Biopsy of signal (sentinel) lymph nodes (LN) has been performed at the N.N. Petrov National Medical Research Oncology Center, Ministry of Health of Russia, for almost 20 years. In the first few years, contrast-visual method (1 % blue isosulfan and triphenyl methane control) was used in 640 patients with early (T1–2N0M0) breast cancer. In 150 patients from this cohort, standard axillary dissection was performed irrespectively of the results of signal (sentinel) biopsy. The rate of false positive responses varied between 4.6 and 6.6 %. Since 2012, radioisotope method of visualization of signal LN with intratumor administration of ^99mТс-technephyte colloid particles has been used (in 708 patients with T1–3N0M0 breast cancer). This type of signal LN biopsy had the following diagnostic characteristics: sensitivity was 58.9 %, specificity was 96.2 %, diagnostic accuracy was 87.1 %.

In parallel with this study, in 2016 a study of diagnostic accuracy and safety of biopsy of axillary LN after neoadjuvant systemic therapy was started. The study included 263 patients with T1N1–3M0, T2–3N0–3M0, T4N0–1M0 breast cancer. To evaluate clinical status of axillary LN, ultrasound, single-photon emission computed tomography, mammography at baseline and after completion of neoadjuvant chemotherapy ± targeted therapy (trastuzumab) were performed. In some patients, in the recent years a double method of signal LN labeling (radioisotope and fluorescent methods) was used.

In patients with baseline cN⁺-status, the rate of false positive signal LN biopsy conclusions was 13.6 %, in patients with baseline cN0-status it was 7.7 %.

The study of double contrast of axillary LN and targeted label of metastatic LN prior to neoadjuvant systemic therapy continues. In total, various modifications of biopsy of signal LN were performed in 2,000 patients with breast cancer.

The study protocol was approved by the biomedical ethics committee of N.N. Petrov National Medical Research Oncology Center, Ministry of Health of Russia.

All patients gave written informed consent to participate in the study.

The aim of the study is to estimate potentiality of the cytological diagnostics of different types of mucin producing carcinomas of the breast.

Materials and methods. Cytological evidences of the investigation of 35 patients with mucinous mass in cytological specimens were studied. Different types of mucinous carcinomas which had been diagnosed by cytological method were identified retrospectively.

Results. “Pure” mucous carcinomas were divided into two types: hypocellular (A) and hypercellular (B) (n = 9 (25.7 %) and 14 (40 %), respectively). Mixed carcinomas (mucous carcinoma with invasive no special type carcinoma) were noticed of 12 women (34.3 %). 24 cell characteristics of mucin producing carcinomas were identified. Some cytological characteristics were estimated due to multiple factor analysis and discriminant analysis.

Conclusions. Investigation results indicated that cytological technique is a high-quality diagnostic method. The fraction of correct classification of mucous carcinoma types based on discriminant analysis was 92–99 %.

The study protocol was approved by the biomedical ethics committee of The Altai State Medical University, Ministry of Health of Russia.

The use of CDK4/6 inhibitors in combination with endocrine therapy (aromatase inhibitors and fulvestrant) allowed us to radically change our understanding of opportunities in the treatment of hormone-positive HER2-negative advanced breast cancer and determine optimal therapy sequencing. The results of randomized clinical trials and over 5-years accumulated international experience in the use of CDK4/6 inhibitors in real clinical practice prove that the use of combinations with CDK4/6 inhibitors can achieve significant efficacy results and increase the survival rates when prescribed in 1 and 2 lines of treatment.

In this paper, we present the results of a survey conducted in July–October 2019 among 48 oncologists in Moscow, that were asked to choose, in their opinion, the most preferable patient’s profile and molecular and biological features of hormone-positive HER2-negative advanced breast cancer, in which the use of combination therapy with CDK4/6 inhibitors will provide the greatest benefit.

Conflict of interest. MD M.A. Mukhina is the medical director of oncology in the Eurasia and Baltic region of Pfizer Innovations Company

The article examines the possibilities and features of ultrasound in the diagnosis of endometrial pathological conditions on the background of taking tamoxifen in women diagnosed with breast cancer based on data obtained from studying the sources of domestic and foreign literature from 1994 to 2018.

The article considers the aspects of selection of post-neoadjuvant therapy for patients with residual breast cancer depending on biological subtype and molecular profile of the tumor. Analysis of morphological and molecular markers allowing to evaluate sensitivity of malignant breast tumors with high recurrence risk to new types of systemic treatment is presented.

