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The Israeli Society for Clinical Oncology and Radiotherapy appointed experts in breast cancer therapy to assess the Society's policy regarding hormone replacement therapy (HRT) in breast cancer survivors with menopausal symptoms. The first policy letter was published in November 2002, and referred to available literature at that time which included retrospective data alone. The professional literature suggested no increased risk in breast cancer recurrence or cancer specific mortality, and no effect on overall survival with the use of HRT for a limited period (up to 3 years). This data served as the rationale for international prospective studies. Former committee recommendations and precautions are detailed in the original publication. In February 2004, the interim analysis of a prospective trial, the HABIT (Hormonal replacement therapy after breast cancer--is it safe?) was published. In that trial, breast cancer survivors with menopausal symptoms were randomized to HRT (estrogens with or without progestins) or no therapy for 2 years. A total of 434 women were recruited from centers in Scandinavia who participated with the International Breast Cancer and the European Organization for Research and Treatment groups. Analysis was restricted to 345 women with at least one follow up report; median follow-up period was 2.1 years. The relative risk for breast cancer event was 3.5 (95% C.I. 1.5-8.1) in HRT users as compared with the non-HRT group and the HABIT trial was terminated. Study limitations are discussed. Thereby, at this time HRT can no longer be considered safe in breast cancer survivors. Physicians treating breast cancer survivors for severe menopausal symptoms should present study results and alternative non-hormonal treatment options to allow patients optimized consented treatment decisions.

Three cases of possible acute cardiopulmonary toxicity following the administration of vinorelbine are reported. The symptoms mimicked acute cardiac ischemia. However, neither ECG changes nor elevations of serum enzymes were observed. The outcome is favorable in 90% of patients developing this adverse event. The putative mechanism remains to be elucidated.

Background & Aims: Israeli Jews of European birth, i.e., Ashkenazim, have the highest colorectal cancer incidence of any Israeli ethnic group. The I1307K APC gene variant was found in 6.1% of American Jews, 28% of their familial colorectal cancer cases, but not in non-Jews. We assessed the I1307K prevalence in Israeli Jews of differing ethnic origin and risk for colorectal cancer. Methods: DNA samples from 500 unrelated Jews of European or non-European origin, with or without a personal and/or family history of neoplasia, were examined for the I1307K variant by the allele-specific oligonucleotide (ASO) method. Results: In persons at average risk for colorectal cancer, I1307K was found in 5.0% of 120 European and 1.6% of 188 non-European Jews ( P = 0.08). It occurred in 15.4% of 52 Ashkenazi Israelis with familial cancer ( P = 0.02) and was not detected in 51 non-European Jews at increased cancer risk. Colorectal neoplasia occurred personally or in the families of 13 of 20 Ashkenazi I1307K carriers, 8 of whom also had a personal or family history of noncolonic neoplasia. Conclusions: The I1307K APC variant may represent a susceptibility gene for colorectal, or other, cancers in Ashkenazi Jews, and partially explains the higher incidence of colorectal cancer in European Israelis. GASTROENTEROLOGY 1999;116:54-57

The CT features of cerebral involvement by metastatic malignant melanoma are described in 28 patients. The most common locations of the primary lesion were the trunk and lower limbs. There was a high incidence of extracerebral metastasis at the time of diagnosis of cerebral involvement. Headache and behavioral changes were the most frequent presenting symptoms; 7% of patients with asymptomatic. The cerebral metastases were classified by size (1 cm, 1-4 cm,4 cm), with more than half measuring 1-4 cm. The larger lesions usually occurred singly. Peritumoral edema was detected in 89% of patients, hemorrhage in 19%, pressure signs on the ventricles in 37%, midline deviation in 15%, and leptomeningeal spread in 11%. No correlation was noted between size of tumor and other radiological features. Unilateral involvement was documented in 44% of cases. In the majority of patients the metastases were located at the periphery of the brain, mostly in the temporal and parietal lobes. Neuroimaging studies of the brain in asymptomatic patients with malignant melanoma may reveal occult metastases and influence the choice of treatment.