Objective: an immunohistochemical analysis of the features of expression, distribution and interaction of E-сadherin and β-сatenin proteins in primary mammary tumors.

Materials and methods. The study group consisted of 148 relevant patients with breast cancer (BC), including patients with metastases in lymph nodes (n = 12) and liver (n = 45). E-сadherin and β-сatenin expression on BC cells was determined using immunohistochemical method with specific antibodies.

Results. It was shown that the reduction and the total absence of E-сadherin expression was observed much more often in patients with BC with metastases in liver, than in patients without metastases (70 % of cases versus 30 % of cases respectively). An increase of cytoplasmic immune reactivity and a nuclear translocation of β-сatenin are found in more than 80 % cases of BC with metastases.

Conclusion. The changes in the expression of E-сadherin and β-сatenin in tumor cell can be considered as factors of a non-favorable prognosis of BC. The emergence of β-сatenin expression indicates the activation of a signaling pathway which is triggered by the aberrant expression of epithelial cadherins leading to an increased mobility and invasion of tumor cells.

Background. Breast cancer is the most common malignant tumor and accounts for the most number of cancer-related deaths among Russian women. Combination of cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitor ribociclib and aromatase inhibitor is approved for the first-line treatment of postmenopausal women with HR-positive HER2-negative advanced breast cancer.

Objective: to conduct pharmacoeconomic evaluation of using ribociclib + aromatase inhibitor for the first-line treatment of HR-positive HER2- negative advanced breast cancer from the Russian healthcare system perspective.

Materials and methods. The comparator was palbociclib + aromatase inhibitor, because ribociclib and palbociclib have similar mechanism of action and are the only available CDK4/6 inhibitors that could be used for treatment of HR-positive HER2-negative advanced breast cancer in Russia. Using clinical trials data and published results of matching adjusted indirect comparison (MAIC), we proposed Markov chain model of breast cancer progression and estimated direct medical costs associated with two considered options (first and subsequent lines of drug therapy, adverse events treatment, inpatient and outpatient care). Budget impact and cost-effectiveness analyses were conducted. Mean duration of treatment in the model was 21,9 and 20,2 months on ribociclib and palbociclib for five year time horizon respectively.

Results and conclusion. Monthly medication costs of ribociclib (270 814.18 RUB) were 9 % less than for palbociclib (296 517.21 RUB). Driven by less monthly medication costs and potential of cost reduction due to dose reduction, five-year total medical per patient costs for ribociclib were 4 991 168 RUB, which were 1 162 666 RUB or 19 % less than for palbociclib. Ribociclib also had better (lower) cost/effectiveness ratio (1 244 906 vs 1 595 867 RUB per life year). As the result, ribociclib was considered a cost-saving option. If 8 162–8 270 women receive ribociclib, public healthcare expenditures will decrease by 20.1 billion RUB (21 %) within 3 years, compared to palbociclib.

Vacuum-assisted aspiration biopsy (VAB) has been in use for over 20 years. It is an accurate and safe procedure with a sensitivity of 97 %, specificity of 100 %, and accuracy of 99 %. VAB is used for the evaluation of nonpalpable tumors suspicious for breast cancer. Since 2000, VAB is widely used as a therapeutic method for total biopsy or resection of benign breast tumors (breast fibroadenoma, recurrent cysts, and intraductal or intracyctic hyperplasia). Many authors consider VAB as an alternative to standard surgery. VAB demonstrates good results in the minimally invasive treatment of nodular mastopathy. VAB technique is continuously being improved, which indicates the progress in medical science and successful implementation of minimally invasive treatments into clinical practice.

This article discusses the historical development of oncoplastic surgery, describes the main stages of oncoplastic breast surgery, indications and contraindications for it, and the algorithms for choosing an appropriate surgical technique for patients with breast cancer.

Ovarian suppression (OS) is an effective method of treating hormone sensitive breast cancer. The combination of OS and tamoxifen in breast cancer is more effective than any of these methods used as monotherapy. A number of clinical trials confirmed the need for OS chemotherapy in patients with hormone-positive operable breast cancer, because women retained their menstrual function for 5 years. OS chemotherapy during adjuvant chemotherapy allows preserving fertility in patients with breast cancer.

Myocardial dysfunction, heart failure and prolongation of the QTc interval are dangerous cardiovascular complications associated with systemic treatment for luminal HER2-negative metastatic breast cancer. Special monitoring is required to control such complications, especially when introducing new drugs. Understanding the mechanisms underlying the development of cardiovascular complications as well as diagnostic, prevention, and treatment strategies is important for optimal patient management.

Objective: to assess molecular profiles of endometrial hyperplasia and endometrial intraepithelial neoplasia.

Materials and methods. We conducted a retrospective study that included 77 patients with a morphologically verified hyperplastic process in the endometrium. Of them, 34 patients had endometrial hyperplasia and 33 patients had endometrial intraepithelial neoplasia. The control group comprised 30 women with no endometrial disorders according to the results of histological examination.

Results. Patients with endometrial intraepithelial neoplasia are at high risk of developing cancer. High angiogenic activity, pronounced vascularization, and endometrial hypoxia are believed to be important risk factors contributing to tumor proliferation and transformation. The expression of inhibitors of apoptosis, such as survivin and Bcl-2, is usually increased in atypical cells, which may indicate their involvement in malignant transformation of cells and tumor invasive growth.

Conclusion. Our findings confirm the important role of survivin and Bcl-2 in hyperplastic processes in the endometrium.

Despite the undeniable successes of modern medicine, the problems of oncology and, in particular, oncogynecology are still unresolved. Thus, a 5-year overall survival rate for stage I ovarian cancer is 89 %, for stage IV – 17 %. Given that complaints in patients with ovarian cancer appear only after the tumor has passed beyond the organ, the most important and key factor in successful treatment is the correct diagnosis of ovarian neoplasm. Observance of the correct algorithm and correct surgery can significantly improve the results of treatment. The article will discuss the difficulties of diagnosing ovarian cancer.

Cervical cancer is currently the second most common form of neoplasia worldwide and third in the female population. The standard surgical treatment, for stages IA2-IIA, is radical hysterectomy with pelvic lymphadenectomy. The risk of intraoperative (vessel or nerve damage) or postoperative complications (lymphedema) is high. The sentinel node concept can reduce risk of such complications but currently is not included in the standard treatment.

Ovarian pregnancy is a rare form of ectopic pregnancy, which causes a great diagnostic problem. One of the important risk factors for the development of ovarian pregnancy is the use of intrauterine spirals. The article presents the clinical case of ovarian pregnancy in a 35-yearold woman who underwent an implantation of fertilized egg in the ovary against the background of the vitreous spiral. Transvaginal ultrasonography showed the presence of echogenic formation in the right ovary, in the absence of data for tubal pregnancy.