Pub Date : 2023-10-27DOI: 10.17650/1994-4098-2023-19-3-63-76
I. V. Kolyadina
The review gives the definition of HER2-low status, shows its clinical and biological role in patients with advanced breast cancer. A unique mechanism of action of trastuzumab deruxtecan and potential for its use in advanced breast cancer with HER2-low expression are described. The key results of the open multicenter phase III DESTINY-Breast04 (DB-04) trial including safety data are presented. Results on the effectiveness of the drug in patients with markers of hormone resistance first presented in 2023 and the place of trastuzumab deruxtecan in the updated ESMO 2023 algorithm of hormone-positive breast cancer treatment are considered.
{"title":"Trastuzumab deruxtecan in the treatment of patients with advanced breast cancer with HER2-low expression: Recent studies review","authors":"I. V. Kolyadina","doi":"10.17650/1994-4098-2023-19-3-63-76","DOIUrl":"https://doi.org/10.17650/1994-4098-2023-19-3-63-76","url":null,"abstract":"The review gives the definition of HER2-low status, shows its clinical and biological role in patients with advanced breast cancer. A unique mechanism of action of trastuzumab deruxtecan and potential for its use in advanced breast cancer with HER2-low expression are described. The key results of the open multicenter phase III DESTINY-Breast04 (DB-04) trial including safety data are presented. Results on the effectiveness of the drug in patients with markers of hormone resistance first presented in 2023 and the place of trastuzumab deruxtecan in the updated ESMO 2023 algorithm of hormone-positive breast cancer treatment are considered.","PeriodicalId":36091,"journal":{"name":"Opuholi Zenskoj Reproduktivnoj Sistemy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136311389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-27DOI: 10.17650/1994-4098-2023-19-3-25-29
Yu. I. Gaman, V. I. Apanasevich, A. V. Laguryova, O. M. Zagrutdinova, N. G. Plekhova, O. A. Argishev, V. I. Nevozhay, Е. P. Kostiv
Background . Intraductal papilloma (IDP) is not usually considered as an obligate precancerous lesion since the cases of its progression into cancer are exceedingly rare. Aim. To analyze the impact of IDP on the risk of breast cancer in the future. Materials and methods . This retrospective study included patients aged 22–82 years operated on for IDP (n = 304) and other benign breast tumors (n = 304) between 2014 and 2022. We checked these patients in the cancer registry of Primorsky Regional Oncology Dispensary to find out whether any of them developed any type of cancer, including breast cancer. Then we calculated the odds of developing breast cancer in both groups. Results and conclusion . We found that paients with a history of IDP are 2.4 times more likely to develop breast cancer. The incidence of other cancer types did not differ significantly between the two groups. Our findings are consistent with the results of similar foreign studies and might indicate that IDP and breast cancer share the same etiological factor. They can also highlight specific characteristics of asymptomatic IDP.
{"title":"Breast cancer associated with intraductal papilloma","authors":"Yu. I. Gaman, V. I. Apanasevich, A. V. Laguryova, O. M. Zagrutdinova, N. G. Plekhova, O. A. Argishev, V. I. Nevozhay, Е. P. Kostiv","doi":"10.17650/1994-4098-2023-19-3-25-29","DOIUrl":"https://doi.org/10.17650/1994-4098-2023-19-3-25-29","url":null,"abstract":"Background . Intraductal papilloma (IDP) is not usually considered as an obligate precancerous lesion since the cases of its progression into cancer are exceedingly rare. Aim. To analyze the impact of IDP on the risk of breast cancer in the future. Materials and methods . This retrospective study included patients aged 22–82 years operated on for IDP (n = 304) and other benign breast tumors (n = 304) between 2014 and 2022. We checked these patients in the cancer registry of Primorsky Regional Oncology Dispensary to find out whether any of them developed any type of cancer, including breast cancer. Then we calculated the odds of developing breast cancer in both groups. Results and conclusion . We found that paients with a history of IDP are 2.4 times more likely to develop breast cancer. The incidence of other cancer types did not differ significantly between the two groups. Our findings are consistent with the results of similar foreign studies and might indicate that IDP and breast cancer share the same etiological factor. They can also highlight specific characteristics of asymptomatic IDP.","PeriodicalId":36091,"journal":{"name":"Opuholi Zenskoj Reproduktivnoj Sistemy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136312128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-27DOI: 10.17650/1994-4098-2023-19-3-54-62
A. G. Kedrova, A. I. Berishvili
Chemotherapy-induced nausea and vomiting is a common problem during cancer treatment, especially in breast cancer patients with anthracycline/cyclophosphamide (ас) chemotherapy. Netupitant/palonosetron (NEPA; Akynzeo®) is a fixed-dose combination of two drugs (netupitant, a neurokinin 1 receptor antagonist; and palonosetron, a serotonin 3 receptor antagonist) which target two diferent signalling pathways involved in the induction of vomiting. Approved for use in the prevention of acute and delayed chemotherapy-induced nausea and vomiting in adults, netupitant/palonosetron is given orally or via intravenous infusion as a single dose prior to chemotherapy. In clinical trials, high proportions of patients who received netupitant/palonosetron (used in combination with the corticosteroid dexamethasone) prior to chemotherapy reported no vomiting, no requirement for rescue medication, and no signifcant nausea in the 5 days post chemotherapy. Both the oral and intravenous formulations of the drug combination are well tolerated. Thus, netupitant/palonosetron is a simple, convenient and efective drug combination for the prevention of acute and delayed xhemotherapy-induced nausea and vomiting in patients receiving chemotherapy that has a moderate to high emetogenic potential.
