Study objective. To improve diagnostics quality and surgical treatment efficiency in patients with non-epithelial and fibroepithelial malignant breast tumors.
Materials and methods. The non-randomized study included 87 patients, among them 16 patients with breast sarcomas and 71 patients with phyllodes tumors of the breast. Primary diagnosis was made based on mammography, ultrasound scan (including contrast-enhanced ultrasound), and sonoelastography data. Organ-preserving surgeries were performed in 48 (67.6 %) patients with phyllodes tumors and 2 (13 %) patients with sarcomas, mastectomy and breast amputations were performed in 23 (32.4 %) patients with phyllodes tumors and 14 (87 %) patients with sarcomas. Follow-up duration varied between 3 and 132 months.
Results and discussion. During routine examination of patients with phyllodes tumors and sarcomas diagnostic errors were made in 62 and 20 % of cases, respectively. Sonoelastography and contrast-enhanced ultrasound allowed to make a correct diagnosis in the majority of patients (70 %). Long-term treatment results correlated with tumor type. Over all survival for benign phyllodes tumors was significantly higher (97.6 %) than overall survival for its malignant type (57 %) and breast sarcomas (60 %). Sparing tumor removal (tumorectomy) was associated with high incidence of local recurrences for all types of non-epithelial and fibroepithelial tumors (between 31 % and 100 %). Segmental resection was also associated with high incidence of local recurrences, especially for the malignant type of phyllodes tumor (83 %).
Conclusion. Primary diagnostics of breast diseases should involve sonoelastography and a contrast-enhanced ultrasound scan. Surgical treatment for malignant phyllodes tumors and sarcomas should include breast amputation or mastectomy.

Dyshormonal breast dysplasia is the most frequent pathology encountered by practitioners. The interest of clinicians to these processes is associated with several factors. On the one hand effective treatment, relieves symptoms, ensures the quality of life. On the other hand, mastitis is a risk factor for subsequent malignant tumor. Therefore, timely correction is a variant of primary prevention of breast cancer. The choice of the adequate tactics of conducting such patients from the existing diversity of dosage forms is the key to success. The paper discusses the main molecular mechanisms that are implemented with the use of the drug Mastodynon.

Fibrocystic breast disease is diagnosed in 20 % of women. Morphological verification of breast lumps is an important part of monitoring of these patients.
Study objective. To study the role of vacuum-assisted core biopsy (VAB) in differential diagnosis of fibrocystic breast disease.
Materials and methods. In 2014 in Innomed plus clinic the VAB method for tumor diagnostics was introduced for the first time in the Primorsky
Region. We studied application of VAB in 22 patients with a diagnosis of nonpalpable breast lesion.
Results. Relapse rate for VAB is 4.5 %, complication rate in the form of postoperative hematomas is 22.7 %, but these complications do not increase duration of rehabilitation and are not clinically relevant.
Conclusion. VAB is a minimally invasive surgical approach which allows to collect the same volume of tumor tissue as sectoral resection. The benefits of the method are better cosmetic results and shorter rehabilitation period with comparable complication rate. This allows to use VAB not only for diagnostic purposes but as a treatment for benign breast tumors.

The article presents a literature review on late radiation injury (RI) of skin and subcutaneous fat after surgical treatment and radiation therapy (RT) in patients with breast cancer (BC). In Russia, the rate of radiation injuries in patients after RT exceeds 10–15 %. Combination treatment of BC (surgery and radiation) carries a risk of RI of skin and subcutaneous fat which might lead to dystrophic changes in the form of prominent radiation-induced fibrosis of the irradiated area, lower the quality of life, cause suffering and even death. Most of BC patients are of working age, so the problem of local RI is of social importance, and it requires effective methods of treatment and rehabilitation allowing for favorable conditions for patients’ social adaptation. Currently, there’s no consensus on the mechanisms of development of skin and subcutaneous fat late RI, and it’s being considered from several angles. Therefore, problems of determination of individual sensitivity to ionizing radiation and further study of local RI of skin and subcutaneous fat after surgical treatment and RT in BC patients are of utmost importance.

