Various benign breast abnormalities are diagnosed in 60% of women in Russia today. This is associated with failure of preoperative recognition of the histological class of an identified nodular mass – its detection is an indication for surgical treatment. By using 67 histologically verified breast fibroadenomas (FA) as an example, the authors describe their magnetic resonance semiotics and present the differential diagnostic criteria used during dynamic contrast-enhanced magnetic resonance mammography. FAs are characterized by well-defined uniform outlines, homogeneous internal structure, centrifugal and homogeneous accumulation of contrast media through- out the study, without deforming the breast vasculature around. One of the criteria that permit differential diagnosis of FA with malignan- cies is their estimated vascularization.

Background. The past decades have been marked by a rise in the incidence of polyneoplasia (PNP), including that of the breast, which necessitates a more in-depth analysis of its manifestations.
Materials and methods. The study was based on the results of a complex radiological and postmortem examination in 120 women with different types of breast PNP (BPNP) and 6 with metastatic breast lesion.
Results. The procedure for radiological and postmortem studies in BPNP was improved; the optimal diagnostic complex developed; and the radiation semiotics of different types of BPNP clarified.
Conclusion. Overall, the comprehensive approach to the examination to be made by one specialist who can use a broad spectrum of vari- ous procedures and competent in allied specialties has allowed the objective criteria for BPNP to be defined.

The current surgical treatment strategy for breast cancer is to fulfill two tasks: a reliable cure for cancer and solution of esthetic problems. The former task is successfully solved by radical mastectomy whereas it is rather difficult to restore the breast because a specialist has to compensate for the whole volume of its tissue and to form a nipple-areolar complex (NAC) and a submammary fold. Subcutaneous mastectomy with and without NAC preservation optimally solves both tasks: its performance, by simultaneously maintaining the high level of radicalism, substantially makes primary breast repair easier and yields a better esthetic result.

There have been recent reports on the expediency of applying postoperative hypofractionated accelerated radiotherapy (RT) regimens in patients who have undergone breast-sparing surgery. The concept of accelerated hypofractionation (AH) includes daily high-dose radiation for a shorter total period of time. In most radiologists’ opinion, the AH RT regimen may be as effective as more conventional treatments that use lower daily radiation doses for a longer period. The appeal of this method is that shorter treatment provides more convenience for patients. By taking into account the fact that the α/β ratio for intact breast tissues is about 3.5 Gy, larger fraction RT regi- mens are likely to be more effective, which will reduce the frequency of recurrences as compared with conventional therapy approaches without increasing the incidence of postradiation intact tissue damage.

The paper presents the results of a follow-up of 593 patients with the internal and central localization of clinical stages I-IIb breast cancer whose treatment comprises parasternal treatment techniques: teleradiotherapy (TRT), intratissue radiotherapy (ITRT), and video-assisted thoracoscopic parasternal lymphadenectomy (VAPL). A control group included 846 patients with the external localiza- tion of a tumor. There was a statistically significant increase in 5-year overall (98.2%) and relapse-free (96.2%) survival rates in Stage I in the VAPL versus TRT and ITRT groups (overall survival, 92.5 and 89.7%; relapse-free survival, 80.8 and 73.4%, respectively) (p < 0.05). There was no difference in survival rates between the study and control groups. It is concluded that VAPL permits the objective staging of the disease and any therapeutic exposure of the parasternal area made survival rates similar in the study and control groups.

The study was undertaken to improve breast cancer (BC) staging by the criterion N ex vivo, by applying the up-to-date ultrasound and microsurgical technologies. A LySonix 3000® with PulseSelectTM system was used to expose lymph nodes and vessels. Axillary adipose tissue classically exposed was examined in 70 patients with Stages II-III BC. Lymph vessels and nodes were separated by the sonolipodestruction technique. The findings permit sonolipodestruction to be used for ex vivo total lymph dissection for BC as a method that improves its N-staging. Sonolymphodissection opens up fresh opportunities for studying the anatomic structure of the lymphatic apparatus.

The determination of mutant p53 and the basic parameters studied by DNA-flow cytofluorometry in combination with other clinical and morphological predictors may be used as additional prognostic criteria individually in each patient with breast cancer.

Noninvasive treatments for chronic pain syndrome benefit in 80-90% of cancer patients. Invasive, intervention procedures for analgesia should be used in other cases. These include neuroablative and neuromodulatory measures. Neuroablation is defined as the physical suspension of painful impulse transmission pathways by a surgical, chemical, or thermal method and comprises lytic and other blocks. Neuromodulation is the dynamic and functional suppression of pain impulse pathways by the intraspinal or intraventricular administra- tion of opioids and other chemicals.

The efficacy of Heptral® (ademethionine) was evaluated in the treatment of chemotherapy-induced hepatotoxicity in 19 patients with various malignancies. Four-week administration of oral Heptral® 400 mg twice daily was shown to reduce the level of transaminases to normal values in 10 of 12 patients with grade 1 toxicity. Longer (2-to-4 month) use of Heptral® was required to normalize the level of transminases in grade 2 hepatotoxicity. The chemotherapy regimen was not changed during the use of this drug.