{"title":"Netupitant/palonosetron (NEPA; Akynzeo®) combination in prevention of the nausea and vomiting in patients with breast cancer receiving anthracyclinbased chemotherapy","authors":"A. G. Kedrova, A. I. Berishvili","doi":"10.17650/1994-4098-2023-19-3-54-62","DOIUrl":"https://doi.org/10.17650/1994-4098-2023-19-3-54-62","url":null,"abstract":"Chemotherapy-induced nausea and vomiting is a common problem during cancer treatment, especially in breast cancer patients with anthracycline/cyclophosphamide (ас) chemotherapy. Netupitant/palonosetron (NEPA; Akynzeo®) is a fixed-dose combination of two drugs (netupitant, a neurokinin 1 receptor antagonist; and palonosetron, a serotonin 3 receptor antagonist) which target two diferent signalling pathways involved in the induction of vomiting. Approved for use in the prevention of acute and delayed chemotherapy-induced nausea and vomiting in adults, netupitant/palonosetron is given orally or via intravenous infusion as a single dose prior to chemotherapy. In clinical trials, high proportions of patients who received netupitant/palonosetron (used in combination with the corticosteroid dexamethasone) prior to chemotherapy reported no vomiting, no requirement for rescue medication, and no signifcant nausea in the 5 days post chemotherapy. Both the oral and intravenous formulations of the drug combination are well tolerated. Thus, netupitant/palonosetron is a simple, convenient and efective drug combination for the prevention of acute and delayed xhemotherapy-induced nausea and vomiting in patients receiving chemotherapy that has a moderate to high emetogenic potential.","PeriodicalId":36091,"journal":{"name":"Opuholi Zenskoj Reproduktivnoj Sistemy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136312295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-27DOI: 10.17650/1994-4098-2023-19-3-30-36
R. M. Paltuev, O. A. Volynshchikova, Sh. R. Abdullaeva, S. N. Aleksakhina, A. S. Artemyeva, E. A. Baychorov, S. Yu. Bakharev, Yu. A. Belaya, A. A. Bozhok, V. A. Vasin, V. I. Vladimirov, A. Yu. Vorontsov, E. A. Gaysina, A. A. Gofman, V. N. Dmitriev, E. N. Imyanitov, V. V. Klimenko, A. V. Komyakhov, M. M. Konstantinova, M. V. Kopp, A. G. Kudaybergenova, I. A. Lalak, D. L. Matevosyan, N. M. Mudzhiri, O. V. Poltareva, O. I. Sevryukova, V. F. Semiglazov, T. Yu. Semiglazova, M. M. Urezkova, A. S. Chichkanova, L. A. Churilova, M. V. Shomova
Background . Individual molecular characteristics of a tumor can serve as a basis for a tailored approach to therapy, prediction of the disease course and outcome, and timely treatment correction in cancer patients. Tumor genomic profiling allows for a more precise tumor assessment in an individual manner. Accurate identification of the HER2 status of a breast tumor is crucial for clinical decisions and appropriate treatment strategy. Aim. To increase the efficacy of systemic therapy for breast cancer, reduce inappropriate prescribing, and ensure a tailored approach to systemic breast cancer therapy using the information on individual molecular characteristics of the tumor. Materials and methods . We explored the expression of 100 genes involved in breast cancer development in 106 tumor samples from patients with metastatic breast cancer. We used the nCounter technology based on direct digital target detection using color-coded molecular barcodes. We analyzed the expression of 28 genes with a high predictive value for breast cancer. Results. The nCounter technology allowed us to perform semiquantitative assessment of the expression of 28 genes in tumor tissue samples. We compared the expression of ERBB2 and HER2. The HER2 expression between 252.32 and 6000 barcodes was equivalent to HER2 (0) status; between 6000 and 9196.25 barcodes, to HER2 (1+); between 9196.25 and 15022.46, to HER2 (2+/ISH±); and 15022.46 barcodes, to HER2 (3+). In case of HER2 (3+) and ERBB2 below 6000 barcodes, the result was considered false positive. In case of HER2 (0) or (1+) and ERBB2 above 15 000 barcodes, the result was considered false negative. In 18 tumors, the discrepancies in the results meant two principally different breast cancer subtypes requiring different treatments; in 2 cases, the discrepancies were in the level of HER2 expression. Conclusion. HER2 testing should be performed on an excision sample (ideally on the same block that was used for genomic testing). Despite the correlation between the HER2-enriched molecular class and the response to anti-HER2 therapy, the final result on HER2 status in discordant cases should be based on currently approved assays after results validation.
