Purpose of review Permanent methods are the most commonly used contraceptive options worldwide. Even with the increase in popularity and accessibility of long-acting reversible methods, there remains high demand for permanent options, especially among women in developing countries. Recent findings Traditional methods of permanent contraception (PC), such as post-partum tubal ligation and interval surgical tubal occlusion or electrocautery by mini-laparotomy or laparoscopy are safe and highly effective. Bilateral total salpingectomy for ovarian cancer risk reduction is currently being investigated. Hysteroscopic tubal occlusion reduces or eliminates the need for anesthesia, but requires surgical training and specialized equipment. Alternative PC methods are being explored including immediately effective hysteroscopic methods, and non-surgical permanent contraception (NSPC) methods that have the potential to improve access and reduce cost. Summary PC methods are an important part of the contraceptive methods mix designed to meet the needs of women who have completed desired family size or wish never to become pregnant. Current surgical approaches to permanent contraception are safe and highly effective. The development of a highly effective nonsurgical approach could simplify the provision of PC.

Breast cancer (BC) intrinsic subtype classification is based on the expression of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and proliferation marker Ki-67. The expression of these markers depends on both the genetic background of the cancer cells and the surrounding tumor microenvironment. In this study, we explore macrophage traits in cancer cells and intra-tumoral M2-macrophage infiltration (MI) in relation to intrinsic subtypes in non-metastatic invasive BC treated with breast conserving surgery, with and without postoperative radiotherapy (RT). Immunostaining of M2-macrophage-specific antigen CD163 in cancer cells and MI were evaluated, together with ER, PR, HER2, and Ki-67-expression in cancer cells. The tumors were classified into intrinsic subtypes according to the ESMO guidelines. The immunostaining of these markers, MI, and clinical data were analyzed in relation to ipsilateral local recurrence (ILR) as well as recurrence-free (RFS) and disease-free specific (DFS) survival. BC intrinsic subtypes are associated with T-stage, Nottingham Histologic Grade (NHG), and MI. Macrophage phenotype in cancer cells is significantly associated with NHG3-tumors. Significant differences in macrophage infiltration were observed among the intrinsic subtypes of pT1-T2 stage BC. Shorter RFS was observed in luminal B HER2neg tumors after RT, suggesting that this phenotype may be more resistant to irradiation. Ki-67-expression was significantly higher in NHG3 and CD163-positive tumors, as well as those with moderate and high MI. Cancer cell ER expression is inversely related to MI and thus might affect the clinical staging and assessment of BC. Electronic supplementary material The online version of this article (10.1007/s00428-019-02563-3) contains supplementary material, which is available to authorized users.

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Medical abortion in the first and second trimesters of pregnancy offers women a safe and effective alternative to surgical termination. The World Health Organization supports a combination of mifepristone and misoprostol as the optimal regimen in both the first and second trimesters of pregnancy, but doses, routes, and timing of administration vary with gestational age. Most methods of contraception can be initiated at the time of medical abortion in women wishing to delay fertility, with the exception of the intrauterine device, which can be initiated as soon as a woman is no longer pregnant.

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