Breast cancer is the most common malignant tumor-affecting women during the child bearing period. With the rising trend in delaying pregnancy later in life, the issue of subsequent pregnancy and lactation following breast cancer diagnosis has been more frequently encountered. In this context, data is scarce particularly those addressing the issue of lactation. In this review, we discussed different endocrinal, clinical and biological aspects dealing with breast-feeding after breast cancer in an attempt to determine how safe and feasible this approach is.

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Little is known regarding the safety and feasibility of breastfeeding in women with a history of breast cancer. We have performed a survey among breast cancer patients who completed their pregnancy following breast cancer management to examine their lactation behaviours and its effect on breast cancer outcome. Out of 32 women identified, 20 were reachable and accepted to take the questionnaire. Ten women initiated breastfeeding, 4 stopped within one month and 6 had long-term success with a median period of 11 months (7-17 months). The latter were all previously subjected to breast conserving surgery and received qualified lactation counselling at delivery. The main reasons for not initiating breastfeeding were "uncertainty regarding maternal safety" and "a priori unfeasibility" expressed either by the obstetrician or by the oncologist. At a median follow-up of 48 months following delivery, all 20 women were alive with two relapses; one in each group (i.e., lactating and non-lactating). This analysis adds to the limited available evidence on the feasibility and safety of breastfeeding in breast cancer survivors. Proper fertility and survivorship counselling is crucial and requires more attention in breast cancer clinics.

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Pattern reversal visual evoked potentials were recorded in 71 children with different types of migraine (e.g. migraine with aura, migraine without aura) or tension-type headache and in 19 controls (mean age of both groups 9 years). P100 latencies were comparable in all three groups.

SUMMARY The headache histories obtained from 214 children were analysed by computer to see whether it was possible to identify and classify migraine, and to distinguish children with psychogenic headache. During headache attacks, most children had no or very few associated symptoms. For classification, 175 patients were divided into four homogeneous groups; the remaining 39 could not be grouped. An overlap between the different groups was found. Psychogenic headache emerged as a clearly definable syndrome, characterised by psychological problems and daily headache for a period of at least one month (10 patients). When the 214 patients were grouped according to the classification of the Headache Classification Committee of the International Headache Society, distinguishing those children with psychogenic headache was no longer possible. RÉSUMÉ Critères diagnostiques de migraines et de céphalées psychogènes chez l'enfant Les anamnèses de maux de tête de 214 enfants ont été analysées sur ordinateur pour voir s'il était possible d'identifier et classer la migraine, et distinguer les enfants présentant des céphalées psychogéniques. Durant les crises de maux de tête, la plupart des enfants présentaient très peu ou pas du tout de symptomes associés. Pour la classification, 175 patients ont été divisés en quatre groupes homogènes; les 39 restants n'ont pu être groupés. Un chevauchement a été observé entre les groupes. La céphalée psychogénique est apparue comme un syndrome clairement défini, caràctérisée par des problèmes psychologiques et des céphalées journalières durant une période d'au moins un mois (10 patients). Quand les 214 patients étaient classés selon le Comité de classification des maux de tête de la Société Internationale des Maux det tête, il n'était plus possible de distinguer les enfant; présentant des céphalées psychogéniques. ZUSAMMENFASSUNG Diagnostische Kriterien für Migräne und psychogene Kopfschmeren bei Kindern Die Kopfschmerzanamnesen von 214 Kindern wurden analysiert, urn festzustellen, ob es möglich ist, Migräne zu erkennen und einzuorden und von psychogenen Kopfschmerzen zu unterscheiden, Während der Kopfschmerzattacken hatten die meisten Kinder keine oder nur wenig Begleitsymptome. Für die Klassifikation wurden 175 Patienten in vier Gruppen geteilt; die restlichen 39 konnten nicht zugeordnet werden. Es fand sich ein Überlappen der verschiedenen Gruppen. Psychogene Kopfschmerzen erwiesen sich als klar definierbares Syndrom, charakterisiert durch psychische Probleme und tägliche Kopfschmerzen über einen Zeitraum von mindestens einem Monat (10 Patienten). Wurden die 214 Patienten anhand der Klassifikation des Kopfschmerzklassifikationskomitees der International Headache Society eingeteilt, war eine Unterscheidung der Kinder mit psychogenen Kopfschmerzen nicht mehr möglich. RESUMEN Criterios diagnósticos sobre la migraña y la cefalea psicogénica en niños Las historias de dolor de cabeza obtenidas de 214 niños fueron analizadas con una computadora con el objeto de ver si era posible identificar y c...

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