Cancer of the uterine cervix is staged using a clinical, rather than a surgical staging system, which is the approach used for other gynecologic tumors. Surgical staging is potentially more accurate. However, the International Federation of Gynecology and Obstetrics (FIGO) has determined that clinical staging is preferable for assessing locally advanced disease (i. e., tumor size, vaginal and parametrial involvement); and it allows to avoid surgery in women who are not candidates for surgical treatment. The staging and pelvic and paraaortic lymph node evaluation for cervical cancer are reviewed here.

With the purpose of studying opportunities of modern ultrasound technologies in diagnostics of an endometrial carcinoma we survey 33 patients. It was revealed high information value of ultrasound for definition of depth of uterus cancer invasion. At carrying out of ultrasonic research the complex of the following techniques two-dimensional/three-dimensional ultrasound in the В mode, Color and Power coding, sonoelastography, spectral Doppler analysis was used. Use sonoelastography, ultrasound in a combination to an wide spectrum modern Doppler techniques allows to solve the broad audience of problems in frameworks for intronozologycal diagnostics of an endometrial carcinoma: to determine
precise localization of a tumor in a cavity of a uterus; volume of the primary tumoral center; depth invasion in myometrium; transition of tumoral process on cervical canals. Sonoelastography is the modern method for a comparative analysis of the density and compressibility of tissues, and it can be an additional diagnostic test for diagnostic test to define of local prevalence of the tumor. It is very important for surgeons to determine an adequate volume of operation.

Endometrial cancer (EC) is the third most common cancer. It comprises almost 10 % of all malignant tumors in women. Peak morbidity is observed at advanced age (62–64 years) and is associated with excess weight. At the time of diagnosis more than 70 % of patients have stage I disease and most of them have a concomitant pathology: diabetes, thrombosis, or hypertension. These patients require a low-trauma panhysterectomy which can be performed laparoscopically or laparotomically. Due to improvement of technological equipment in hospitals and development of surgical and anesthetic techniques, frequency of laparoscopic surgeries at large medical institutions is increasing. Comparative long-term results of oncological treatment allow to pose a problem of comfort in the postoperative period as a reason to prioritize laparoscopic
access. In order to include the surgery into standard practice, it is beneficial to calculate economic costs for each type of surgical access. Objective. Evaluation of effective costs of panhysterectomy performed laparoscopically and laparotomically for treatment of early stage endometrial cancer. Materials and methods. We performed a retrospective analysis of medical histories of 170 patients with stage I EC who underwent panhysterectomy at the N. N. Petrov Research Institute of Oncology in 2010–2017. Calculations of direct medical costs took into account costs of surgery, drug therapy, treatment of complications, and in-patient care. Indirect costs were based on statistical data on salaries in 2016 and employment in the Russian Federation.
Results. For laparoscopic panhysterectomy we observed significant decrease in intraoperative blood loss (82 %), number of drugs, rate of early postoperative complications (mostly associated with postoperative wound healing), and duration of postoperative rehabilitation characterized by short hospital stay and quick return to work. Cost component of the above-mentioned trends amounts to decrease in cost value of 4,000–5,000 rubles for every patient. Conclusions. In long-term perspective, initial investments into high-tech minimally invasive techniques lead to economic benefits due to decrease in costs of in-patient care and treatment of postoperative complications and quick rehabilitation. At the same time, at early stages of EC
laparoscopic surgeries don’t affect oncological prognosis for these patients.

The article presents a clinical observation of a combination of multiple primary tumors: cancer of the cecum, mixed Müllerian atypical proliferative (borderline) tumors, atypical hyperplasia of the uterus endometrium with uterus didelphys. A rare combination of uterine malformation at the organogenesis stage suggests presence of ectopic Müllerian epithelium in different tissues, where, due to various reasons, notably endometriosis and metabolic disorders, cancerogenic mutations may quickly accumulate. Active metaplasia of ectopic epithelium serves as a favorable medium for microsatellite instability and several pathways of atypical proliferation. This increases the risk of development of multiple
primary tumors.