For many years, tamoxifen has been the _gold standard_ amongst anti-oestrogen therapies for breast cancer. However, the selective aro- matase inhibitors (AIs), anastrozole, letrozole and exemestane, have demonstrated advantages over tamoxifen as first-line treatments for advanced disease. Anastrozole is also more effective as an adjuvant treatment in early, operable breast cancer and is being increasingly used in the adjuvant setting. Generally, the selective oestrogen receptor modulators (SERMs), such as toremifene, droloxifene, idoxifene, ralox- ifene, and arzoxifene, show minimal activity in tamoxifen-resistant disease and show no superiority over tamoxifen as first-line treatments. In addition to these agents, other treatment options for advanced disease include high-dose oestrogens and progestins. Response rates for high- dose oestrogens and tamoxifen are similar, but the use of oestrogens is limited by their toxicity profile. Consequently, there is a need for new endocrine treatment options for breast cancer, particularly for use in disease that is resistant to tamoxifen or AIs. Fulvestrant (_Faslodex_) is a new type of steroidal oestrogen receptor (ER) antagonist that downregulates cellular levels of the ER and progesterone receptor and has no agonist activity. This paper reviews the key efficacy and tolerability data for fulvestrant in postmenopausal women in the context of other endocrine therapies and explores the potential role of fulvestrant within the sequencing of endocrine therapies for advanced breast cancer.

There have been presented the main achievements in the field of mammologic service development in Russia owing to creation and introduction of the domestic mammographic stationary digital and mobile mammographs, organization of the system of the continuous education of the specialists on basis of interdisciplinary integration, as well as introduction of the novel technologies of the radiologi- cal examination, interventional radiology, molecular biology, informational technologies, realization of the wide-ranging information- al educational work. The diagnostic mammology development perspectives are outlined.

The aim of the study was to determine the most effective regimens of the neo- and adjuvant therapy of the primary breast cancer of the T3—4N0M0 stages. The data of the clinical observations of the 145 patients with the locally advanced T3—4N0M0 breast cancer, who underwent treatment in the N.N.Blokhin CRC over the period of 1998—2003, were used in the study. The mean age of the patients was 55,3±12,9 years (from 19 to 83 years, median-55 years). The duration of the observation of the patients was 46,5±28,51 months (from 3,6 to 109,4 months, median-44,5 months). For patients with the breast cancer of the T3—4N0M0 stages combined treatment modality was implemented with the use of neo- and adjuvant therapy in all the cases.

The analysis of the changes of the content of the angiogenic factor VEGFR-2 in the cytosol of the tumor and blood sera of the 30 breast can- cer patients determined by immunoenzyme method during neoadjuvant therapy is given. Likewise the correlation of this index with the main clinicomorphological characteristics of the disease is assessed. The obtained results suggest on the possibility of the use of VEGFR-2 as the one of the diagnostic markers of the breast cancer. The index dynamics didn’t depend on the given therapy type but nonetheless the correlation of the VEGFR-2 content in the residual tumor after preoperative therapy with the grade of the treatment pathomorphosis is determined.

Surgery is the main method of treatment of the patients with the uterine leiomyosarcoma. A standard extent of surgery is extirpation of the uterus without its appendages in the reproductive period or with uterine appendages in the postmenopause. The comparative analysis of the remote results of the treatment of the patients depending on the radicality of the performed surgery let to find out that the presence of the resid- ual tumor in the minor pelvis significantly worsens the course and the prognosis of the disease in the patients with the uterine leiomyosarco- ma. The adjuvant therapy is worth using for the prophylaxis of the distant metastasizing in the patients with the uterine leiomyosarcoma in the presence the poor prognosis factors. The postoperative radiotherapy of the patients is ineffective due to the low radio sensitivity of the tumor. The poor prognosis factors are: postmenopause, age over 60 years, the presence of the residual tumor, invasion depth more than half of the myometrium, invasion of the tumor up to the tunica serosa uteri, tumor size more than 5 cm, tumor necroses, low grade of the tumor differ- entiation, mitoses rate more than 10 in 10 view fields. The vital prognosis of the patients with the distant metastases depends on their charac- ter. In case of solitary metastases — the prognosis is favorable, in patients with the multiple metastases the prognosis worsens essentially.

