In the paper we analyzed radiographic findings related by the radiologist to BI-RADS 4 (68 patients) and BI-RADS 5 (38 patients) depending on the nature of histologic findings. Digital mammography allows to perform a more accurate estimation of pathological process in the breast due to computer image processing. This can improve diagnosis of early breast cancer. In analyzing the findings referred to BI-RADS 4 we noted significantly much higher (up to 20.59 ± 4.89 %) detection rate of breast cancer compared to analog mammography. Breast cancer was confirmed histologically in 97.37 ± 6.16 % of patients with BI-RADS 5. Definable node formation was the leading symptom in BI-RADS 5 cases and was observed in 26 patients (68.42 ± 6.14%). An average node size was 2.12 ± 0.19 cm, which corresponds to T2 category.

Levels of intratumoral lymphocytes have direct interrelations with clinical, morphological and biological characteristics of tumor. Rates of CD4+lymphocytes rise in a process of increase of tumor size. At the same time, content of intratumoral CD4+CD25+ lymphocytes is maximal at small size tumors. In the absence of metastases of a breast cancer in the regional lymph nodes are noted a higher content of activated (HLA-DR+) intratumoral T-lymphocytes (CD3, CD4, CD8), which is represented in a higher levels of HLA-DR+CD45+ lymphocytes in patients with a lack of metastasis in comparison with patients, who has metastasis. In case of II and III grade of breast cancer malignancy the percent of intratumoral lymphocytes is higher, in comparison to I grade malignancy. The rate of intratumoral lymphocytes as well as activated T-cells (CD3) and T-helpers (CD4) is higher in stage I of breast cancer, then in II–III stages. The number of intratumoral CD3+ T-lymphocytes and CD8+ cells is higher in tumors with low level of Ki-67+ proliferated cells. Authentically higher content of activated T-cells and activated CD4+ lymphocytes is noted in HER-2 / neu-negative cases. Higher content of CD4+CD3+ T-lymphocytes was noted in 2–3 scores of HER-2 / neu than negative HER-2 / neu status. At an infiltrative ductal cancer authentically higher levels of infiltration of a tumor are revealed by the lymphocytes, activated T-cells and activated T-killers CD3+CD8+. Tumor infiltration levels in luminal A cancer are 5 times higher, then in luminal B (10,5 and 2,2 % correspondingly). At the same time, luminal B subtype is characterized by higher tumor infiltration of T-lymphocytes (81 and 70 %).

Breast cancer is the leading cancer pathology of the female population and one of the leading causes of death. The possibility of early diagnosis makes a significant contribution to the reduction in mortality from breast cancer. We studied the frequency of breast cancer from 2002 to 2014 by age groups. As part of the screening from 2007 to 2014, 352,780 women were surveyed in the region, which accounted for about 95 % of the total coverage of screening for each round (2 years) – 32 %. 9.4 % of the women surveyed were aimed at further examination. During the initial screening detection rate of breast cancer was 2.8 per 1,000 women surveyed. The sensitivity of the test for the first round was 80 %.

The article presents the results of analysis of long-term treatment outcomes of 162 patients who received neoadjuvant chemotherapy for breast cancer based on City Clinical Hospital No. 40 of Ekaterinburg. ER-negative status, triple-negative subtype of tumor and lymph node negative status were found to be significant predictive factors of complete tumor regression. In studying long-term results of the treatment it was showed that negative status of lymph nodes significantly predicts improvement in relapse-free survival, while the surgical treatment does not increase relapse-free survival time in case of complete tumor regression.

Introduction. Triple-negative breast cancer (BC) is very aggressive form of breast malignancies with high levels of dissemination, frequent ecurrence and poor survival rate, as compared to other breast cancer subtypes.

Aim of the study – development and introduction of optimized treatment strategy of patients with triple-negative breast cancer into the clinical practice of City Clinical Oncological Dispensary.

Materials and methods. The study included 201 patients (21–90 years, mean age 52 years) who were treated in the first department
of St. Petersburg City Clinical Oncological Dispensary from 2005 to 2011. Stage IА–IIIC invasive breast cancer with triple-negative phenotype according to immunohistochemical study of the tumor material was verified in all the patients before beginning of the treatment. Standard chemotherapy by FAC, CMF and taxane-containing regimen was used as neoadjuvant chemotherapy. The degree of therapeutic pathomorphism was evaluated according to Miller-Payne (2003) classification, which was designed taking into account an overall survival rate of patients, depending on the degree of pathologic tumor regression.

