The expression of the SMAD2, SMAD4, SMAD7, and СOX-2 genes and the levels of Smad4, phosphorylated Smad2, and Smad7 proteins were analyzed in the human breast cancer (BC) cell lines MCF-7, BT-474, and ZR-75-1. The SMAD2 and SMAD4 genes were found to suppress COX-2 gene expression in the estrogen receptor-positive BC cells and to be linked to their metastatic potential. Smad4 and Smad2 apparently suppress COX-2 mRNA and protein synthesis and Smad7 is their antagonist and stimulates COX-2 formation. Smad2, Smad4, Smad7 proteins may be regarded as new potential targets for targeted BC therapy.

Assessment of quality of life is an important, valid, informative, and cost-effective procedure for evaluating the efficiency of treatment in patients with breast cancer metastasizing to the bone, receiving therapy with bone-modifying agents, including targeted therapy with denosumab. The administration of denosumab significantly improves quality of life in patients with breast cancer metastasizing to the bone, by maintaining their general status, reducing the intensity of pain syndrome, and prevents osseous complications: pathological fractures, spinal cord compression, hypercalcemia, as well as the need for radiotherapy or surgery for bone metastases.

The paper gives the results of evaluating the time course of changes in the level of bone resorption markers (S-CTx and dPir) in pami- dronate-treated patients with bone metastases from breast cancer. It shows the relationship of these markers to clinical and X-ray find- ings. The markers were not found to be of high clinical significance as a means for diagnosing bone metastases and estimating treat- ment trends.

Objective: to develop and introduce an accelerated partial breast irradiation procedure in patients with early-stage breast cancer after organ-saving operations using three-dimensional conformal teleradiotherapy (3D CRT) and to assess the preliminary results of treat- ment.
Subjects and methods: the trial enrolled 48 patients with verified T1-2N0-1micM0 stage breast cancer who received organ-saving treatment in the N.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, in 2008–2012. The median age of the patients was 63 years. All the patients underwent organ-saving operations with subsequent 3D CRT applied to the resected tumor bed with margins. Radiotherapy with a dose of 2.5 Gy was performed twice daily; the daily dose was 5 Gy; the course dose was 40 Gy. Indications for accelerated partial irradiation of the tumor bed were listed; the data of randomized trials were given.
Results. The median follow-up was 27 months; locoregional recurrences or distant metastases were found in no patients. Late radia- tion skin and soft tissue injuries were seen in no cases. All the patients were ascertained to have early-stage grade I radiation cutane- ous injuries according to the RTOG-EORTC classification. Excellent, good, fair, and poor cosmetic results were obtained in 12 (25 %), 34 (71 %), 2 (4 %), and 0 patients, respectively.
Conclusion. The developed accelerated partial breast irradiation procedure in patients with early-stage breast cancer after organ- saving operations at the median follow-up of 27 months showed good results, such as no local recurrences or distant metastases. Excel- lent and good cosmetic results were noted in 96 % of the patients.

Breast cancer and metabolic syndrome remains one of the most urgent problems of modern medicine worldwide. In this review, highlights the molecular pathways that underlie the negative impact of metabolic syndrome on the risk and prognosis of breast cancer. A better understanding of these pathways will help to optimize prevention and treatment of breast cancer in patients with metabolic syndrome.

The characteristics of the treatment tactics of the non-nodular forms of gynecomastia as mammary gland’s cancer prevention is given in the ar- ticle on the basis of the own observations and the example of the work of domestic and foreign authors. Variants of the mono- and combined drug therapy are analyzed. Treatment results are given. An attempt was made to determine the priority of the treatment variants being used.

Maintaining of the children and adolescents’ health is a priority tend in health policy of the Russian Federation. Among the total number of women seeking to mammologist clinic health from 2007 to 2011, teenage girls were just 0.3 %. But all of them were found breast disease such as a diffuse form of fibrocystic disease (61 %), nodular breast after surgery (17.3 %), contusion of breast cancer (13 %), non-lactational mastitis (8.7 %). Questionnaire of the adolescents showed that they do not know anything about risk factors of breast diseases, do not conduct monthly self-examination. A set of preventive measures is required to preserve women's reproductive health since their childhood.

A retrospective analysis of the impact of chemotherapy on the cognitive functions of patients with locally advanced breast cancer during treatment and long-term posttreatment period revealed a direct correlation of the degree of cognitive dysfunctions in relation to the number of courses of chemotherapy and the time after its termination.