{"title":"Assessment of <i>ERBB2</i> and HER2 expression in metastatic breast cancer using the nCounter® system and a 100-gene scale","authors":"R. M. Paltuev, O. A. Volynshchikova, Sh. R. Abdullaeva, S. N. Aleksakhina, A. S. Artemyeva, E. A. Baychorov, S. Yu. Bakharev, Yu. A. Belaya, A. A. Bozhok, V. A. Vasin, V. I. Vladimirov, A. Yu. Vorontsov, E. A. Gaysina, A. A. Gofman, V. N. Dmitriev, E. N. Imyanitov, V. V. Klimenko, A. V. Komyakhov, M. M. Konstantinova, M. V. Kopp, A. G. Kudaybergenova, I. A. Lalak, D. L. Matevosyan, N. M. Mudzhiri, O. V. Poltareva, O. I. Sevryukova, V. F. Semiglazov, T. Yu. Semiglazova, M. M. Urezkova, A. S. Chichkanova, L. A. Churilova, M. V. Shomova","doi":"10.17650/1994-4098-2023-19-3-30-36","DOIUrl":"https://doi.org/10.17650/1994-4098-2023-19-3-30-36","url":null,"abstract":"Background . Individual molecular characteristics of a tumor can serve as a basis for a tailored approach to therapy, prediction of the disease course and outcome, and timely treatment correction in cancer patients. Tumor genomic profiling allows for a more precise tumor assessment in an individual manner. Accurate identification of the HER2 status of a breast tumor is crucial for clinical decisions and appropriate treatment strategy. Aim. To increase the efficacy of systemic therapy for breast cancer, reduce inappropriate prescribing, and ensure a tailored approach to systemic breast cancer therapy using the information on individual molecular characteristics of the tumor. Materials and methods . We explored the expression of 100 genes involved in breast cancer development in 106 tumor samples from patients with metastatic breast cancer. We used the nCounter technology based on direct digital target detection using color-coded molecular barcodes. We analyzed the expression of 28 genes with a high predictive value for breast cancer. Results. The nCounter technology allowed us to perform semiquantitative assessment of the expression of 28 genes in tumor tissue samples. We compared the expression of ERBB2 and HER2. The HER2 expression between 252.32 and 6000 barcodes was equivalent to HER2 (0) status; between 6000 and 9196.25 barcodes, to HER2 (1+); between 9196.25 and 15022.46, to HER2 (2+/ISH±); and 15022.46 barcodes, to HER2 (3+). In case of HER2 (3+) and ERBB2 below 6000 barcodes, the result was considered false positive. In case of HER2 (0) or (1+) and ERBB2 above 15 000 barcodes, the result was considered false negative. In 18 tumors, the discrepancies in the results meant two principally different breast cancer subtypes requiring different treatments; in 2 cases, the discrepancies were in the level of HER2 expression. Conclusion. HER2 testing should be performed on an excision sample (ideally on the same block that was used for genomic testing). Despite the correlation between the HER2-enriched molecular class and the response to anti-HER2 therapy, the final result on HER2 status in discordant cases should be based on currently approved assays after results validation.","PeriodicalId":36091,"journal":{"name":"Opuholi Zenskoj Reproduktivnoj Sistemy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136312296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-27DOI: 10.17650/1994-4098-2023-19-3-43-53
I. V. Vysotskaya, E. A. Kim, M. V. Geletko, F. E. Misrikhanova, V. Yu. Kirsanov
Breast cancer (BC) ranks first in cancer incidence among women. For successful treatment of BC, depending on the molecular type and stage of the disease, chemotherapy is used, the side effects of which are manifested by menopausal symptoms, sexual dysfunction, and depressive states. However, not all patients after BC receive appropriate therapy for menopausal symptoms, what significantly worsens their quality of life. One of the symptoms that brings the most severe discomfort is the vasomotor symptom, a form of temperature dysfunction with peripheral vasodilation and increased cutaneous blood flow that results in increased heat loss. There are several types of drugs that are used to prevent menopausal symptoms in patients taking endocrine chemotherapy, many of which are in the experimental phase of development. In this review, we will try to identify proven effective and safe methods for correcting menopausal symptoms in women who underwent chemotherapy and endocrine therapy for BC.
