Vol 15, No 4 (2019)

Background. The development of effective methods for diagnosing multicentric breast cancer patients (BC) is of great clinical importance, because it determines the tactics of surgical and radiation treatment.

The aim of study: to compare diagnostic accuracy of scintimammography (SMG), digital mammography (MMG) and ultrasound (US) in the diagnosis of multicentric BC.

Materials and methods. 410 women with histologically confirmed BC were included in this analysis. SMG was performed with dual detector SPECT unit Forte (Philips, Netherlands). Mammographic digital images were obtained on Senographe DS unit (GE Healthcare, USA). In 319 of 410 evaluated women we were able to determine results of preoperative US with high-frequency (7—18 MHz), high resolution linear array transducer. The pathological report was used as the gold standard. Multicentric BC was defined as 2 or more distinct invasive tumors occupying more than one quadrant. Detection of additional grouped calcifications of malignant type occupying a small portion of breast tissue (more than 15 pieces per 1 sq. cm) was considered as another mammographic sign of multicentric BC.

Results. According to histopathological examinations multicentric BC was diagnosed in 51 of 410patients. SMG was more effective than MMG in detecting multicentric BC: sensitivity — 84.3 % vs 54.9 % (p <0.001), specificity — 98 % vs 95.8 % (p = 0.02), accuracy — 96.3 % vs 90.7 % (p = 0.04), positive and negative predictive values — 86 % vs 65.1 % (p = 0.004) and 97.8 % vs 93.7 % (p = 0.01), respectively. Histologically multicentric BC was revealed in 44 of 319 women that had US of the breasts. Sensitivity, specificity, accuracy, positive and negative predictive values for US were 52.3 %, 94.5 %, 88.7 %, 60.5 % and 92.5 %, respectively. SMG significantly (p <0.001) outperformed US for all diagnostic characteristics. Combination of MMG and SMG characterized by increased sensitivity (94.1 %), 94.2 % specificity, 94.1 % accuracy and positive predictive value of only 69,6 %.

Conclusions. SMG is significantly more sensitive (84.3 %) than MMG (54.9 %) and US (52.3 %) in detection of multicentric BC. High (86 %) positive predictive value of SMG advocates it as a tool for surgery and radiotherapy planning.

Breast cancer is the most common malignancy in females. More than 1.7 million of cases are detected annually worldwide. The incidence of breast cancer in Russia has increased by 64 % over the last 20 years. There was a 1.43-fold increase in the prevalence of breast cancer (from 297 to 457cases per 100,000) between 2005 and 2017. A total of59,538 new cases were registered in the Russian Federation in 2012. In Russia, breast cancer is the most common malignancy among women aged 40—85years and the second most common cancer among women aged 15—39 (after cervical cancer). The disease is primarily detected in women aged between 40 and 54 years (29.5 %). More than 66,000 of new cases of breast cancer are registered in the Russian Federation annually. In 2017, there were 70,293 new cases of breast cancer; of them, 49,134 patients (69.9 %) hade stage I—II breast cancer. There was a 0.02 % increase in the proportion of new cases of stage I—II breast cancer in 2016—2017. For this reason, it is important to study in depth the markers of breast cancer used in everyday practice in order to personalize the treatment of patients with breast cancer.

Background. The non-genomic effects of thyroid hormones, mediated through exposure to the membrane receptor CD51/CD61, are expressed in the activation of atypical cell proliferation, stimulation of tumor angiogenesis and cell migration. In connection with these cellular effects, the thyroid status of cancer patients can have prognostic value.

The aim of study: to assess the effect of thyroid status on disease-free survival of patients with stage III ovarian cancer (OC).

Materials and methods. Prospective trial with eligibility criteria for the inclusion and exclusion of participants was conducted. The study included 128 patients with stage III OC aged 45 to 70 years. All patients before treatment was determined thyroid status by examining the serum levels of thyroid hormones and performing an ultrasound examination of the thyroid gland. All patients received a comprehensive treatment of OC, including surgery and chemotherapy, and have complete remission following after treatment. After confirming the recurrence of the disease and/or death of the patient, the duration of the disease-free survival was determined.

Results. Medians disease-free survival were 13.5 months, 17.8 months and 11.1 months for the euthyroid, hypothyroid and hyperthyroid groups, respectively, while significant differences in the medians disease-free survival occurred between the euthyroid and hypothyroid groups (p = 0.0206) and between the hypo- and hyperthyroid groups (p = 0.0156).

Conclusions. Patients with hypothyroidism before the treatment of advanced OC have better disease-free survival. Thyroid status is independent favorable prognostic factor for survival in OC.

This article discusses the problems of rational pharmacotherapy in women with vulvovaginal atrophy developed after gynecological operations or during combination treatment for tumors of the female reproductive system. The range of adverse effects makes long-term treatment of these patients necessary not only to relieve the symptoms, but also to prevent possible problems, such as sexual dysfunction, postcoital bleeding, and recurrent urinary tract infections. Considering the pathogenesis of vulvovaginal atrophy associated with many unpleasant symptoms, such as dryness, burning, and dyspareunia resultedfrom low levels of estrogen, we have provided a rationale for topical application of Flamen® gel with subsequent restoration of vaginal pH. Effective relief of pain syndrome, which usually manifested itself with burning, itching, swelling, and hyperemia of the vaginal vestibule and perineal tissues, ensured maximum compliance during treatment and allowed the achievement of not only clinical, but also pathogenetic effect.

The article is devoted to the history of the St. Petersburg School of Oncogynecology from the moment of its creation to the present day. Brief biographies of the founders and scientific directions of the St. Petersburg School of Oncogynecology are presented.