Aim. To monitor antitumor therapy using the level of circulating tumor cells (CTC) in the peripheral blood of breast cancer (BC) patients using aptamers.
Materials and methods. The study included 34 patients with BC. The primary determination of CTC content was performed before surgical treatment in 2017. 32 and 48 months after surgical treatment, the number of CTC and their derivatives was re-determined to assess the dynamics of the disease. Detection of CTC was carried out in 3.5 ml of blood from BC patients using the aptamer MDA231, which is affinity for BC cells and labeled with the fluorescent dye Cy5. Counting of CTC in smears of blood samples was performed using fluorescence and scanning laser microscopy.
Results. The observation period for patients ranged from 1 to 143 months. 7 (20.6 %) of 34 patients experienced disease progression. The median time to disease relapse was 69 months. A statistically significant inverse moderate correlation (p <0.05) was revealed between age and the number of CTC (–0.39). A statistically significant direct average correlation (p <0.05) between proliferative activity index Ki-67 and the number of CTC (0.42) was also found. Statistically significant differences were found between patients divided into two groups depending on the presence or absence of CTC in the time until the onset of disease relapse (p = 0.015). The median survival and interquartile range in patients with CTC was 68 (23–70) months, and in patients without CTC 76 (58–108) months.
Conclusion. The risk of developing BC relapse with positive detection of CTC is 28.6 %. The value of the absolute risk indicator in BC patients without CTC in the peripheral blood is 5.9 %. The value of the relative risk indicator is 4.857.

Background. Benign breast disease (BBD) is the most common multidisciplinary problem in women globally. Surgery enables complete removal of the pathological tissue and its morphological assessment. However, breast sectoral resection causes excessive injury, increases the risk of postoperative complications, and might result in aesthetic defects. The capacity of minimally invasive surgeries, such as laser ablation and sclerotherapy, for treating breast cysts should be thoroughly analyzed since these methods might provide a highly effective alternative to conventional surgical strategies.
Aim. To evaluate treatment efficacy and quality of life in BBD patients with a prevailing cystic component who underwent minimally invasive percutaneous surgeries and sectoral breast resection.
Materials and methods. This retrospective study included 471 BBD patients with a prevailing cystic component. Women were divided into three groups depending on the surgery type: 1) sectoral resection (n = 155 (32.9 %)); 2) ultrasoundguided percutaneous laser ablation (n = 152 (32.3 %)); 3) ultrasound-guided percutaneous sclerotherapy with 1 % solution of sodium tetradecyl sulfate (n = 164 (34.8 %)). In each group, we evaluated short-term surgery outcomes, surgery duration, length of hospital stay, incidence and severity of early postoperative complications, pain intensity in the early postoperative period, and aesthetic results and quality of life 24 months postoperatively.
Results. We observed a significant advantage of minimally invasive percutaneous surgeries over sectoral resection as they were faster and required shorter in-hospital stay (p <0.01). Better aesthetic results and stable results (no recurrent cysts) 24 months postoperatively were observed in patients after laser ablation and sclerotherapy rather than after sectoral resection (p <0.01). Minimally invasive percutaneous surgeries caused less pain than sectoral resection and, therefore, these patients didn’t need nonsteroidal anti-inflammatory drugs (p <0.01). BBD with a prevailing cystic component resulted in a reduced quality of life in all patients before treatment. All types of surgery (both minimally invasive and conventional) had a positive effect on the quality of life in the long-term perspective. The improvement of the quality of life was more pronounced in patients after laser ablation and sclerotherapy than in those after sectoral resection (p <0.01).
Conclusion. Minimally invasive percutaneous surgical methods (laser ablation and sclerotherapy) were highly effective in BBD patients with a prevailing cystic component. They reduced injury, ensured good aesthetic results, and increased patients’ quality of life.