{"title":"Modern possibilities for the correction of menopausal symptoms in patients with breast cancer, depending on the molecular biological characteristics of the tumor (literature review)","authors":"I. V. Vysotskaya, E. A. Kim, M. V. Geletko, F. E. Misrikhanova, V. Yu. Kirsanov","doi":"10.17650/1994-4098-2023-19-3-43-53","DOIUrl":"https://doi.org/10.17650/1994-4098-2023-19-3-43-53","url":null,"abstract":"Breast cancer (BC) ranks first in cancer incidence among women. For successful treatment of BC, depending on the molecular type and stage of the disease, chemotherapy is used, the side effects of which are manifested by menopausal symptoms, sexual dysfunction, and depressive states. However, not all patients after BC receive appropriate therapy for menopausal symptoms, what significantly worsens their quality of life. One of the symptoms that brings the most severe discomfort is the vasomotor symptom, a form of temperature dysfunction with peripheral vasodilation and increased cutaneous blood flow that results in increased heat loss. There are several types of drugs that are used to prevent menopausal symptoms in patients taking endocrine chemotherapy, many of which are in the experimental phase of development. In this review, we will try to identify proven effective and safe methods for correcting menopausal symptoms in women who underwent chemotherapy and endocrine therapy for BC.","PeriodicalId":36091,"journal":{"name":"Opuholi Zenskoj Reproduktivnoj Sistemy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136311388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-27DOI: 10.17650/1994-4098-2023-19-3-77-84
G. Z. Kulieva, L. S. Mkrtchyan, L. I. Krikunova, S. A. Ivanov, A. D. Kaprin
A review of domestic and foreign literature was carried out. Statistical analysis of the available literature showed that at present, despite the improvement of screening programs around the world, there is a steady increase in the incidence and mortality of cervical cancer in women of reproductive age with a high percentage of patients with advanced forms, whose proportion is 32 %. The percentage of deaths during the year since the verification of the disease in 2020 was 12.6 %. In the structure of mortality in the Russian population, malignant diseases occupy the second ranking place, accounting for 13.6 % after diseases of the cardiovascular system – 43.9 %. Diseases of the female reproductive system account for 18.2 %. At the same time, cervical cancer in the overall structure of oncological morbidity occupies the 4th ranking place, and among the organs of the reproductive system – the 2nd place – 13.3 %, yielding to breast cancer (47.8 %). These figures reflect the lack of implemented programs aimed at reducing the incidence of cervical cancer.
{"title":"Epidemiological aspects of the incidence and mortality of cervical cancer (literature review)","authors":"G. Z. Kulieva, L. S. Mkrtchyan, L. I. Krikunova, S. A. Ivanov, A. D. Kaprin","doi":"10.17650/1994-4098-2023-19-3-77-84","DOIUrl":"https://doi.org/10.17650/1994-4098-2023-19-3-77-84","url":null,"abstract":"A review of domestic and foreign literature was carried out. Statistical analysis of the available literature showed that at present, despite the improvement of screening programs around the world, there is a steady increase in the incidence and mortality of cervical cancer in women of reproductive age with a high percentage of patients with advanced forms, whose proportion is 32 %. The percentage of deaths during the year since the verification of the disease in 2020 was 12.6 %. In the structure of mortality in the Russian population, malignant diseases occupy the second ranking place, accounting for 13.6 % after diseases of the cardiovascular system – 43.9 %. Diseases of the female reproductive system account for 18.2 %. At the same time, cervical cancer in the overall structure of oncological morbidity occupies the 4th ranking place, and among the organs of the reproductive system – the 2nd place – 13.3 %, yielding to breast cancer (47.8 %). These figures reflect the lack of implemented programs aimed at reducing the incidence of cervical cancer.","PeriodicalId":36091,"journal":{"name":"Opuholi Zenskoj Reproduktivnoj Sistemy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136311387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-27DOI: 10.17650/1994-4098-2023-19-3-37-42
A. Yu. Vorontsov, A. N. Volodin, M. A. Kurochkina, V. V. Radovskiy, T. V. Burova, S. V. Gamayunov
Background. Despite the fact that sentinel lymph node biopsy (SLNB) in breast cancer patients has become a routine diagnostic procedure, it is still of great interest to researchers, since the priority issues of choosing methodology, equipment, technology, and stages of use are still being discussed. Although all obstacles to this technique implementation into routine clinical practice have been eliminated, SLNB in locally advanced breast cancer is still rarely used. We describe the experience of implementing SLNB in Nizhny Novgorod Regional Clinical Oncology Dispensary. We also discuss organizational, tactical, and practical approaches aimed to minimize the number of errors in technical terms, as well as to choose a multidisciplinary approach to the development of regulations for the examination and treatment of patients with locally advanced breast cancer. Aim. To assess the efficacy of SLNB implementation for patients with locally advanced breast cancer at the regional level. Materials and methods. This study included 500 patients with invasive (T1–2) breast cancer with clinically negative sentinel lymph nodes of all immunohistochemical subtypes that had undergone SLNB and histological examination. Sentinel lymph nodes were