Results. We performed evaluation of 3-year relapse-free survival, depending on the degree of pathomorphological regression and histological degree of malignancy. There is a clear dependence of the 3-year relapse-free survival on the degree of histological differentiation of the tumor. We noted an inverse correlation between high degree of histological malignancy with a short relapse-free period. The disease progressed in patients who have a high degree of histological malignancy.

Conclusion. The highest efficiency was achieved in patients receiving chemotherapy with the addition of taxanes. It is advantageous to include taxane-containing chemotherapy regimens in the treatment of patients with a high degree of histological malignancy.

The review deals with trials of pegylated liposomal doxorubicin (PLD) used to treat metastatic breast cancer (mBC), including first-line monotherapy, maintenance therapy, combinations with other cytostatics, trastuzumab regimens for a HER-2-positive subvariant, and rescue therapy for intensively pretreated forms of the disease. PLD is shown to be highly competitive with conventional anthracyclines in efficacy and to greatly surpass them in safety particularly in patients at high cardiac risk; the lack of cumulative toxicity and maximum allowable dose makes it possible to perform therapy until the disease progresses, to use the drug as a support, and to effectively and safely combine PLD with trastuzumab in HER-2-positive mBC. A clinical benefit from the administration of PLD does not depend on susceptibility to anthracyclines. The drug is also an important treatment option for taxane-refractory mBC.

Current standards of treatment of endocrine-dependent cancers (breast cancer (BC), prostate cancer) imply sequential use of endocrine therapy and cytotoxic agents: it is believed, that steroid hormone antagonists cease the division of transformed cells and therefore make them resistant to other therapeutic modalities. It is important to recognize that conceptual investigations in this field were carried out dozens of years ago, and often involved relatively non-efficient drugs, imperfect laboratory tests, etc. There are several recent examples of combined use of endocrine therapy and other compounds. The addition of docetaxel (6 cycles) to androgen deprivation resulted in significant improvement of overall survival in men with metastatic prostate cancer. Clinical trial involving the combined use of exemestane and everolimus demonstrated promising results. There are ongoing studies on inhibitors of cycline-dependent kinases. Use of these drugs in the beginning of endocrine therapy may significantly delay resistance to the antagonists of estrogen signaling.

The results of cytological diagnostics of 138 patients with adenocarcinoma of the uterine cervix were analyzed. Cytological verification of adenocarcinoma in specimens by the uterine cervix material allowed diagnosing as primary adenocarcinoma of the uterine cervix as well as metastatic lesions. The diagnose adenocarcinoma by the uterine cervix material was occurred in cases of 1) endometrioid carcinoma of 87 (63.0 %) patients; 2) endocervical carcinoma of 21 (15.2 %) patients; 3) metastases of serous ovarian carcinoma in 18 (13.0 %) cases; 4) other metastases-colon carcinoma of 6 (4.4 %) patients, rectal carcinoma 2 (1.4 %), glandular carcinoma including gastric signet ring cell carcinoma 3 (2.3 %), and mucinous carcinoma of unknown organs of 1 (0.7 %) patient. Particular features of the uterine cervix adenocarcinoma, endometrioid carcinoma and ovarian carcinoma due to data of discriminate analysis were not noticed. Metastatic intestinal adenocarcinoma has specific palisade-like cells located in complexes that allowed to verify carcinoma. Also, presence signet ring tumour cells allowed to diagnose the metastasis of gastric signet ring cell carcinoma.