Central nervous system (CNS) involvement by endometrial carcinoma is uncommon. Among 1710 patients registered for brain metastases at our institution between 1990 and 2012, 3 (0.18 %) developed brain metastases. All lesions (1 multiple, 2 single) were contrast enhancing on com- puted tomography scans, and were located in the cerebrum (lobus occipitalis) in 2 cases. The CNS was the only site of detectable disease in 1 patient with recurrent disease. One patient received radiotherapy (survival, 3 months) and two underwent surgical resection of solitary metas- tasis followed by radiotherapy (survival = 3 and 5 months and alive to the present). Prognosis of patients with CNS metastases from endometrial carcinoma appears poor; however, in a selected group of patients early diagnosis followed by multimodal treatment may result in a palliation of the disease.

The paper describes a rare case of invasive vulvar cancer in a young woman. Her medical history shows that cancer ulcer appeared 3 years ago; due to the fact that vulvar cancer is extremely rare, no sample from the 25-year-old woman during her visit to an obstetrician/gynecologist was taken to be microscopically examined. When the patient came to another regional oncology dispensary, she underwent only radiotherapy (the cumulative focal dose was 60 Gy). Symptomatic therapy for prolonged tumor growth was proposed. The woman was operated on with cutaneous- fascial plasty in the Novgorod Regional Clinical Oncology Dispensary. Primary intention healing occurred with a relatively good cosmetic result.

Paper deals with the content of CD95+-cells in the blood of patients with ovarian cancer and benign tumors. Found that patients with a malignant process and low CD95+-cells before treatment and during chemotherapy have a poor survival. The initial increase in the relative level CD95+- cells has no effect on survival, increasing the relative level CD95+-cells during chemotherapy is associated with poor survival. Concluded that the CD95 can not be a factor in the forecast, but the reaction of the organism to maintain its level within the physiological range in the treatment of ovarian cancer patients can achieve significantly better long-term results.

In the publication some clinical results and characteristics of dynamics of life quality in patients with cervical cancer are presented at carrying out an immunotherapy. Complex inspection of 77 patients, including 40 – with IIB and 37 – with the III clinical stage is carried out. The increase in extent of primary tumor regression is revealed at a combination of beam the

The article covers the problems of optimization of multidisciplinary hospital’s work in modern conditions. The example of the district clinic pres- ents activities for the organization of inpatient and outpatient specialized medical assistance which allow to improve its quality and effectiveness.

Persistent trophoblastic tumors (PTT) are the most common trofhoblastic tumors, which develop in women when proliferative trophoblastic activ- ity remains after evacuation of hydatidiform mole. The term persistent trophoblastic disease (PTD) is also widely used in the world literature. When PTD develops, new tissue is often not obtained. PTD is defined as a plateau or rise of serum β-hCG concentrations in tree subsequent weekly blood samples for 2 consecutive weeks (1, 8, 15 measurement days), the detection of β-hCG rise 6 months after hydatidiform mole evacu- ation. β-hCG is a glycoprotein hormone produced by trophoblastic tissue and a key tumor marker of gestational trophoblastic disease (GTD) with almost 100 % sensitivity and specificity. A persistent trophoblastic tumor may have the histological features of invasive hydatidiform mole, cho- riocarcinoma or rare forms of trophoblastic disease. PTD is a fatal disease, which occurs in women of reproductive age. PTT is nowadays typi- cally treated with chemotherapy according to international standards for GTD management. In the case of early identification and adequate treatment of PTT the cure rates approach 100 %.

The study included patients observed and treated in Russian scientific centre of roentgenradiology Ministry of Health Russian Federation in the period from 1999 to 2010 (n = 405): including 111 postmenopausal women who are without anamnestic data on the presence of cancer at any site, and the group of patients with gynecological cancer in postmenopause in including 60 patients with endometrial cancer, 67 patients with malignant epithelial ovarian tumors, 87 observations of cervical cancer and 80 patients with vulva cancer. The average age of the patients was 58.6 ± 0.4 years. The study of bone mineral density, body mass index and the level of estrogen receptor localization in different cancers of the reproductive system. Formed by 4 different types of menopause that best reflects a combination of hormone and hormone receptor status. This separation makes it possible to plan more differentiated the hormone replacement therapy in postmenopause. Along with this, there is reasonable prospects for prevention and early diagnosis of hormone-dependent tumors of the female reproductive system.

The review of literature describes the etiology and clinical features of sarcomas of the cervix uteri and current approaches to their diagnosis and treatment.