Background. Malignant neoplasms of the vulva account for about 4 % of all gynecological cancer neoplasms. Every year in Russia more than 2000 new cases of vulvar cancer are registered, in the North-Western Federal Region of Russia (NWFRR)¹ – more than 200 (2022). The incidence rate for Russia as a whole is within 2.5 cases per 100,000 female population (in the NWFRR – about 3,0^0/0000). Standardized incidence rates for Russia and the NWFRR are within 1.1 and 1.2^0/0000. Before the age of 30, vulvar cancer practically does not occur; the maximum number (200–300) of cases is registered mainly among women over 60 years of age. There is no information on the mortality rate of the female population for this cancer localization in Russia, as well as calculations of such analytical indicators as mortality and patient survival, information about which can only be obtained on the basis of databases of individual population cancer registries.
Aim. To study the prevalence of vulvar cancer based on the newly created population cancer registries database of the NWFRR, to consider the detailed structure of this tumor localization taking into account the fourth digit of the International Classification of Diseases-10, the histological structure of tumors, and the calculation of one-year and five-year patient survival.
Materials and methods. The research material is data from the International Agency for Research on Cancer, reference books P.A. Herzen National Medical Research Center of Oncology and National Medical Research Oncology Center, databases of population cancer registries of Saint Petersburg and the NWFRR. Data processing was carried out using licensed programs MS Excel 2013–2016 and Statistica 6.1. To calculate survival, a modified Eurocare program was used, as well as mathematical, bibliographic and statistical methods.
Results and conclusion. The first population-based study of the prevalence and effectiveness of anti-cancer measures based on the population cancer registries database, conducted in Russia, showed an increase in morbidity among the female population of malignant tumors of the vulva, decreased mortality of patients at each year of observation. The one-year relative survival rate of patients with vulvar cancer reached 72.0 %, five-year – 41.8 %. One-year survival rate by stage of the disease: I stage – 91.6 %, II stage – 79.7 %, III stage – 53.1 %, IV stage – 29.0 %. Five-year survival rate by stage of the disease: I stage – 68.2 %, II stage – 46.7 %, III stage – 18.6 %, IV stage – 5.6 %.

Aim. To study equipment of health care systems of territorial subjects of the Russian Federation mobile mammography caravans and to estimate results of their work.
Materials and methods. Sources of information on volumes of work of mobile mammography caravans – a form of federal statistical observation No. 30 on each of territorial subjects of the Russian Federation. For assessment of dependences between variables the regression analysis and data from a form of federal statistical observation No. 7 for 2022 was used.
Results. Indicators of load of one mammography installation averaged in 2022 49.9 ± 44.6 departures a year and fluctuated in different territorial subjects of the Russian Federation from 3 to 130 departures in a year. The regression analysis showed that only 4.3 % of a variation of an indicator “the share of the cases of a breast cancer revealed actively” depends volumes of activity of mobile mammographs. At the same time the regional variation of an indicator “number of the accepted patients at departures” does not depend neither on population density, nor on volumes of medical care in policlinics, and statistical bonds between a share of the cases of a breast cancer revealed actively and number of the patients accepted at departures of mobile mammographs no.
Conclusion. It is necessary to call into question efficiency of total inspection of the population with use of mobile mammography and also to personalize selection of the contingents for mammography on the basis of assessment of polygenic risk and the family anamnesis.

Background. In the developed countries breast cancer (BC) is the most frequent form of localization of malignant neoplasms at women.
Aim. The analysis of BC morbidity and death rates from it in Tashkent for 2012–2022 in intensive (IR) and standardized rates (SR) in the international standard of World Health Organization.
Materials and methods. Data of cancer-register which is functioning at organizational-statistical department of the Tashkent City Branch of the Republican Specialized Scientific and Practical Medical Center of Oncology and Radiology, Ministry of Health of the Republic of Uzbekistan were studied. The IR and SR of morbidity of BC and death rates from it in Tashkent are calculated.
Results. The female morbidity by malignant neoplasms (in IR) in Tashkent city gradually growth during 2012–2022, and it some decreases in 2020. SR in 2020 (the basic year of pandemic COVID-19) there was “splash” in 2020 morbidity by malignant neoplasms, in particular, BC, and SR of death rate from them among the female population of Tashkent in comparison with other years of this period. This occurred at the expense of increase of their frequencies (mainly) in women aged 45–64 years and older.
Conclusion. Detected facts are connected with practice of diagnostics and treatment of BC on the basis of spontaneous reference to a doctor of the population (generated in Uzbekistan for the last decades) and by absence of regular practice of early diagnostics Bс (screening). These facts are important for further development of system of control of BC in Tashkent.

