The main aim of this study is to evaluate the current results of the Breast Cancer Screening Program performed in the State Clinical Hospital of Khanty-Mansiysk. The screening covers women over 40 years old. The screening interval is 2 years, with 2-view mammography and single reading as the standard. During 2007– 2010 within the Program, 6980 w omen were screened. The screening coverage rate is the app roxi- mately 55.6 %. 8.3 % of screened w omen were referred for further assessment. The average cancer detection rate w as 5 per 1000 s creened women. The test sensitivity was estimated as 98.2 %. The main criteria are within the international standard’s level.

There is now extensive proof that high percentage of mammographic density (MD) is an independent risk factor for breast cance.r Taking this into account, the research data are summarized with regard to relation of MD to anthropometric, as well as hormonal, genetic and genotoxic factors. There is a negative correlation between MD and such risk factors as age, number of deliveries, BMI and waist-hip ratio. Most inves- tigations show a direct connection between MD and prolactin level or insulin-like growth factor in blood, mostly in premenopaus al women. Relations of MD with blood estrogens, testosterone, sex hormone binding globulin prove to be too diverse to be taken in account of. It is pos- sible that the action of hormones, especially estrogens, is mediated through their metabolites catecholestrogens and / or reactive oxygen spe- cies. There is certain evidence that a genetic component plays a role in MD. It refers to COMT Val158Met, IGF-I rs6220 A> G and UGT1A1 in premenopausal women, and to ESR1 (XbaI и PvuII) in menopausal cases.
Although it is obvious that the risk of breast cancer related to MD is brought about by many factors, there is a necessity for studying addi- tional criteria modifying the process, as well as for searching means for preventing it.

Microwave mammography permits thermal changes to be estimated both within the breast and onto its surface. It is obvious that i
replace X-ray mammography or ultrasonography (USG) since it gives no information on breast structural changes, which is very ne
for a physician.
At the same time microwave mammography can yield additional information on the magnitude of proliferative processes and on the thermal activity of tissue. In many cases, this information may be decisive in elaborating treatment policy.
Due to its simplicity , non-invasiveness, and safety , decimetric microw ave radiothermometry may be a promising method for diagno sing breast cancer and evaluating the efficiency of its treatment. When used in combination with X-ray study and USG, this technique provides incomparable assistance in defining the management of patients. The concurrent use of mammography , USG, and radiothermometric d iag- nosis of the breast assists in reducing the level of diagnostic errors to 1-3%.

The paper considers a role of repair plastic surgery in the treatment of patients with breast cancer (BC). It describes the cur rent surgical BC treatment strategy aimed at fulfilling two tasks: to ensure a reliable cancer cure and to create favorable conditions for breas t repair. There is evidence that there is no association between the prognosis of BC and the performance of repair plastic operations. It is concluded that plastic surgery heads the list of rehabilitation measures for BC today.

Given postmastectomy, all the muscles of chest w all and humeroscapular region have been tested for the first time ever . Mentioned muscles spasms predominate over weakness of shoulder girdle lower clamps and of antagonist muscles. Postisometric relaxation of spastic muscles as well as the goal-directed gymnastics for relaxed muscles gives good results in early rehabilitation after mastectomy.

Objective: to improve the results of neoadjuvant chemotherapy (CT) in patients with locally advanced (L A) inoperable breast cancer (BC) at baseline, by using the intensified combination CT at the interval being reduced between the administration of cytostatic dru gs to 2 weeks to give a chance to the patients to be surgically treated.
Subjects and methods. The study enrolled 26 patients aged 33 to 75 years with L A BC. Paclitaxel was administered intravenously (IV) over 3 hours at a dose of 175 mg/m2 on day 1, followed by gemcitabine, 2000 mg/m2, given by 30-minute IV infusion on day 1 every 2 w eeks. If the cytostatics were well tolerated and their effect increased, the treatment was continued up to 6 courses.
Results. Eighteen (69.2%) out of the 26 patients achieved the objective effect of treatment; of them 17 (65.4%) had a partial remission and 1 (3.8) had a complete remission.
The therapeutic pathomorphism of a tumor w as rated in 22 patients; fourth-degree tumor pathomorphism w as found in 2 (9%) patien ts. The follow-up of patients w as 11 to 28 months (median, 20 months). The median time to progression w as not reached in the entire group of patients.
Conclusion. A combination of paclitaxel and gemcitabine in intensive dose-dense scheduling has a marked antitumor activity in BC and
is characterized by its good tolerability without a pronounced myelosuppressive effect. This therapy regimen may be used as neoadjuvant CT.

