Objective of the study is to present the current information on the diagnosis and treatment of breast cancer during pregnancy, as well as to evaluate the effect of pregnancy on the prognosis of the disease in patients diagnosed with breast cancer (BC).
Materials and Methods. The review includes an analysis of data obtained from articles found in PubMed, eLIBRARY on the subject published over the past 20 years.
Results. Diagnosis and treatment of breast cancer in pregnant women is a challenging issue. A multidisciplinary approach is required to determine the optimal therapeutic strategy. The molecular-biological subtype of the tumour, stage and gestational age at diagnosis are the main factors in the choice of treatment strategy for such patients. Chemotherapy and surgical treatment of breast cancer are considered safe methods if gestational age is respected.
Conclusion. Diagnosis and treatment of breast cancer during pregnancy can be provided according to standard surgical and chemotherapeutic approaches, with strict observance of the timing of therapy and gestational age. In most cases, when treating the early stages of breast cancer in pregnant patients, the prognosis for a mother is the same as for non-pregnant patients.
Keywords: breast cancer, chemotherapy, endocrine therapy, immunotherapy, pregnancy, pregnancy in breast cancer, radiation therapy, surgery, targeted therapy
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More than ten years have passed since the release of the FIGO 2009 classifi cation for endometrial cancer, which has been used by oncologists and gynaecologists until now. During this period, a large number of clinical and diagnostic studies on endometrial cancer have been conducted, and four molecular genetic subtypes have been discovered, and that has had a substantial impact on the understanding of the nature of the tumour and of the signifi cance of risk factors for the disease progression.
As a consequence of the above mentioned, a new FIGO 2023 classifi cation for endometrial cancer, which in staging additionally takes into account molecular features of the tumor, lymphovascular invasion, identifi cation of micrometastatic lesions of lymph nodes, was developed. In this regard, practicing physicians and researchers show interest in comparing these classifi cations.
Keywords: FIGO classifi cation, endometrial cancer, molecular genetic classifi cation, methodological guidelines
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Objective of the study is to carry out a systematic analysis of the data available in current literature on various molecular mechanisms of pathogenesis of uterine leiomyoma and ectopic leiomyomatosis.
Materials and Methods. The review comprises the data of foreign and Russian scholarly articles found in PubMed, Scopus, Web of Science, MedLine on the subject, published over the past 10 years.
Results. Uterine leiomyomas are benign tumors of smooth muscle origin with diverse symptomatology, most often occurring in women of reproductive age. However, in clinical practice, ectopic leiomyomatosis, which has different forms of manifestation with unusual localization, is sometimes encountered. These are peritoneal disseminated leiomyomatosis, benign metastasising leiomyoma, intravenous leiomyomatosis and hereditary leiomyomatosis and renal cell cancer syndrome. Variants of ectopic leiomyomatosis have differences not only at clinical but also at molecular genetic levels.
Conclusion. Although genetic and exogenous factors predisposing to leiomyomatosis have not been fully established to date, the heterogeneity of localization and growth pattern of leiomyomas indicate a complex biological mechanism of their development, which requires further investigation.
Keywords: leiomyomatosis, clinical forms, chromosomal abberations, HMGA, MED12, FH, molecular subtypes
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Objective of the study is to present a clinical observation of the treatment of recurrent giant cell adenosarcoma of the uterus.
Materials and Methods. A 65-year-old female patient presented with complaints of a rapid increase in abdominal size, diffuse abdominal pain of moderate intensity, swelling of both legs, shortness of breath at rest. She had a history of hysterectomy with bilateral salpingo-oophorectomy in November 2020 and post-operative radiation therapy in March 2021. In October 2022 the patient noticed a rapid increase in abdominal size. According to the data of CT and MRI with intravenous contrast, a multinodular mass 26,0×24,0 cm in size in the pelvis, dilation of the right renal pelvis and ureter, involvement of bladder apex and base into tumor structure were detected.
Results. For life-saving reasons, due to an acute worsening of respiratory insuffi ciency cytoreductive surgery that included tumor removal, cystectomy, resection of the sigmoid colon, of the three sections of small intestine, atypical resection of liver segment IV, was performed. Postoperative period elapsed without complications, the patient was discharged to her local primary care oncologist for follow-up on the tenth day. Pathological and immunohistochemical examination confi rmed the recurrence of uterine adenosarcoma. Macroscopically the removed tumor specimen measured 49,0×40,0×26,0 cm. Adjuvant therapy was not given.
Conclusion. Maximal possible extent of cytoreduction appears to be the only potentially effective treatment option for patients with uterine adenosarcoma.
