Objective: development of a predictive model based on binary regression to determine the likelihood of progression of I stage breast cancer.

Materials and methods. A retrospective analysis of data of 385 patients with T1N0M0 stage breast cancer was performed. The minimum follow-up period was 120 months and the maximum made 256 months, with an average follow-up of 191 ± 36 months (16 ± 3 years). Using a forward stepwise selection (binary regression), the most important prognostic factors were selected, on the basis of which the predictive model “Risk Assessment Algorithm for Recurrence of Breast Carcinoma” was constructed.

Results. During the study period, recurrence of stage I breast cancer was reported in 67 patients, representing 17.4 % of the total cohort. Five prognostic factors were selected by binary regression: grade, histological type, estrogen receptor expression, HER2 / neu overexpression and Ki-67 amplification. Kaplan–Meier analysis and Cox proportional hazards method demonstrated the influence of each of the selected factors on disease-free survival. Comparative analysis with other existing models showed that our prognostic model is inferior to Adjuvant! Online in terms of sensitivity (85 % ver- sus 95 %). However, it is superior in specificity (58 % versus 38 %), PPV (69 % versus 63 %) and AUC (84 % versus 70 %).

Conclusions. In I stage breast cancer, factors such as grade, histological type, estrogen receptor expression, HER2 / neu overexpression and Ki-67 amplification are the most significant predictive factors influencing recurrence rates. The algorithm for assessing the risk of recurrence of stage I breast cancer can predict the risk of tumour progression with a sensitivity of 84 % and a specificity of 58 % (p <0.05).

Background. Breast cancer (BC) is the most common type of malignant neoplasm among women, with a high rate of metastasis. Early non-invasive diagnosis is required to increase the effectiveness of anticancer therapy.

Objective: to determine the content of circulating tumor cells (CTCs) and their derivatives in the peripheral blood using the MDA-231 aptamer, compare the results obtained with the clinical and molecular characteristics of BC.

Materials and methods. The study included 22 patients with BC. Detection of CTCs and circulating tumor microemboli was carried out in 3.5 ml of the blood of BC patients with the help of the MDA-231 aptamer which is affine for breast cancer cells, labeled with the fluorescent Cy3 dye. The count of CTCs in the blood samples was performed using fluorescent and laser scanning microscopy.

Results and conclusions. The content of CTCs and circulating tumor microemboli in the peripheral blood of patients with BC of various molecular subtypes was analyzed using the MDA-231 aptamer. The relationship between the number of CTCs and the molecular biological subtype was revealed. The obtained results show the possible prognostic value of CTCs use for monitoring effectiveness of anticancer therapy and control of recurrence of BC.

Background. Standard treatment for hormone-dependent operable breast cancer includes surgery, hormone therapy (HT), and radiation therapy and chemotherapy (when necessary). Some elderly patients do not undergo surgery because of the high risk or refuse to be operated on. In such case, the only possible option is conservative treatment with hormones (± radiotherapy).

Objective: to compare progression-free survival, local relapse-free survival, and metastasis-free survival between elderly patients with hormone-dependent breast cancer receiving different treatments (surgery + HT vs HT alone).

Materials and methods. This study included 60 patients with stage I–II hormone-dependent breast cancer aged 65 years and older. Thirty patients in the experimental group received HT only, while 30 patients in the control group received surgery + adjuvant HT. All patients were treated at Saint Petersburg Clinical Oncology Dispensary. Patients were followed up for 3 years.

Results. During 3 years of the study, three women from the experimental group (10 %) were found to have local tumor growth despite treatment. Three patients in the control group (10 %) also had disease progression, but it was associated with the development of bone metastases.

Conclusion. The conservative approach to treatment of early hormone-dependent breast cancer in elderly patients is a possible option in routine clinical practice; however, it requires the analysis of indications and identification of patients who will benefit from this approach.

Background. Given the steady and intense increase in the incidence of breast cancer, the problem of the development of early complications of reconstructive operations, depending on the characteristics of surgery, remains urgent.

Objective: to analyze the characteristics of the early postoperative period in patients operated on for breast cancer using different surgical techniques.

Materials and methods. A comparative analysis of clinical examination data was carried out, as well as laboratory and instrumental diagnostic methods for 353 women with stage I to IIIA breast cancer after various surgical treatment options and 40 patients after mammoplasty.

Results and conclusions. It has been shown that neither single-step nor delayed reconstructive operations after radical mastectomy increase the incidence of complications in the early postoperative period. Single-step breast reconstruction with the help of an expander can be used in patients with I–IIIA stages of the tumor process.

