Reconstruction of natural-looking breast involves the restoration of all the constituent elements that define the identity of a normal breast. The inframammary fold is one of the main anatomical elements that determine the shape of the breast. That is why the technical features of various methods of the inframammary fold reconstruction affect the final aesthetic result of the reconstructive surgery. This article considers a comparative evaluation of the quality of life and satisfaction with the reconstructed breast after the two-stage breast reconstruction with different inframammary fold creation techniques.

The article is devoted to the determination of the cytological criteria of differentiation of fibroadenoma and phyllodes tumor. By means of multivariate analysis the 11 most informative cellular signs of fibroadenoma, juvenile fibroadenoma and benign phyllodes tumors were identified. According to the discriminant analysis, only 37.97 % of patients with benign phyllodes tumors are classified correctly, that indicates the difficulties of differentiation of these tumors. Some cellular signs of fibroadenoma, borderline and malignant phyllodes tumor allow to diagnose these forms of tumors.

Objective: to evaluate the frequency of axillary lymph node metastasis (detected at routine pathomorphological examination) in order to determine the group of patients who do not require lymph node surgery.

Materials and methods. We analyzed medical records of 485 patients with breast cancer and no signs (either clinical or instrumental) of regional lymph node involvement who underwent surgery at the first stage of their treatment.

Results and conclusion. In patients with cN0 cancer, only the size of primary tumor ≤1 cm was found to be a significant factor indicating that regional lymph nodes are not involved (in addition to palpation, ultrasound, mammography, and spiral x-ray computed tomography of the chest). In patients with сТ1c cancer, the majority of standard immunohistochemical markers cannot yet be used as predictors of regional lymph node involvement. However, tumor differentiation grade G1 is rather an exclusion, which in combination with the size of the primary tumor сТ1c can also be considered as a significant prognostic factor.

Transarterial chemoembolization of the main vessels feeding the tumor is a minimally invasive procedure, which is intended to block off the blood supply to the tumor and to deliver a cytotoxic agent to tumor cells. Initially, this method was used in emergency cases, but later it gained the trust of clinicians, who began to use it in non-emergency patients with clinical manifestations, when angiography showed well-supplied tumors inaccessible for ablation or surgical removal, including those in non-standard difficult cases. Selective catheterization of dominant arteries in recurrent tumors along with chemoembolization with drug-eluting microspheres is extremely challenging, since most of recurrent tumors have a well-developed neovascular network. HepaSphere microspheres, due to their hydrophilicity and high biological compatibility with tissues, allow the deposition of a chemotherapeutic agent in the tumor. This therapy provides pronounced hemostatic and antitumor effects confirmed by morphological and immunohistochemical examination. Currently, transarterial chemoembolization is mainly used for primary tumors and becomes increasingly popular as an element of combination therapy for patients with pelvic tumors. In this article, we analyze clinical data for 14 patients with recurrent pelvic tumors who underwent chemoembolization with HepaSpheres loaded with doxorubicin or irinotecan as a part of their palliative care.

Objective: comparative evaluation of treatment methods for neoadjuvant intra-arterial chemotherapy and chemoembolization by drug-saturated microspheres followed by surgical treatment in II–IVa stages cervical cancer.

Materials and methods. This study presents the results of complex treatment in 209 patients (average age – 40.57 ± 8 years) with II– IVa stages cervical cancer and 384 endovascular interventions as the first stage of complex treatment in the period from 2010 to 2016. The scheme neoadjuvant intra-arterial chemotherapy was carboplatin (AUC6 intra-arterial) + irinotecan (200 mg/m2 intravenously on day 1) every 21 days. Radical surgical treatment was performed basically after 2 cycles of chemotherapy. Patients who did not respond sufficiently to neoadjuvant intra-arterial chemotherapy underwent a radical course of chemoradiation therapy according to the standard scheme.

Results. The overall response to neoadjuvant intra-arterial chemotherapy was 84.8 % and 79 % of patients in groups of chemoinfusion and trans-arterial chemoembolization, respectively (p >0.05). Operability was higher in group of chemoinfusion (69 % versus 46.4 %) (p <0.01), and fewer patients with metastases to regional lymph nodes were revealed in this group (30.2 % versus 42 %), p <0.05. Overall and survival rate is statistically significantly better in group of chemoinfusion – 63.9 % and 61 % versus 43 % and 42 %, respectively, p <0.05. At the same time, statistically significant differences between the groups were revealed only at stages III–IVа cervical cancer. Radically operated patients, as expected, had a better prognosis (p <0.001). The age of patients, tumor differentiation and therapeutic pathomorphosis did not affect the prognosis of life.

Conclusions. Neoadjuvant intra-arterial chemoinfusion and chemoembolization using irinotecan + carboplatin scheme are relatively safe treatment methods with acceptable toxicity and have a high cytotoxic effect. Patients in chemoinfusion group have a better prognosis compared with patients in chemoembolization group. Selective chemoembolization with subsequent surgical treatment or radiation therapy may be the treatment of choice for stage II cervical cancer complicated by bleeding.

Objective: to study the possibilities of ultrasound using modern technologies in monitoring the effectiveness of radiation therapy of cervical cancer.

Materials and methods. The results of observations of 96 patients were analyzed.

Results. Thirty-seven patients were diagnosed with recurrences and metastases of cervical cancer, and 59 patients were determined the criteria of full therapeutic effect.

Conclusions. Multiparametric ultrasound is a highly informative method that allows diagnosing both the progression of the disease and the full therapeutic effect after radiation therapy of patients diagnosed with cervical cancer.

This article describes the clinical and epidemiological characteristics of neuroendocrine tumors (NET) of the female reproductive system, including ovarian NET. We focus on current approaches to the classification of these tumors based on the embryogenesis and biological properties of the tumor. We also cover the most important clinical and morphological characteristics of ovarian NET as well as their microscopic and immunohistochemical features.

This article summarizes the results of the most recent studies exploring changes in the stromal component of the endometrial tissue during malignant transformation in patients with precancerous conditions, particularly transformation of glandular hyperplasia of the endometrium into endometrioid adenocarcinoma. We cover the most important issues related to microcirculatory remodeling and changes in the cellular microenvironment of the stroma in terms of the effects exerted by biologically active molecules produced by different cell populations. We analyzed specific changes occurring in the stromal components in various types of glandular hyperplasia of the endometrium and changes during endometrioid adenocarcinoma progression. We focus on the prognostic and diagnostic values of these morphological changes, considering the results of the latest molecular studies, which can be later used for personalization of patient prognosis.

High efficacy of anti-PD-1 therapy has been shown in malignant tumors with mismatch repair deficiency. According to the literature review, mismatch repair deficiency is determined in 20–40 % of all endometrial cancer cases and up to 48 % of its endometrioid subtype. We report the short review of the recent literature and the case of durable partial response on pembrolizumab immunotherapy in a patient with a metastatic endometrioid adenocarcinoma with MMR-deficiency progressed on 2 chemotherapy lines. Partial response was achieved after 6th course, treatment was stopped after 8th course. Patient is on follow-up without any anticancer treatment for 11 months. Partial response lasts for 13 months, with further reduction in tumor size. The treatment was well tolerated without adverse events.