visualized using the radioisotope colloid 99mTc-Nanotop. We present the implementation algorithm for this procedure into routine clinical practice and evaluate short-term results. Results. A total of 500 patients have undergone SLNB. The first 30 cases were considered pilot cases, where all patients positive for sentinel lymph nodes additionally underwent standard axillary lymph node dissection. We observed a 100 % concordance of histological results. Then the surgery was routinely performed for all patients from this category. The assessment of short-term surgical outcomes demonstrated significant improvement of the postoperative period, reduced frequency of postoperative complications (persistent seroma of the axillary area to 2.85 %), reduced length of hospital stay (by 52.7 %) and improved functional and aesthetic results in the majority (>62 %) of patients. Conclusion. Our algorithm of SLNB use in patients with breast cancer in routine clinical practice at the regional level allows for rapid method implementation, reduced length of hospital stay, better functional and aesthetic results, and lower incidence of persistent seroma of the axillary area.
{"title":"Sentinel lymph node biopsy in patients with breast cancer. Experience in implementing at the regional level. Priority issues","authors":"A. Yu. Vorontsov, A. N. Volodin, M. A. Kurochkina, V. V. Radovskiy, T. V. Burova, S. V. Gamayunov","doi":"10.17650/1994-4098-2023-19-3-37-42","DOIUrl":"https://doi.org/10.17650/1994-4098-2023-19-3-37-42","url":null,"abstract":"Background. Despite the fact that sentinel lymph node biopsy (SLNB) in breast cancer patients has become a routine diagnostic procedure, it is still of great interest to researchers, since the priority issues of choosing methodology, equipment, technology, and stages of use are still being discussed. Although all obstacles to this technique implementation into routine clinical practice have been eliminated, SLNB in locally advanced breast cancer is still rarely used. We describe the experience of implementing SLNB in Nizhny Novgorod Regional Clinical Oncology Dispensary. We also discuss organizational, tactical, and practical approaches aimed to minimize the number of errors in technical terms, as well as to choose a multidisciplinary approach to the development of regulations for the examination and treatment of patients with locally advanced breast cancer. Aim. To assess the efficacy of SLNB implementation for patients with locally advanced breast cancer at the regional level. Materials and methods. This study included 500 patients with invasive (T1–2) breast cancer with clinically negative sentinel lymph nodes of all immunohistochemical subtypes that had undergone SLNB and histological examination. Sentinel lymph nodes were visualized using the radioisotope colloid 99mTc-Nanotop. We present the implementation algorithm for this procedure into routine clinical practice and evaluate short-term results. Results. A total of 500 patients have undergone SLNB. The first 30 cases were considered pilot cases, where all patients positive for sentinel lymph nodes additionally underwent standard axillary lymph node dissection. We observed a 100 % concordance of histological results. Then the surgery was routinely performed for all patients from this category. The assessment of short-term surgical outcomes demonstrated significant improvement of the postoperative period, reduced frequency of postoperative complications (persistent seroma of the axillary area to 2.85 %), reduced length of hospital stay (by 52.7 %) and improved functional and aesthetic results in the majority (>62 %) of patients. Conclusion. Our algorithm of SLNB use in patients with breast cancer in routine clinical practice at the regional level allows for rapid method implementation, reduced length of hospital stay, better functional and aesthetic results, and lower incidence of persistent seroma of the axillary area.","PeriodicalId":36091,"journal":{"name":"Opuholi Zenskoj Reproduktivnoj Sistemy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136311385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-27DOI: 10.17650/1994-4098-2023-19-3-85-91
A. L. Chernyshova, A. A. Chernyakov, E. Yu. Garbukov, N. A. Tarabanovskaya, Yu. M. Trushchuk, O. S. Dil, S. E. Krasilnikov, A. V. Shumeykina
Breast cancer (BC) occupies the second place in terms of incidence and the first ranking place in terms of mortality among oncopathology in women. The article presents the current state of the problem of the combination of BC and pregnancy, the impact of pregnancy on the course and outcome of breast oncopathology, as well as modern hypotheses for the development of breast cancer during pregnancy. It is shown that the current studies are quite contradictory and in many ways not accurate enough in methodology and materials. We present a clinical case of BC associated with pregnancy. The case is interesting from 2 positions: on the one hand, the patient’s tumor process is associated with pregnancy, on the other hand, there is a very rare combination of HER2/neu- and BRCA1 -positive status. According to the presented literature data and our own data, it was concluded that the treatment of patients with BC during pregnancy is a difficult task and is often accompanied by tumor progression, despite the standard treatment regimens. Undoubtedly, this group of patients needs to develop new methodological approaches to antitumor treatment based on a deep analysis of the molecular genetic characteristics of the tumor, the hormonal background in general, and its effect on the tumor process during pregnancy. Such a personalized approach will improve the results of treatment of young patients with BC during pregnancy.