Magnetic resonance imaging (MRI) is sensitive and specific method of study in patients with cervical cancer (CC). A number of studies have demonstrated the possibility to determine histological type (squamous cell cancer and adenocarcinoma) and the degree of differentiation of this type of tumor by using the apparent diffusion coefficient maps (ADC-map) compiled on the basis of diffusion-weighted images (DWI) (p <0.05). We have tested whether a more accurate assessment of the histological type and tumor grade in the preoperative stage is possible, by using a wide range of MRI techniques. According to multiparametric MRI, which included T2-weighted imaging (WI), DWI with reconstruction of ADC-maps and dynamic MRI with contrast enhancement, performed in 90 patients with histologically verified cervical cancer, it was shown that adenocarcinoma is characterized by a high intensity and less heterogeneity of MRI signal in fat-suppressed T2WI images as compared to squamous cell carcinoma. Furthermore, patients with adenocarcinomas who underwent dynamic MRI with contrast enhancement had curves with gradually higher change in MRI-signal intensity on T1WI images in 15 seconds after detection of the magnetic resonance contrast agent (MRCA) in tumor, continuous increase in MRI signal intensity (when observing for about 2.5 minutes) after detection of MRCA in tumor, while in case of squamous cell cancer – a lower variation in MRI signal intensity in T1WI mode to 10-20 second after detection of MRCA in the tumor followed by a biphasic course of the curve, dependence of MRI-signal on time and formation of the “plateau” or the same signal decrease down to 125 sec (about 2.5 min) as well as less signal heterogenecity in the period from 10-20 sec to 125 sec (about 2.5 min) after MRCA detection in tumor. The differences were statistically significant (p <0.05), and had sensitivity and specificity up to 0.76 and 0.75, respectively for particular signs. According to binary logistic regression that combines all the relevant parameters in a complex – up to 0.80 and 0.86 or 0.96 and 0.67, respectively. For poorly- and well differentiated adenocarcinomas it was shown significant difference in heterogeneity of MRI signal of the tumor compared to unaffected tissue with the following sensitivity and specificity: ≈1.00; 0.83 (poorly differentiated) and 0.75; 0.96 (well differentiated) respectively.

The results of diagnostics of 65 patients with serous ovarian carcinoma are given in the article. Analysis of the investigation has allowed to include 13 patients (20 %) in the group 1 (low grade) and 52 (80 %) in the group 2 (high grade). According to the results of the executed work it is determined that the Immunocytochemical technique allows to verify ovarian carcinoma, differentiating it with carcinoma metastases of the other organs, that is very important for following treatment. In case of sufficient tumour cells in cytological specimens, specimens are valuable material for molecular-genetic researches. According to the results of genetic DNA investigations, suitable for the estimation, there was absence mutation of V600E in the BRAF-gene in all cases. The genetic mutation of KRAS-gene with 5 patients from the group1 (low grade) was noticed. Among them the genetic mutation of G12V was detected in 4 cases and mutation of G12D in 1 case. The mutations in the BRCA1-gene were
detected in 4 cases from the 2th group (high grade) three of them were presented by 5382insC mutation and one of them by T300G mutation. The usage of the multivariate analysis evaluating the cell composition of low and high grade carcinomas was allowed to distinguish the most significant features off ovarian carcinoma cells that will be allow to differentiate them by means of light microscopy.

A better understanding of the life cycle of human papillomaviruses (HPV) and innate immune control responses made it possible to look
for ways of reducing the replication load of viral proteins and to activate the mechanisms of innate immunity for rapid viral elimination. This is extremely important since persistent infection mainly with papillomavirus types 16, 18, 35, 45, and 52 is the major cause of cervical cancer. Over 3 years, the screening program proposed by the World Health Organization in 2001 could reveal about 10 % of the 30 000 women who had moderate and severe or more cervical epithelial lesion and other 14 % had a HPV positive test showing mainly the presence of several strains. The level of persistent infection (the presence of one type of the virus within 12 months) was significantly higher among smokers and women older than 35 years of age. In our trial, the use of Isoprinosine in a dose of 50 mg/kg/day for 28 days contributed to rapid viral elimination persisting longer than 12 months in 91.8 % of the patients.

Results of treatment of 134 patients with stage I ovarian cancer were analyzed, 48 of these patients underwent laparoscopic surgery. From a technical point of view, concerning duration of the surgery, blood loss, lack of both intra- and postoperative complications, shorter periods of patient rehabilitation, laparoscopic approach can be regarded as the most preferred. However, when comparing the timing of relapse-free survival there was a trend towards its reduction after laparoscopic surgery compared with an open surgery, causing a widespread use of this technique even in the initial stages of ovarian cancer.