Background. Oncologists notice an increasing prevalence of female reproductive system pathological conditions that lead to benign and malignant diseases of mammary glands. Fibrocystic breast diseases (FBD) occur in approximately 80 % of women of reproductive age worldwide. Currently, there is no single widely accepted treatment for FBD. The therapy mainly includes surgery and hormonal treatment. A few herbal medicines effective against FBD include Vitex agnus-castus (VAC) medications. According to many studies, the absence of timely targeted preventive therapy puts patients with FBD at risk of developing malignant tumors. FBD is a risk factor for cancer development and turns into cancer in 3–6 % of patients.
Aim. To assess the effectiveness of VAC against FBD.
Materials and methods. In this study, 150 women aged 40+ with FBD were randomly assigned to the treatment group (n = 78) or the controls (n = 72). The groups were similar in demographic characteristics, including age, parity, menopause, history of abortions, family history of breast cancer, and alcohol and tobacco consumption. The treatment group received two tablets of VAC extract (each containing 162 mg) daily for six months. At baseline, weeks 12 and 24, all participants were evaluated using a visual analog scale and ultrasound examination.
Results. Breast pain decreased significantly in the treatment group, and the median visual analog scale scores at weeks 12 and 24 decreased significantly compared to baseline in the treatment group (89.7 % at baseline, 76.9 % at week 12, and 42.3 % at week 24) compared to the controls (66.3 % at baseline, 63.9 % at week 12 and 61.1 % at week 24). Furthermore, the breast ultrasound findings at weeks 12 and 24 revealed that regression rates in the treatment group were significantly higher than in the control arm (46.2 % vs. 6.9 % at week 12; 55.1 % vs. 8.3 % at week 24).
Conclusion. VAC is effective in managing patients with FBD. VAC treatment efficacy can be evaluated using a visual analog scale and ultrasound examination. The herbal remedy VAC extract used in this treatment for patients with FBD has proven effective in preventing breast cancer.

 The history of progesterone and progesterone receptors (PR) in breast cancer is as great, as controversial. In this review, we summarize the early history of PR research in breast cancer, debunk the myth that progesterone causes cancer, discuss recent discoveries in PR regulating cellular heterogeneity, attempt to reconcile theories that PR play “good” and “bad” role in tumorigenesis, and discuss new directions that may help elucidate the role of this puzzling hormone and its receptors. 

Over 5,000 new cases of breast cancer are diagnosed in the Republic of Kazakhstan every year. More than 40 % of them are treated with organ-preserving surgery followed by radiation therapy to minimize the risk of local recurrence. Notably, over 70 % of breast cancer recurrences occur within the primary tumor bed. Radiation therapy aims to prevent recurrence after radical surgery, and precise targeting is crucial for its effectiveness. However, the lack of standardized methods for the exact localization of the tumor margin presents a significant challenge. Radiation oncologists must carefully determine the tumor bed when planning radiation therapy.
Publications for analysis were searched in the PubMed and eLibrary databases using the relevant keywords.
Titanium surgical clips are commonly used to localize the tumor cavity in mammary gland radical surgery. However, tissue movement and postoperative seroma formation can compromise the positioning of clips within the cavity, especially with abnormal fluid accumulation. Originally designed for hemostasis, these clips may create ambiguity when used to mark tumor bed margins. Various alternative methods for more precise delineation of tumor bed margins have advantages and limitations regarding practicality, patient comfort, and precision. Despite certain challenges in clinical application, gold markers remain the most efficient way of localizing primary tumors and resection margins.
These findings highlight the urgent need for innovative approaches to marking the tumor cavity in mammary gland surgery to improve the precision of tissue localization for radiation therapy. Future advancements in this area should build on the advantages of gold markers and ensure accurate tumor localization.