The results of basic clinical randomized trials of hypofractionated (HF) radiotherapy (R T) regimens used after organ-sparing su rgery for Stages I-IIa breast cancer (BC) were analyzed. The HF adjuvant RT regimens were shown to be safe and an alternative to the standard RT in patients with BC after organ-saving operations.

The study analyzed the results of preoperative examination and treatment of 15 patients with nonpalpable breast cancer . Complex diagnos- tics included ultrasound, X-ray mammography, needle biopsy. Breast-conserving surgery was planned for all the patients. We included pa- tients with tumor sites of up to 1.0 cm ± 0.2 cm and patients with clusters of pleomorphic calcifications area up to 1 cm 2. All patients made interstitial markings tumor under X-ray control. According to radiological and histological examination of tumor growth in marg ins was absent in all 15 cases.

The author analyzes an algorithm for identifying and treating w omen with cervical intraepithelial neoplasias (CIN) and microinv asive cancer of the cervix uteri in cases of the hidden area of transformation and in the absence of visible cervical changes. There are excep- tional difficulties of making the diagnosis of epithelial damages due to the incomplete reproducibility of cytological abnormal ities and the low informative value of a histological study of scrapes from the cervical canal. To avoid hypodiagnosis, it is justifiable to prefer human papillomavirus testing (Hybrid Capture 2 (HC2)) to repeat smears for the choice of a management tactic. Conization is recommend ed as a diagnostic and/or therapeutic procedure when the viral load is high in over 35-year-old patients with abnormal smears anda hidden transformation area.

Metastatic involvement of the central nervous system (CNS) is very rarely observed in gynecological cancer . Ten case histories were analyzed in patients with malignancies of the cervix uteri, endometrium, and ovaries concurrent with metastatic involvement of the brain and spine. The CNS involvement was metachronous in all the patients. The mean interval between the detection of a primary tumor and the emergence of metastases was 3.1, 4.5, and 2.3 years for cervix uteri, corpus uteri, and ovarian cancers, respectively. All patients with gynecological cancer are indicated to undergo a follow-up including neurological examination and X-ray or magnetic resonance imaging of the brain and spine. When meat static CNS involvement is detected, multimodality treatment involving surgery followed by chemoradiation therapy is recommended.

The paper considers the specific features of the course and therapy of cancer of the corpus uteri on the basis of some clinical and biological characteristics of the tumor. The objective of ongoing and future clinical trials is to expand the arsenal of active drugs and to individualize therapy in patients with endometrial cancer.

The results of observation of 22 patients with refractory ovarian cancer were analyzed. The usefulness of chemotherapy the second and  subsequent lines of treatment is shown. Sequential treatment by not cross-resistant chemotherapy allows increase median survival up  to 12.5 months in general group. In 36 % of patients with good performance status prolonged stabilization of disease with median overall survival of 22.3 months was achieved.

