The recurrence rate after organ-sparing surgeries for breast cancer depends on the resection margins: R1 status is associated with a higher risk of recurrence than R0.
We analyzed a group of breast cancer patients with an R1 resection margin who underwent organ-sparing/oncoplastic surgeries. The R1 resection margin was detected in 62 out of 1279 patients who had organ-sparing/oncoplastic surgeries (4.9 % ± 0.6 %). In the group with invasive cancer and R1 resection margin, 80 % of patients were diagnosed with lobular carcinoma, whereas 14.8 % of patients had invasive cancer with no specific signs.
We divided the group of repeated surgeries according to their histological structure at the resection margin: 28 patients were found to have carcinoma in situ, while 13 patients had invasive cancer.
Among patients with carcinoma in situ, the resection margin after repeated surgery had no signs of malignancy in 14 women (50 %), while 10 (35.7 %) and 4 (14.3 %) women were diagnosed with carcinoma in situ and invasive cancer, respectively.
In case of invasive cancer, 4 patients (30.8 %) had no signs of malignancy in their resection margins, while 1 (7.7 %) and 8 (61.5 %) patients were found to have carcinoma in situ and invasive cancer, respectively
Follow-up of patients with an R1 resection margin after repeated surgery or radiotherapy revealed no cases of local recurrence between 3 and 65 months.

Breast cancer is one of the most commonly diagnosed cancers and the leading cause of cancer mortality among women. Approximately 70–80 % of breast cancers are estrogen (ER) and/or progesterone receptor-positive, thus making endocrine therapy an important stage of treatment. Receptor expression in breast cancer cells is usually assessed by tissue immunohistochemistry. The method of positron emission tomography, combined with computed tomography (PET/CT), makes it possible to evaluate not only anatomical and structural, but also metabolic changes in tumor tissue. ¹⁸F-Fluoroestradiol (¹⁸F-FES) is a radiopharmaceutical drug, an estradiol analogue, which is used in the diagnostics of ER-expressing tumors and is utilized for detection and quantification of ER expression in vivo. Various studies show that ¹⁸F-FES accumulation indicates presence of ER-positive tumor tissue, which, in most cases, is confirmed by tissue immunohistochemistry. Although current guidelines recommend ¹⁸F-fluorodeoxyglucose PET/CT when routine examinations demonstrate ambiguous results, ¹⁸F-FES PET/CT can be the preferable imaging modality in the diagnostics of ER-positive breast cancer. It should be noted, that PET/CT with ¹⁸F-FES can also be effective for evaluation of tumors with a high level of ER expression, like ovarian cancer.

The article discusses modern approaches in the treatment of HER2-positive breast cancer (BC) with brain metastases (BM).
The patients are subject to multidisciplinary, comprehensive and biologically – oriented treatment, with the involvement of a neurosurgeon and a radiation therapist to make a decision considering local treatment of BM, as well as a clinical oncologist to choose systemic drug therapy. Local treatment of HER2+ BC with BM patients includes surgical treatment and/or radiotherapy. Use of targeted anti-HER2 therapy changes “biology” of the disease from aggressive to indolent.
In the prospective KAMILLA trial, clinically significant antitumor activity of trastuzumab emtansine was found for the first time both in patients with HER2+ BC with BM, who were previously treated with radiotherapy, and without radiotherapy in the anamnesis, which suggests the validity of further use of trastuzumab emtansine in this category of patients.
The antitumor activity of trastuzumab emtansine in patients with HER2+ BC with BM was also confirmed in preclinical models. Despite the similar drug distribution in the tissues, trastuzumab emtansine, in contrast to trastuzumab, significantly slowed the growth of metastases, causing the induction of apoptosis in HER2+ BC models with BM in mice.

Descripton of metastatic HER2-positive breast cancer clinical case is introduced, multilineal strategy basing on clinical situation and disease features is justified, justification of the choice of anti-HER2 treatment in every line is made, in compliance with russian and foreigh oncology associations guidelines, along with comparance of rutine treatment results and randomised trials data.

Background. Infection with oncogenic types of human papillomavirus (HPV) is the leading cause of cervical cancer and its immediate precursors – squamous intraepithelial lesions. However, the persistence of HPV may not be sufficient for the occurrence of malignant transformation, and there may be other exogenous or endogenous factors that, in combination with the virus, increase the risk of developing and progressing cervical neoplasia.
Objective: identification of risk factors that modulate the course of low-grade squamous intraepithelial lesions (LSIL) in women of reproductive age.
Materials and methods. In 110 women aged 18 to 45 years with a diagnosis of LSIL, we evaluated the impact of risk factors (sexual behavior, reproductive function, contraceptive methods, smoking, HPV infection) on the course of the process (recovery, persistence or progression) during the 12-month follow-up period. HPV testing was performed by real-time PCR.
Results. The average age of the study participants was 31.55 ± 7.17 years. Our observations showed that frequent artificial abortions, the practice of risky sexual behavior (early sexual debut, frequent change of sexual partners) increased the risk of persistence and progression of mild cervical cytological abnormalities. The use of oral contraceptives, barrier contraception and smoking did not affect the outcome of the disease.
The prevalence of HPV among women with LSIL was 70.91 % (78/110). The predominant types were HPV 16 (35.45 %), HPV 33 (12.73 %) and HPV 18 (12.73 %). HPV 16 was more common in the progression group (62.50 %) than in the regression and persistence groups (14.63 % and 43.40 %, p <0.05). Progression of neoplasias was more often observed in patients with signs of multiinfection of the cervical epithelium with HPV. Single HPV infection was higher in the group of recovered women.
Conclusions. The study found that a large number of induced abortions, the practice of risky sexual behavior, the presence of HPV type 16 and multiple HPV infection are factors contributing to the persistence of LSIL and progression to HSIL. These data may be useful for the management of women with mild cervical cytological abnormalities.

Objective: to study the incidence of cervical cancer in women in urban and rural areas of the Republic of Buryatia.
Materials and methods. The material of registered cases of cervical cancer for 30 years (1987–2019) is taken from the documentation of the Republican Oncological Dispensary, and calculations are carried out in intensive indicators of morbidity per 100,000 women in the whole Republic, in cities, in rural areas using data from the annual population. The prognostic assessment of the incidence of cervical cancer was carried out using the method of regression analysis by extrapolating the trend. All materials were processed using the programs Statistica 8.0 and Excel 2003 with a statistically significant level of p <0.05.
Results. In the region, during the analyzed period, the incidence of cervical cancer among women is high, mainly in urban than in rural areas. However, the latter also have an upward trend. The most susceptible to this pathology is the age group active in the labor and social plan – 35–54 years.
Conclusions. A feature of the morbidity process of women in the city was its earlier age, 25–29 years, and its peakthe period of 45–49 years. When forming high-risk groups, it is necessary to pay close attention to the category of rural women and take into account the age group most susceptible to this pathology.

The article considers the possibility of surgical treatment of a patient with giant Buschke–Löwenstein condyloma and the possibility of a reconstructive plastic component. The positive aspects of the surgical technique with a reconstructive plastic component are presented. The question of closing a wound defect after extensive vulva resections and performing plastic techniques has always caused ambiguous disputes among various authors, and has led to the complication of the plastic component, as well as a decrease in indications or refusal of this type of operation.