{"title":"Combination of pregnancy and breast cancer","authors":"A. L. Chernyshova, A. A. Chernyakov, E. Yu. Garbukov, N. A. Tarabanovskaya, Yu. M. Trushchuk, O. S. Dil, S. E. Krasilnikov, A. V. Shumeykina","doi":"10.17650/1994-4098-2023-19-3-85-91","DOIUrl":"https://doi.org/10.17650/1994-4098-2023-19-3-85-91","url":null,"abstract":"Breast cancer (BC) occupies the second place in terms of incidence and the first ranking place in terms of mortality among oncopathology in women. The article presents the current state of the problem of the combination of BC and pregnancy, the impact of pregnancy on the course and outcome of breast oncopathology, as well as modern hypotheses for the development of breast cancer during pregnancy. It is shown that the current studies are quite contradictory and in many ways not accurate enough in methodology and materials. We present a clinical case of BC associated with pregnancy. The case is interesting from 2 positions: on the one hand, the patient’s tumor process is associated with pregnancy, on the other hand, there is a very rare combination of HER2/neu- and BRCA1 -positive status. According to the presented literature data and our own data, it was concluded that the treatment of patients with BC during pregnancy is a difficult task and is often accompanied by tumor progression, despite the standard treatment regimens. Undoubtedly, this group of patients needs to develop new methodological approaches to antitumor treatment based on a deep analysis of the molecular genetic characteristics of the tumor, the hormonal background in general, and its effect on the tumor process during pregnancy. Such a personalized approach will improve the results of treatment of young patients with BC during pregnancy.","PeriodicalId":36091,"journal":{"name":"Opuholi Zenskoj Reproduktivnoj Sistemy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136312090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-26DOI: 10.17650/1994-4098-2023-19-3-16-24
V. M. Merabishvili, V. F. Semiglazov, A. V. Komiakhov, T. Yu. Semiglazova, P. V. Krivorotko, А. M. Belyaev
Background . Breast cancer is the main cause of morbidity and mortality of the female population among economically developed countries, including in Russia. Despite the continued increase in morbidity, mortality is decreasing, which is confirmed by a decrease in the index of accuracy (the ratio of the number of deaths to the sick). Calculations of survival at the population level (the most important criterion for evaluating the activities of the oncological service) in Russia are carried out only on the basis of databases of the population cancer registry of the North-Western Federal District. The accumulated 1.5 million primary cases of malignant tumors allowed for the in-depth development of data on rare tumor localities, including breast cancer among the male population. Aim. To study the impact of the coronavirus pandemic on the dynamics of the process of detection, mortality and survival of breast cancer patients in Russia and in the North-Western Federal District of the Russian Federation. Materials and methods . The material of the study is the reference books of the P. Hertzen Moscow Oncology Research Institute – branch of the National Medical Research Radiology Center, Ministry of Health of Russia, and the N.N. Petrov National Medical Research Oncology Center, Ministry of Health of Russia, and the database of the population cancer registry of the North-Western Federal District, clinical materials of the surgical department of breast tumors of the N.N. Petrov National Medical Research Oncology Center. More than 110 thousand primary cases of breast cancer were selected. Data processing was carried out by standard methods of oncology statistics recommended by the International Association of Cancer Registries (Eurocare program). Results . A significant impact of the coronavirus pandemic on the primary registration of breast cancer in Russia from 2019 to 2020 has been established, with some weakening of its impact in the subsequent period. The pandemic has had a significant impact on the quality of primary registration of patients. The value of the index of accuracy has been set back five years, but there is a sign of its improvement in 2021. The positive dynamics of one-year and five-year survival of patients with breast cancer is shown. The quality of registration of patients with breast cancer by detailed localization and histological structures of breast cancer was investigated. A significant decrease in the mortality of patients was noted when studying the patterns of dynamics in annual mortality over three follow-up periods. Conclusion . A steady increase in the incidence of breast cancer among women has been established, and the negative impact of the coronavirus pandemic has been noted. The mortality rate of the Russian population from breast cancer continues to decrease. The localization and histological structure of the incidence of breast cancer in women remains unchanged. The one-year and five-year survival rate of breast cancer