Epidermal cysts can be located anywhere: on the scalp, face, trunk, neck and limbs. In the article, specialists from the Department of Surgical Treatment Methods and Antitumor Drug Therapy for Breast Tumors at the Mammology Clinic of the Russian Research Center of Radiology present a rare clinical case of a cyst of atypical localization and a literature review aimed at raising awareness of the existence of epidermal cysts in the parenchyma of the mammary gland. This clinical experience is also interesting from the point of view of differential diagnostics between other benign and malignant formations of the mammary gland to choose the right treatment tactics.

The new generation conjugate trastuzumab deruxtecan (Т-DXd) is indicated for the treatment of adult patients with unresectable or metastatic HER2-positive breast cancer (BC) who have previously received a drug regimen containing anti-HER2 targeted agents, as well as for the treatment of adult patients with unresectable or metastatic HER2-weakly positive breast cancer (1+ or 2+ by immunohistochemistry/negative by in situ hybridization) who have received prior systemic therapy for metastatic disease or who have relapsed during or within 6 months of completion of adjuvant chemotherapy. Given the positive data on the use of Т-DXd in different populations of patients with metastatic BC, it is advisable to collect data from real-world clinical practice to expand treatment options.
A 67-year-old female patient received Т-DXd as a sixth-line therapy for recurrent HER2-low metastatic BC, with a 20 % reduction in the size of the liver metastasis and no progression during therapy. The data of the clinical case were collected as part of a study of Т-DXd monotherapy in patients with metastatic BC who had previously received at least 2 lines of systemic therapy, in the real-life practice of the Clinical Oncological Dispensary No. 1 of Krasnodar.
The presented clinical case is consistent with the data of the clinical study DESTINY-Breast04 and shows the potential for using Т-DXd in real-life clinical practice in patients with metastatic HER2-weakly positive BC in late lines.

Background. The reproducibility of cytomorphological abnormalities results of the glandular epithelium of the cervix between cytopathologists is low.
Aim. To evaluate the lesions of the glandular epithelium in the cervix according to the Bethesda system in the practicing cytological work.
Materials and methods. In a retrospective study, a comparative analysis of cytological cervical smears with abnormal changes in the glandular epithelium was performed. The evaluation of cytological material was carried out in accordance with the Bethesda system (2014). For the analysis, we used information about 112 patients from the cancer registry of the Altai Regional Oncology Dispensary (Barnaul) for 2023. In some cases, liquid-based cytology (ThinPrep™ Processor (Hologic)) was used. The preparations were stained using Papanicolaou, Pappenheim and hematoxylin-eosin tests. When assessing the effectiveness of cytological diagnostics, the results of histological studies were used taking into consideration clinical and anamnestic information.
Results. The studied cytograms of patients with glandular cell abnormalities were divided into groups: atypical glandular cells, not otherwise specified (n = 19 (0.13 %)); atypical glandular cells suspicious for adenocarcinoma (or favor for neoplastic) (n = 9 (0.06 %)); endocervical adenocarcinoma in situ (n = 4 (0.03 %)); adenocarcinoma (n = 80 (0.54 %)).
Conclusion. Cytological diagnosis of glandular lesions of the cervical canal is crucial for subsequent colposcopy and obtaining biomaterial for intravital histological examination. When determining whether cells belong to the “Atypical glandular cells” group, there is a large differential range of different diseases. These cases provide future outlook for further improvement of cytological diagnostics. In the group of patients “Atypical glandular cells suspicious for adenocarcinoma”, endometrial adenocarcinoma was subsequently diagnosed in 88.89 %. The proportion of correct cytological diagnosis in the 2 described groups was 91.94 %. In observations of endocervical adenocarcinoma in situ, cellular elements in cytological preparations characterized adenocarcinoma. All diagnosed adenocarcinomas – endocervical, endometrial and various internal organs of the woman’s body – were identified during subsequent histological examination. Adenocarcinoma accounted for 24.02 % of the number of cervical carcinomas diagnosed cytologically during the year.