This is a retrospective review of treatment results of 35 patients with dysgerminomas in the Departments of Clinical Pharmacology and Gynecology, N.N.Blokhin Russian Cancer Research Center (NNBRCRC) between 1990 and 2006.
Primary surgery was carried out in all patients. Twenty patients (57%) underwent fertility-sparing surgery. Postoperative systemic chemotherapy was administered to 28 (80%) women: аmong them 23 received platinum-based chemotherapy, 5 were treated with non- platinum combinations.
At a median follow-up of 75 months the disease-free survival was 71,4% and the overall survival was 97,1%. Our data confirmed that prog- nosis of dysgerminomas is excellent if managed with standard treatment initially, this is possible, as a rule, only in specialized cancer centers.

Non-Hodgkin's lymphomas are extremely rare among all tumors of female reproductive system. Diagnostic mistakes and inadequate therapeu- tic tactics in these diseases are results of usual absence of alertness of gynecologists. The aims are to analyze reasons of diagnostic mistakes in patients with non-Hodgkin's lymphomas of female reproductive system and to discover definitive clinical and morphological characteristics of female reproductive system lymphoid tumors. During the period between 1989 and 2006, 305 cases of primary extranodal non-Hodgkin's lym- phomas were detected; female reproductive system was affected in 7% of patients (totally 40 patients), which were included in investigated group. In the whole analyzed group of women (n=40, median age 43 yrs, range 17-84 yrs), patients with primary lesion of female reproductive system had median age of 40 yrs and with secondary involvement - 46 yrs. Most of patients were fertile (60%, n=24). Such tumors was localized in breast in 40% of cases (n=16), in ovaries - 20% (n=8), in uterine corpus - 12,5% (n=5), in uterine cervix - 15% (n=6), and in vagina - remaining 12,5% (n=5). Average time from diagnosis to beginning of the treatment was 7,5 months. As a result, the onset of specific therapy was delayed in 65% cases (n=26) and 50% (n=20) underwent unneeded surgery. Diagnostic mistakes lead to inadequate treatment. Extranodal non-Hodgkin’s lymphomas of female reproductive system, both primary and secondary, are rare pathology. Primary lesion is more typical for older women, sec- ondary is mainly affecting younger women (in reproductive period). Chemotherapy response and prognosis are better in primary cases.

With the help of monoclonal antibodies (MCA-1, MCA-3, G1 class immunoglobulins) and polyspecific antiserum (As) by means of immunoblotting (IB) the increase of the expression of the tumor-associated proteins (TAP) in the samples of the tumor tissues (in 94, 55 and 38% respectively), metastatic lymph nodes — LN(m+) and sera of the patients with ovarian cancer (OC) (in 82, 77 and ~100% of the cases, respectively), was detected. The important feature of As was the reactivity with the samples of the LN (m+) on the numerous proteins (>5-10) in 78% of the patients. The statistical analysis of the data using Student t-criterion revealed the significant differences (MCA-1, MCA-3) in the expression of the markers in the tumor tissues and blood sera of the oncological patients compar- ing with the samples of the adjacent tissues, blood sera of the patients with the other tumor localization and healthy donors (p<0,05). The further research using a larger amount of the clinical material and development of the more precise quantitative immunoenzyme analysis to measure TAP, is needed. It is possible that detection of TAP using MCA-1 and As may serve a basis for the creation of the test-system for the immunodiagnostics of the OC and determination of the stage of the tumor process.

According to data from World Health Organization (WHO) the median duration of life of the world population has been increasing over the last years.
In Russia, the proportion of women among the population aged 70 years and over account for 75%.
One of the investigations included 457 patients with morphologically verified ovarian carcinoma (OC) who had received treatment from 1990 to 1999. Among them 304 patients were over 60 years old and 153 patients were under 45 years old.
Yet long-term results of treatment of elderly patients with ovarian cancer are considerably worse than that of the younger patients. Five- year survival of elderly and younger patients with OC were 34,6% and 14%, respectively, and median survival were 40,92,2 and 18,9 0,8 months.
Other group included 510 patients with morphologically verified cervical cancer. Among them 259 patients were at ages over 60 and 251 patients were at ages under 45 years. Overall, the complication rate after combined modality treatment was 1,5 times higher in elderly patients in comparison with younger patients.
Thereby, the age of the patients is an important factor, which determines the course and prognosis of the cancer of the female repro- ductive organs. The treatment of elderly onco-gynecologic patients requires thorough assessment, preoperative preparation, individual adjustment of the dose intensity of chemo- and radiotherapy, as well as the prophylaxis and treatment of possible and developed com- plications.