Keywords: adenosarcoma, endometrial cancer
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Objective of the work is to study the epidemiological situation and the state of cervical cancer diagnostics in Voronezh region.
Materials and methods. The statistical data of incidence and mortality from cervical cancer in the Voronezh region, Central Federal District and the Russian Federation was analyzed. Standardized indicators were used for the evaluation of incidence and mortality.
Results. The analysis of incidence and mortality rates from cervical cancer over the past 5 years in the Voronezh region, Central Federal District and Russian Federation showed lower rates in the region.
Conclusion. Elimination of cervical cancer is one of the leading international public healthcare issues, which is related to the corresponding high incidence and mortality rates among women of working and reproductive age. The decrease in the incidence and mortality may indicate some advances in the diagnosis and treatment of this pathology in Voronezh region.
Keywords: cervical cancer, incidence, mortality
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Objective of the study. Postmastectomy lymphoedema (PLE) is a common late complication of antitumor treatment for breast cancer. Objective of the study is to determine risk factors for the development of postmastectomy lymphoedema (PLE) in Russian patients with breast cancer who had undergone radical antitumor treatment.
Materials and Methods. The study comprised patients with clinical manifestation of postmastectomy lymphoedema (PLE) of ipsilateral upper limb, who consecutively sought help of a rehabilitation therapist at Federal State Budgetary Institution “N. N.Blokhin National Medical Research Center of Oncology” of the Ministry of Healthcare of the Russian Federation for the period from 10.01.2023 to 30.04.2023. In the course of the observational prospective study an analysis of prior surgical, systemic, radiation therapy and concomitant pathology was carried out. Results. The study included 100 women aged 59,5 ± 12,9 years. The median of postmastectomy lymphoedema development (PLE) was 24 months after surgical treatment (range: 3-120 months), the median of the removed lymph nodes was 13 (range: 2-24). A statistically signifi cant difference was found in the incidence of lymphoedema among patients who had undergone radical mastectomy and radical resection in comparison with patients who had undergone surgeries of various extent with sentinel lymph node biopsy (SLNB) (p = 0,03), who had received radiation therapy (p = 0,02) and had a history of erysipelatous infl ammation of the upper limb (p < 0,001) and were obese (p < 0,001).
Conclusions. The results, obtained in the study, indicate that the major risk factors for the development of postmastectomy lymphoedema (PLE) in a Russian population of patients who underwent radical treatment for breast cancer were axillary lymph node dissection, postoperative radiation therapy, soft tissue infection of the affected limb and obesity (BMI ≥ 30 kg/ m2). Elimination or prevention of the last two factors, which do not affect the effi cacy of antitumour treatment, may reduce the incidence of postmastectomy lymphoedema (PLE) and improve the quality of life of patients.
Keywords: postmastectomy lymphoedema, breast cancer, risk factors
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Abstract. An upward trend in the incidence of cervical cancer is worrying, as an increasing number of reproductive malignancies, including cervical cancer, are diagnosed in young women. Radical antitumor treatment is often accompanied by adverse events and side effects that affect various aspects of a woman’s life. Along with morphological and functional abnormalities in various organs and systems, women may experience psycho-emotional disorders, sexual dysfunction, and social disadaptation, which taken together reduce the general quality of life (QoL). Timely integration of rehabilitation programmes in the strategy of management of this group of patients plays a key role in mitigating complications associated with anti-tumor therapy. Comprehensive active rehabilitation contributes to the regaining of fulfi lling sex life and social activity, which improves the quality of life (QoL) of women in the recovery period after radical treatment for cervical cancer.
Keywords: cervical cancer, CC, treatment, rehabilitation, quality of life, QoL
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Objective of the study is to carry out a systematic analysis of the data available in current literature on the preservation of genetic material in patients of reproductive age with established diagnosis of malignant neoplasms of various localizations.
Materials and Methods. The review comprises the data from foreign and Russian scholarly articles found in PubMed on the subject published over the past 10 years.
Results. Preservation of genetic material has become a signifi cant aspect of the treatment of patients of reproductive age with established diagnosis of malignant neoplasms of various localizations in recent years. High rates of breast cancer incidence among the population of reproductive age, on the one hand, and the trend of delayed childbearing, on the other hand, make up a category of patients with a high risk of the development of gonadal insuffi ciency which leads to infertility. This raises the need to advance and use the methods of fertility preservation in this category of patients. The present literature review analyzed publications on the major techniques of fertility preservation in breast cancer.
Conclusion. Despite the encouraging results on fertility preservation in cancer patients, it is necessary to carry out further research in this area, in particular with respect to the study of the safety of the applied protocols and techniques.
Keywords: breast cancer, fertility preservation, cryopreservation
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