It is known that currently PARP inhibitors are actively used in the treatment of tumors of the female reproductive system. A large number of studies have been presented demonstrating the effectiveness of PARP inhibitors in the treatment of BRCA-associated ovarian cancer. It was found that mutations in the BRCA1 and BRCA2 genes are also characteristic of breast cancer (BC). However, PARP inhibitors are rarely used in clinical practice in the treatment of BC. So far, only olaparib has become the first PARP inhibitor approved for the treatment of metastatic BC. This review presents data over the past ten years showing the high efficiency of PARP inhibitors in the treatment of malignant neoplasms of the mammary gland. In 7 of 28 studies analyzed, positive results were achieved with combined treatment with chemotherapeutic drugs and PARP inhibitors. So, for example, in two studies in the treatment of BRCA-associated BC, the response to treatment in patients was 72.5–73.2 %. Thus, PARP inhibitors are of great interest and are of practical value in the treatment of patients with BC.

In breast cancer, genetic profile and expression of immunohistochemical markers determine prognosis and treatment scheme. Triple-negative breast cancer is characterized by absence of hormone receptor expression and negative HER2 status, as well as high proliferative index. These features of the tumor tissue limit doctors» selection of antitumor drugs. Development of triple-negative variant of tumor tissue is associated with a mutation in the BRCA1/2 gene. Consequently, determination of BRCA1/2 mutations is a prognostic biomarker, and in triple-negative cancer presence of expression of immune checkpoint proteins, multiprotein receptors on the surface of immune cells and tumor tissue play an important role in prognosis and selection of treatment strategy. Additionally, some studies demonstrate existence of multiple prognostic markers which allow to divide patients with triple-negative breast cancer into subgroups facilitating prognosis and selection of treatment strategy.

The aim of the study is to evaluate the role and prognostic significance of magnetic resonance imaging (MRI) perfusion methods in prognosis of disease course and outcome based on evaluation of the perifocal infiltration zone in pelvic disorders in women.

Materials and methods. Retrospective analysis of pelvic MRI data obtained using MRI system with induced magnetic field of 1.5 T was performed. The study included 530 protocols of pelvic scans in women. Two equal groups (n = 265) of patients with oncological and nononcological pathologies of pelvic organs were formed; after application of propensity score matching, each group contained 165 patients. All examination protocols included dynamic contrast enhancement. The obtained data were statistically analyzed using the Stata 13 software.

Results. In the study, types of dynamic curves obtained using dynamic contrast enhancement from the perifocal infiltration zone were analyzed. There was no data showing a correlation between the type of dynamic curve from the zone of perifocal changes and disease prognosis or possibility of differential diagnosis.

Conclusions. Evaluation of the perifocal infiltration zone per MRI results with intravenous contrast does not affect prognostic accuracy of the method (p >0.05); contrast can be used only for differential diagnosis or evaluation of local advancement of the process.

Researches about the origin of epithelial ovarian tumors (EOT) tell about its conception. In particular, the origin of cells from the secondary mullerian system. Also, in the article we examine a new hypothesis that the EOT originates in the epithelium of the fallopian tube (FT) – their contradictoriness and new conception of “precursor escape” which tries to explain the phenomenon of injuries absence of FT by high-grade serous ovarian carcinoma. Carcinogenesis from the FT represents great opportunities for reassessment of clinical data. Also, the article represents the role of stem cells of the surface epithelium of ovaries and FT in EOT carcinogenesis.

The past 2019 and the beginning of 2020 were remembered as the beginning of the spread of the threatening human civilization of the Coronavirus Disease 2019 infection (COVID-19) caused by the SARS-CoV-2 coronavirus, that threatens human civilization. In connection with the epidemic, which quickly turned into a pandemic, on March 11, 2020, the World Health Organization declared a public health emergency of international significance, with high risks at the global level. Despite the growing incidence and spread of COVID-19 in our country, ensuring the protection of patients» rights is still one of the priorities of public health. It is necessary to assess the extent to which the re-profiling or introduction of an anti-epidemic regime in medical institutions that provide cancer care restricts the rights of patients whose guarantees, despite the pandemic, are enshrined in current legislation.

The aim of the study is to analyze the legislation on restricting the rights of patients in connection with the threat of spread of COVID-19, evaluate the effectiveness and validity of re-profiling and switching to an anti-epidemic mode of operation of medical institutions that provide cancer care.

It is noted that any legal prohibitions and restrictions must be justified by the purposes for which they are established, be scientifically justified and not violate the human rights and freedoms proclaimed by the Constitution of the Russian Federation. Measures taken by the state to contain the spread of the COVID-19 epidemic should be necessary to prevent or eliminate possible harm, if this cannot be done by other means and if the harm to the rights of citizens is the least possible.