The capacity of drugs to penetrate across the blood-brain barrier (BBB) is primarily traditionally taken into account on choosing chemotherapy (CT) regimens for patients with brain metastatic involvement. P aclitaxel and carboplatin have a low ability to cross the BBB in its normal state. As of now, there is experimental and clinical evidence for BBB dysfunction in brain metastases. The described case serves as another evidence for the successful application of standard approaches to choosing CT regimens for patients with platinum-susceptible recurrent ovarian cancer when the disease recurs and progresses as brain metastatic involvement. The authors also show the effe ctive use of combination treatment: CT in combination with radiation treatments (stereotactic radiosurgery and conventional whole brain radiotherapy) with complete tumor regression being achieved in a patient with ovarian cancer and brain metastatic involvement.

Ovarian cancer (OC) is characterized by its late diagnosis, mainly local tumor dissemination within the abdomen and small pelvis, and a relatively high susceptibility to drug therapy . Intraabdominal chemotherapy (CT) allows the higher intraabdominal drug concentrations to be produced as compared to systemic CT and, according to the data of some investigations, improves the results of treatment in a few patients with minimal tumor foci. In this connection, it is urgent to master the procedure of intraperitoneal CT, including to pl ace an intraabdominal port, to elaborate a regimen, and to determine the spectrum of its toxicity and safety.
Subjects and methods. The paper gives the preliminary results of a pilot trial using intraabdominal CT in 8 patients with disseminated OC and fallopian tubes who have undergone optimal-volume surgical interventions in stage 1. All the patients received CT by the scheme: intravenous paclitaxel (135 mg/m 2) on day 1, intraabdominal cisplatin (75 mg/m 2) on day 2, and intraabdominal paclitaxel (60 mg/m 2) on day 8. A total of 6 courses were scheduled.
Results. At the analysis of the results, 5 out the 8 patients received all the scheduled courses of CT, 3 patients continued treatment, including 1 patient in whom the intraabdominal port w as removed after the first course of CT because of significant fibrosis along the in traabdominal catheter, thereafter she continued to be treated by the standard intravenous scheme. Among local toxicity signs, there was a preponderance of grades 1–2 abdominal pains occurring after the intraabdominal administrations of chemotherapy preparations. Systemic toxicity, including hematological one, was moderate; in any cases it did not cause life-threatening complications or lead to the increase of course intervals or to the refusal of intraabdominal CT. At a median follow-up of 10.2 months (range 1.9–24.7 months or more), one patient w as found to have disease progression 12 months of therapy termination.

The epidemiology, diagnosis, and treatment of squamous or glandular cell carcinoma of the cervix uteri (CCU) are considered. The risk factors for histologic types of CCU are comparatively described. Current treatment options for this pathology are presented. The d ata available in the literature on the prognosis and late results of treatment of squamous or adenogenic CCU are given.

The paper considers some pathogenetic aspects of ovarian tumor development, on the basis of which the authors recommend to perform more aggressive chemotherapy in patients with the so-called early stages of ovarian cancer.

Human papillomavirus (HPV) that is a main cause of cancer of the cervix uteri (CCU) has immunogenic properties, i.e. an abilityto activate antiviral immunity responses as adaptive HPV-specific and innate ones. For this reason, despite multiple mechanisms generated by HPV to avoid immunity responses, the human body can eliminate the infection in most cases. At the same time, CCU results from the combined influence of many factors of different nature, among which the factors that impair the normal course of an immune response are of vital importance.
This review describes the major factors and mechanisms, which promote the establishment of persistent HPV infection and the progression of dysplasia to cancer, on the one hand, and allow the tumor cells in CCU to restrict the body’s immune reactions, on the other Immune disorders induced by the virus and/or tumor cells are considered at both local and systemic levels. Particular emphasis is placed on the molecular mechanisms that can change the population composition and functional activity of leukocytes and the cytokine profile of cells and can form the tumor suppressor microenvironment.

Examine changes in the parameters reflecting the activation of humoral immune system, the severity of the destructive processesand autoimmune reactions in patients with endometrial cancer . The findings suggest that the significance of activation of autoimmune reac tions and destructive processes in pathogenetic mechanisms of development of malignant tumors of the corpus uteri.

Sixth Expert Forum on Breast Cancer Treatment