational exposures were estimated using logistic regression and adjusting for minimally sufficient confounder sets, identified using directed acyclic graphs.Results: Excess ovarian cancer risks were suggested for accountancy, sales, hairdressing, and sewing occupations, and for occupational exposure to agents linked to hairdressing-related occupations. Interpretations of results for single agents were limited due to multiple correlated exposures. For breast cancer, occupational exposure to agents, particularly textile fibre dusts, organic solvents, polycyclic aromatic hydrocarbons, plastic dusts and pyrolysis fumes, were potentially associated with increased risks. Relative risks were suggested to differ among breast cancer subtypes and according to menopausal status for some agents. For lung cancer, elevated odds ratios were observed for teaching, professional, white-collar, sales, and service occupations, and for numerous occupational exposures, some of which were consistent with previous studies in women, such as cooking fumes, formaldehyde, organic solvents, polycyclic aromatic hydrocarbons, metals, and paints/varnishes. Lung cancer risks for some agents were suggested to differ by smoking status.Conclusions: Certain occupations and occupational exposures may be associated with excess ovarian, breast, and lung cancer risks in women. As many odds ratios observed were imprecise, further population-based research on women is warranted to replicate findings. Studies with larger sample sizes and expert assessment information that can perform more advanced statistical methods accounting for multiple exposures may be useful in disentangling the effects of correlated agents in the estimation of cancer risk
Li, Zhijin. "Task-based optimization of 3D breast x-ray imaging using mathematical observers." Thesis, Université Paris-Saclay (ComUE), 2017. http://www.theses.fr/2017SACLN038.
Full field digital mammography, a 2D x-ray breast imaging modality has been proved to reduce the breast cancer mortality. Today, digital breast tomosynthesis, a 3D x-ray breast imaging modality, is being integrated in clinical practice and is believed to replace standard mammography in the near future. To assess the clinical performance of various aspects of tomosynthesis, clinical trials are needed. Clinical trials are burdensome, expensive and may impose increased risk to the patient due to additional radiation exposure. Virtual Clinical Trials aim to offer a more efficient alternative by using computational components. Today, active research is ongoing to develop computational components dedicated to 2D and 3D breast imaging, especially to 3D tomosynthesis. This thesis aims to advance several aspects in the development of Virtual Clinical Trials. First, we focused on analytical characterization of state-of-the-art 3D random field breast texture models. The estimation of statistical characteristics (breast density, spectral index) from clinical x-ray breast images was also studied. Next, we proposed a mathematically traceable 3D breast texture model based on stochastic geometry, that allows to simulate realistic 2D and 3D images. The statistical inference of the texture model parameters from a database of clinical 3D breast images was also tackled. We then developed a mathematical observer based on the textit{a contrario} theory, that allows to model the microcalcification detection process by radiologists in 2D and 3D breast images. Finally, these two proposed components were applied to implement a virtual clinical trial experiment, demonstrating their potential in the conduct of more advanced virtual clinical studies in the future
Ousmen, Ahmad. "Détermination du sens clinique d'un changement pour les questionnaires de qualité de vie relative à la santé en cancérologie." Thesis, Bourgogne Franche-Comté, 2019. http://www.theses.fr/2019UBFCE001/document.
In oncology, the health-related quality of life (HRQOL) is generally considered as a second endpoint in the clinical trials. The interpretation of the results of the longitudinal analysis of such data must be made in both statistical and clinical point of view in order to produce meaningful results for both patients and clinicians. The main objective is to assess the impact of the treatment on patient’s HRQOL level over time. The minimal clinically important difference (MCID) was defined as the smallest change between two scores in a treatment outcome that a patient would identify as important. Indeed, the longitudinal analysis of HRQOL remains complex, particularly due to the potential occurrence of a Response Shift effect characterizing the process of adaptation of the patient in relation to the illness and its treatment. Hence, the first objective of this work is a literature review concerning the determination of the MCID by the most commonly used methods: anchor-based and distribution-based methods. Secondly, calculating the MCID using anchor-based and distribution-based methods by applying different distribution criteria and several different anchors. The objective is to compare the results obtained by the different methods and to compare them to others obtained by previous studies. Finally, studying the impact of the Response Shift effect on the determination of MCID for the HRQOL questionnaires in cancer research using several data corresponding to different therapeutic situations and cancer locations
Normand, Julie. "Symptomatologie dépressive et communication conjugale chez des femmes atteintes de cancer du sein." Thèse, 2008. http://hdl.handle.net/1866/6364.