The main goals of the study were to evaluate the efficacy and safety of intravenous topotecan (Hycamtin) used in a dose of 4 mg/m2 on days 1, 8, and 15 of a 28-day course of therapy in patients with recurrent ovarian cancer. The study revealed a number of benefits from use of topotecan in patients with this diagnosis.

Despite great efforts to publish the 7th edition of the clinical TNM classification, the major aim of the International Union Against Cancer continues to create unified statistical information on the prevalence of disease in each specific case. This information can, in the general context, help specialists evaluate a tumor process, avoid disagreements in the planning of treatment and in the assessment of its results, and make a prognosis, thereby favoring further investigations of malignancies.

The paper gives the rates of recurrences and metastases occurring after primary therapy in 109 patients with Stage II corpus uteri cancer (CUC) treated at the Unit of Gynecology, N.N. Blokhin Russian Cancer Research Center.
The distribution of patients with Stages IIA and IIB CUC is shown by the rates of recurrences and metastases; the time of their emergence is defined; the mean survival is estimated in patients with progressive CUC. The distribution of patients with recurrent Stage II CUC and separately its metastases is considered in relation to the early unstudied morphological characteristics of primary tumor.

The paper analyzes and presents the clinical and laboratory data of 978 female patients, including 268 (27.4%) control women having no reproductive organ tumors, 478 (48.8%) and 232 (23.7%) patients with slowly and rapidly growing uterine myoma (UM), respec- tively. A new procedure has been developed and tested to diagnose rapidly growing UM, including the latter concurrent with endometrial hyperplastic processes, which is based on the comparison of the levels of lipid peroxidation products in the biomolecules in the study biological fluids (endometrial lavages) and on the analysis of their morphostructural features. A mathematical model to calculate uterine volume has been proposed to objectify the estimation of tumor growth rates. The proposed multimodal approach makes it possible to detect UM, to determine its growth rate and endometrial status, and to assess the likelihood of a recurrence occurring after conservative surgery.

Epithelioid trophoblastic tumor (ETT) is a rare form of trophoblastic disease, which is characterized by high malignancy and a number of diagnostic features: a long interval between the last pregnancy and labor and the onset of the disease; a visual pattern at gynecological examination, relatively low β-chorionic gonadotropin (CG) levels, as well as the diffuse expression of cytokeratins-7 (+++) and -18 (+++), р63 (nuclear ++), E-cadherin (+++), EGFR (+), and CD-117(++) by tumor cells, as determined by immunohistochemical assay, and focal expression of CG (++) and PLAP (+) by these cells.

To solve the problem of preserving reproductive function in cancer patients is very urgent today because antitumor treatment comprising different combinations of radio- and chemotherapy and surgery lead to ovarian reserve depletion and premature menopause in repro- ductive-aged women. The authors propose to consider one of the fertility preservation techniques – ovarian tissue cryopreservation. A procedure for cryopreservation is described in detail; its efficiency is evaluated. In the authors’ opinion, this procedure is one of most promising in preserving the sexual material of cancer patients.

Forty-six patients with various cervix uteri (CU) diseases were examined and treated. The examinees’ age was 21 to 72 years (mean age 37.4 ± 1.1 years).
In 16 patients, the rate of N33, MLH1, p16 gene hypermethylation was determined in the tissue samples of the CU in its various dis- eases: there was hypermethylation of the p16 (83%) and MLH1 (66%), and N33 (33%) genes in CU leukoplakia; the p16 (100%) and MLH1 (100%), and N33 (62%) genes in CU dysplasia, and the p16 (100%) and MLH1 (50%), and N33 (50%) genes in squamous cell carcinoma of the CU.
A follow-up of patients with established gene hypermethylation revealed a recurrence in 50% of cases of CU leukoplasia and in 37.5% of cases of CU dysplasias. No recurrences were observed in a group of 30 patients without abnormal gene methylation in CU tissues during the follow-up.

The paper characterizes paranoic hypochondriacal development, that is comparable with expan-sive paranoia, in patients with a >5-year history of malignancies at examination. A study sample comprised 8 treated out- and inpatients (mean age 55.7±7.02 years) diagnosed as having repro-ductive organ malignancies. Their examination was made by the clinical catamnestic technique. Psychopathological disorders in the described cases of expansive paranoia are associated with the development of abnormal querulant activity that is aimed at having the medical care volume inadequate to the somatic status of patients with malignancies.
The described variant of development of paranoid disorders enables their determination within the framework of cancer-induced chang- es in personality disorders with the formation and further reinforcement of the psychopathological manifestations of mainly the hy- poparanoia type. The constitutional predictors of hypochondriacal development via expansive paranoia type, which include not only certain types of personality disorders (paranoic, 50%; schizoid–expansive pole, 12.5%; icteric, 37.5%; sensitive, 12.5%), but also ac- centuations (segmental depersonalization accentuation) against which the study reactions manifest themselves as a continuation of but ab-normally transformed constitutional properties.

Leiomyomas predominate among benign nonepithelial tumors of the corpus uteri. According to the data available in the literature, they occur in 25% of women above 35 years of age and constitute 33% of all gynecological diseases. Leimyoma is commonly an asymptomatic tumor and detectable in most cases at routine gynecological examinations. However, some forms of leiomyomas have a definite metastatic potential and, despite its benign morphological signs, may metastasize to the lung. Fatal cases resulting from tumor spread along the postcava to the right atrium are described.