The article deals with a peculiar group of breast diseases, which belongs to the B3 category according to the BI-RADS classification, the so-called lesions with undefined malignant potential. The basic information concerning their biological behavior and modern tactical approaches to the management of patients with similar changes in the mammary gland are presented. The possibility of conservative management, as well as the minimization of surgical aid, in cases of indications for it, up to vacuum aspiration biopsy is being considered. In addition, the significance of these diseases for the subsequent development of pre-invasive and infiltrative cancer is discussed.

The luminal HER2-negative subtype is the dominant variant of metastatic breast cancer; modern combined endocrine therapy with CDK4/6 inhibitors due to significantly change the prognosis of the disease, not only for increasing progression free survival, but also for significantly prolonging the life expectancy of patients. This review presents the features of the mechanism of action of CDK4/6 inhibitors, the most significant and updated results of large, randomized trials with ribociclib (MONALEESA-2, MONALEESA-3, and MONALEESA-7) assessing the efficacy and safety of combined endocrine therapy with various endocrine partners in a population of premenopausal women and menopausal patients. The prospects for the use of CDK4/6 inhibitors for therapy patients with visceral crisis are shown.

In this article, we review of the existing literature on cystic lymphangiomas and report a case of cystic lymphangioma of the breast in an 83‑year-old patient. This case required differential diagnosis between infiltrative cancer and cystic lymphangioma of the breast. The patient has undergone surgery (tumor removal). No complications were observed.

Breast cancer is one of the most common female cancers and the leading cause of cancer death in women. The method of positron emission tomography, combined with computed tomography, makes it possible to assess not only anatomical and structural, but also metabolic changes in tumor tissue. The increased accumulation of 18F-fluoroestradiol in the pathological focus correlates with the estrogen receptor-positive status of the tumor, which is confirmed by tissue immunohistochemistry studies. The receptor status of a tumor formation fundamentally affects the choice of therapeutic tactics. The presented clinical examples demonstrate the capabilities of positron emission tomography, combined with computed tomography, with 18F-fluoroestradiol in the diagnosis of the estrogen receptor-positive tumor lesions.

Objective: to identify the features of the frequency of occurrence, clinical presentation, methods of diagnosis and treatment of vitreous cell carcinomas of the cervix.

Materials and methods. The publication highlights 4 cases of diagnosed GCC of the cervix at the N. N. Petrov National Medical Research Oncology Center for a five-year period from 2015 to 2020.

Results. The incidence of vitreous cell carcinomas of the cervix is 1.08 % of all cases of cervical cancer. The study included only patients with locally advanced forms of stage II and III diseases. All patients underwent individualized treatment. In three cases, progression of the disease was observed during treatment.

Conclusions. The main problem is the rare occurrence of vitreous cell carcinomas of the cervix. The choice of treatment tactics is decided only on a multidisciplinary basis and requires further research.

Due to the availability of effective primary prevention methods and screening strategies, cervical cancer is one of the pre-ventable malignancies. Death rates from cervical cancer remain high. Moreover, in most cases, the tumor is detected at advanced stages. It creates the problem of finding the reasons for the late primary diagnosis of invasive cervical cancer. The article discusses issues related to the characteristics of the main histological types of cervical cancer from the standpoint of the clinical, morphological and socio-demographic characteristics of the profiles of patients with advanced disease. The current understanding of the factors associated with late primary diagnosis of cervical cancer at advanced stages is highlighted.

A clinical case of endometrial cancer in a patient with complete doubling of the cervix and the body of the uterus is presented. The combination of this pathology is quite rare and is often accompanied by difficulties in timely diagnosis and choice of treatment tactics. The article presents an analysis of studies to identify similarities and differences in the clinical and morphological characteristics and prognosis of endometrial cancer associated with uterine abnormalities. This clinical case clearly demonstrates the features of the clinical course of endometrial cancer against the background of a congenital abnormality of the uterus. The standard combined treatment performed showed a good result and a satisfactory quality of life for the patient.

Cervical cancer (CC) is the fourth most common cancer in women worldwide. Every year, more than 500,000 women are diagnosed with CC, and the disease leads to more than 300,000 deaths worldwide. Infection with the human papillomavirus is the cause of CC in most cases. The disease is largely preventable through preventive vaccination. Approximately 90 % of CC cases are diagnosed in low-and middle-income countries where there are no organized human papillomavirus screening and vaccination programs. A special group in this disease consists of patients who develop recurrent / metastatic CC. To date, the most promising direction of drug treatment for this pathology is drugs that act on the control points of immunity – the PD-1 receptor / PD-L1 ligand, which are used by the tumor to block the immune system. The article presents a clinical case demonstrating the efficacy of the PD-1 inhibitor pembrolizumab for the treatment of recurrent / metastatic CC.