Aim. To assess the efficacy and safety of lenvatinib plus pembrolizumab for the treatment of mismatch repair-proficient (pMMR) endometrial cancer (EC) in routine clinical practice in Russia.
Materials and methods. This multicenter, retrospective, cohort study included 114 patients with recurrent and metastatic EC from 37 cancer centers in Russia treated between December 2020 and November 2024. Patients with histologically verified EC without microsatellite instability were included. The primary endpoint was progression-free survival; the clinical characteristics of the patients were additionally analyzed; the objective response rate and the toxicity profile of therapy were assessed.
Results. Median patients’ age was 66.5 (33–83) years. The most common histologic tumor subtype was endometrioid adenocarcinoma (72.8 %); serous adenocarcinoma was diagnosed in 18.4 % of cases, other subtypes – in 8.8 %. The median progression-free survival was 8.15 months (95 % confidence interval 0.4–41.1). Objective response rate was 38.0 %. The median overall survival was not achieved with a median follow-up of 12.23 months. During treatment, dose reduction rate due to adverse events was 50 %. The most frequent adverse events were hypertension (n = 64; 56.1 %), fatigue (n = 45; 39.5 %), and diarrhea (n = 20; 17.5 %).
Conclusion. In the conducted study of routine clinical practice in Russian patients with recurrent and metastatic EC without mismatch repair system deficiency (pMMR/MSS), lenvatinib plus pembrolizumab showed good efficacy with a manageable safety profile.

Abnormal uterine bleeding (AUB) is bleeding that is excessive in frequency, duration and/or volume of blood loss compared to normal menstruation. AUB is one of the most common gynecological problems and occurs in 3–30 % of women of reproductive age. Adolescent patients undergoing cancer treatment are at high risk of presenting AUB associated with thrombocytopenia, coagulopathies, dysfunctions of hypothalamic-pituitary-gonadal axis. According to the National Institution of Oncology up to 5 % of new cancer cases are diagnosed in women aged from 15 to 39 years, which underlines the relevance of the problem. AUB is a serious complication that can result in anemia and lifethreatening bleeding. Thus, even normal menstrual blood loss can cause adverse outcomes in women who already suffer from anemia and/or thrombocytopenia. To prevent severe uterine bleeding during the treatment of oncology oncologist, obstetrician-gynecologist and a hematologist are required. Causes of AUB, management approaches and prevention therapy for oncological patients are considered in this article.

 Mucinous ovarian carcinoma is a rare histological form of epithelial ovarian cancer. These tumors demonstrate poor objective response to standard chemotherapy regimens for epithelial ovarian cancer and PARP inhibitors maintenance therapy, resulting in short overall and disease-free survival, as well as a poor prognosis in patients with advanced disease. Macroscopically, mucinous ovarian carcinoma is characterized by the presence of mucus in the cystic cavity, consisting mainly of mucin. This review examines in detail the role of mucins in the pathogenesis and therapy of mucinous ovarian carcinoma in the context of the formation of chemoresistance and a possible point for targeted therapy. 

The article presents a clinical case of a patient with stage IA endometrial cancer, who, at a later date following specialized treatment conducted according to established standards, was diagnosed with disease progression complicated by an abscess in the pelvic area. The treatment strategy involved radical surgical intervention, which included pelvic sanitation, abscess resolution, and simultaneous complete cytoreduction – resection of the sigmoid colon, ureteral ligation, creation of a single-barrel colostomy, and extended pelvic lymphadenectomy. A key factor in implementing the treatment plan was an interdisciplinary approach involving specialists from various fields to address both the oncological process and the resulting complications, which led to the effectiveness of the procedures performed.

Female adnexal tumor of Wolffian origin is an extremely rare and poorly studied tumor arising from remnants of Wolffian (mesonephric) duct and having an ambiguous malignancy potential. Immunohistochemical diagnostics of these tumors is important to exclude other pathologies. Interpretation of the prognosis is ambiguous. There are no clear standards for surgical or chemotherapeutic treatment. This is due to the lack of a sufficient number of observations and clinical studies. The article presents a clinical case of Wolffian duct tumor diagnosed in a 75-year-old patient, with a discussion of the terminological, morphological, immunohistochemical and molecular genetic features of the tumor.