{"title":"The state of cancer care in Russia: breast cancer. Epidemiology and survival of patients. The impact of the SARS-CoV-2-beta-coronavirus epidemic (clinical and population study)","authors":"V. M. Merabishvili, V. F. Semiglazov, A. V. Komiakhov, T. Yu. Semiglazova, P. V. Krivorotko, А. M. Belyaev","doi":"10.17650/1994-4098-2023-19-3-16-24","DOIUrl":"https://doi.org/10.17650/1994-4098-2023-19-3-16-24","url":null,"abstract":"Background . Breast cancer is the main cause of morbidity and mortality of the female population among economically developed countries, including in Russia. Despite the continued increase in morbidity, mortality is decreasing, which is confirmed by a decrease in the index of accuracy (the ratio of the number of deaths to the sick). Calculations of survival at the population level (the most important criterion for evaluating the activities of the oncological service) in Russia are carried out only on the basis of databases of the population cancer registry of the North-Western Federal District. The accumulated 1.5 million primary cases of malignant tumors allowed for the in-depth development of data on rare tumor localities, including breast cancer among the male population. Aim. To study the impact of the coronavirus pandemic on the dynamics of the process of detection, mortality and survival of breast cancer patients in Russia and in the North-Western Federal District of the Russian Federation. Materials and methods . The material of the study is the reference books of the P. Hertzen Moscow Oncology Research Institute – branch of the National Medical Research Radiology Center, Ministry of Health of Russia, and the N.N. Petrov National Medical Research Oncology Center, Ministry of Health of Russia, and the database of the population cancer registry of the North-Western Federal District, clinical materials of the surgical department of breast tumors of the N.N. Petrov National Medical Research Oncology Center. More than 110 thousand primary cases of breast cancer were selected. Data processing was carried out by standard methods of oncology statistics recommended by the International Association of Cancer Registries (Eurocare program). Results . A significant impact of the coronavirus pandemic on the primary registration of breast cancer in Russia from 2019 to 2020 has been established, with some weakening of its impact in the subsequent period. The pandemic has had a significant impact on the quality of primary registration of patients. The value of the index of accuracy has been set back five years, but there is a sign of its improvement in 2021. The positive dynamics of one-year and five-year survival of patients with breast cancer is shown. The quality of registration of patients with breast cancer by detailed localization and histological structures of breast cancer was investigated. A significant decrease in the mortality of patients was noted when studying the patterns of dynamics in annual mortality over three follow-up periods. Conclusion . A steady increase in the incidence of breast cancer among women has been established, and the negative impact of the coronavirus pandemic has been noted. The mortality rate of the Russian population from breast cancer continues to decrease. The localization and histological structure of the incidence of breast cancer in women remains unchanged. The one-year and five-year survival rate of breast cancer","PeriodicalId":36091,"journal":{"name":"Opuholi Zenskoj Reproduktivnoj Sistemy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134905790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-29DOI: 10.17650/1994-4098-2023-19-3-00-00
R. M. Paltuev, O. A. Volynshchikova, Sh. R. Abdullaeva, S. N. Aleksakhina, A. S. Artemyeva, E. A. Baychorov, S. Yu. Bakharev, Yu. A. Belaya, A. A. Bozhok, V. A. Vasin, V. I. Vladimirov, A. Yu. Vorontsov, E. A. Gaysina, A. A. Gofman, V. N. Dmitriev, E. N. Imyanitov, V. V. Klimenko, A. V. Komyakhov, M. M. Konstantinova, M. V. Kopp, A. G. Kudaybergenova, I. A. Lalak, D. L. Matevosyan, N. M. Mudzhiri, O. V. Poltareva, O. I. Sevryukova, V. F. Semiglazov, T. Yu. Semiglazova, M. M. Urezkova, A. S. Chichkanova, L. A. Churilova, M. V. Shomova
Background. Individual molecular characteristics of a tumor can serve as a basis for a tailored approach to therapy, prediction of the disease course and outcome, and timely treatment correction in cancer patients. Tumor genomic profiling allows for a more precise tumor assessment in an individual manner. Accurate identification of the HER2 status of a breast tumor is crucial for clinical decisions and appropriate treatment strategy. Aim. To increase the efficacy of systemic therapy for breast cancer, reduce inappropriate prescribing, and ensure a tailored approach to systemic breast cancer therapy using the information on individual molecular characteristics of the tumor. Materials and methods. We explored the expression of 100 genes involved in breast cancer development in 106 tumor samples from patients with metastatic breast cancer. We used the nCounter technology based on direct digital target detection using color‑coded molecular barcodes. We analyzed the expression of 28 genes with a high predictive value for breast cancer. Results. The nCounter technology allowed us to perform semiquantitative assessment of the expression of 28 genes in tumor tissue samples. We compared the expression of ERBB2 and HER2. The HER2 expression between 252.32 and 6000 barcodes was equivalent to HER2 (0) status; between 6000 and 9196.25 barcodes, to HER2 (1+); between 9196.25 and 15022.46, to HER2 (2+ / ISH±); and ≥15022.46 barcodes, to HER2 (3+). In case of HER2 (3+) and ERBB2 below 6000 barcodes, the result was considered false positive. In case of HER2 (0) or (1+) and ERBB2 above 15000 barcodes, the result was considered false negative. In 18 tumors, the discrepancies in the results meant two principally different breast cancer subtypes requiring different treatments; in 2 cases, the discrepancies were in the level of HER2 expression. Conclusion. HER2 testing should be performed on an excision sample (ideally on the same block that was used for genomic testing). Despite the correlation between the HER2‑enriched molecular class and the response to anti‑HER2 therapy, the final result on HER2 status in discordant cases should be based on currently approved assays after results validation.
{"title":"Assessment of <i>ERBB2</i> and HER2 expression in metastatic breast cancer using the nCounter® system and a 100‑gene scale","authors":"R. M. Paltuev, O. A. Volynshchikova, Sh. R. Abdullaeva, S. N. Aleksakhina, A. S. Artemyeva, E. A. Baychorov, S. Yu. Bakharev, Yu. A. Belaya, A. A. Bozhok, V. A. Vasin, V. I. Vladimirov, A. Yu. Vorontsov, E. A. Gaysina, A. A. Gofman, V. N. Dmitriev, E. N. Imyanitov, V. V. Klimenko, A. V. Komyakhov, M. M. Konstantinova, M. V. Kopp, A. G. Kudaybergenova, I. A. Lalak, D. L. Matevosyan, N. M. Mudzhiri, O. V. Poltareva, O. I. Sevryukova, V. F. Semiglazov, T. Yu. Semiglazova, M. M. Urezkova, A. S. Chichkanova, L. A. Churilova, M. V. Shomova","doi":"10.17650/1994-4098-2023-19-3-00-00","DOIUrl":"https://doi.org/10.17650/1994-4098-2023-19-3-00-00","url":null,"abstract":"Background. Individual molecular characteristics of a tumor can serve as a basis for a tailored approach to therapy, prediction of the disease course and outcome, and timely treatment correction in cancer patients. Tumor genomic profiling allows for a more precise tumor assessment in an individual manner. Accurate identification of the HER2 status of a breast tumor is crucial for clinical decisions and appropriate treatment strategy. Aim. To increase the efficacy of systemic therapy for breast cancer, reduce inappropriate prescribing, and ensure a tailored approach to systemic breast cancer therapy using the information on individual molecular characteristics of the tumor. Materials and methods. We explored the expression of 100 genes involved in breast cancer development in 106 tumor samples from patients with metastatic breast cancer. We used the nCounter technology based on direct digital target detection using color‑coded molecular barcodes. We analyzed the expression of 28 genes with a high predictive value for breast cancer. Results. The nCounter technology allowed us to perform semiquantitative assessment of the expression of 28 genes in tumor tissue samples. We compared the expression of ERBB2 and HER2. The HER2 expression between 252.32 and 6000 barcodes was equivalent to HER2 (0) status; between 6000 and 9196.25 barcodes, to HER2 (1+); between 9196.25 and 15022.46, to HER2 (2+ / ISH±); and ≥15022.46 barcodes, to HER2 (3+). In case of HER2 (3+) and ERBB2 below 6000 barcodes, the result was considered false positive. In case of HER2 (0) or (1+) and ERBB2 above 15000 barcodes, the result was considered false negative. In 18 tumors, the discrepancies in the results meant two principally different breast cancer subtypes requiring different treatments; in 2 cases, the discrepancies were in the level of HER2 expression. Conclusion. HER2 testing should be performed on an excision sample (ideally on the same block that was used for genomic testing). Despite the correlation between the HER2‑enriched molecular class and the response to anti‑HER2 therapy, the final result on HER2 status in discordant cases should be based on currently approved assays after results validation.","PeriodicalId":36091,"journal":{"name":"Opuholi Zenskoj Reproduktivnoj Sistemy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135246972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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