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  • Nikolaev, K. S.  (4)
  • Unknown  (4)
  • 2020-2024  (4)
  • 1
    Online Resource
    Online Resource
    Indeterminate (B3) breast lesions: experience with vacuum-assisted biopsy under ultrasound guidance
    Baltic Medical Education Center ; 2022
    In:  Diagnostic radiology and radiotherapy Vol. 13, No. 3 ( 2022-10-19), p. 43-50
    Details
    In: Diagnostic radiology and radiotherapy, Baltic Medical Education Center, Vol. 13, No. 3 ( 2022-10-19), p. 43-50
    Abstract: INTRODUCTION: Introduction of breast cancer screening programs has led to an increase in detection of non-palpable masses requiring core needle biopsy. Masses that fall into B3 category based on the histological results of core biopsy specimens, are of interest precisely because of their uncertain malignant potential and the lack of a final consensus on their management. OBJECTIVE: To analyze the 3-year experience of ultrasound guided vacuum-assisted biopsy (VAB) in patients with B3 breast lesions based on the results of histological examination of core biopsy specimens. MATERIALS AND METHODS : Between June 2019 and June 2022, 163 VABs were performed. The study group included patients with category 2–4 breast lesions according to the BI-RADS scoring system. The decision to perform VAB was made by the oncologist in each specific case on the basis of anamnesis, clinical data and the results of core biopsy histological examination: in cases of B3 or B2 lesions with a discordant radiologic pattern. RESULTS : In 155 (95.0%) cases, the removed lesions were benign, invasive cancer was detected in 2 (1.2%) cases, ductal cancer in situ in 6 cases (3.8%). The сomplications included: in 5 (3.1%) cases, patients had pain after the procedure, and in 37 (22.7%) cases there was a hematoma. In 5 (3.1%) patients, residual tissue was found at the site of removed lesions. CONCLUSIONS: VAB is a safe alternative to exploratory surgery in patients with B3 lesions diagnosed by core biopsy.
    Type of Medium: Online Resource
    ISSN: 2079-5343
    URL: Article
    DOI: 10.22328/2079-5343-2022-13-3-43-50
    Language: Unknown
    Publisher: Baltic Medical Education Center
    Publication Date: 2022
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  • 2
    Online Resource
    Online Resource
    Accuracy of core biopsy image-guided post-neoadjuvant chemotherapy breast to predict pathologic complete response
    Publishing House ABV Press ; 2022
    In:  Tumors of female reproductive system Vol. 18, No. 3 ( 2022-12-01), p. 29-39
    Details
    In: Tumors of female reproductive system, Publishing House ABV Press, Vol. 18, No. 3 ( 2022-12-01), p. 29-39
    Abstract: Background. Achieving a pathologic complete response (pCR) after neoadjuvant systemic therapy (NST) is a predictive factor for improving disease free and overall survival. In triple negative (TN) and HER2-positive breast cancer (BC), the pCR rate exceeds 60 %. Patients with TN and HER2-positive BC who demonstrate an excellent response to NST are like­ly ideal candidates for downsizing surgery. The condition for reducing the volume of surgical intervention is a reliable determination of pathologic complete response using instrumental imaging and biopsy methods. Aim. To further assess the accuracy of post-NST image-guided biopsy to predict pCR. Materials and methods. Sixty one patients with T1-3N0-3 triple negative or HER2-positive BC receiving NST in the Department of Breast Tumors of the NMRC of Oncology named after N.N. Petrov in the period from 2017 to 2019 were enrolled in this single-center retrospective trial. Patients underwent ultrasound-guided core-biopsy of the initial breast tumor region before surgery. Findings were compared with findings on pathologic evaluation of surgical specimens to determine the performance of biopsy in predicting pCR after NST. Results. After neoadjuvant systemic therapy, clinical partial response (cPR) was diagnosed in 47 (77 %) patients, clinical complete response (cCR) in 14 (23 %) patients. pCR in the core-biopsy tissue and surgical material was achieved in 46 (75.4 %) and 37 (60.7 %), respectively. Performance of image-guided core-biopsy: sensitivity 100 % (95 % confldence interval (CI) 90.51-100), specificity 62.5 % (95 % CI 40.59-81.20), false-negative rate (FNR) 0 %, positive-pre­dictive value (PPV) 75.00 % (95 % CI 59.46-85.99), negative predictive value (NPV) 100.00 %. Conclusion. This retrospective trial showed that ultrasound-guided core biopsies are accurate enough to identify breast pCR in patients with triple-negative or HER2-positive BC with good response after NST (FNR 0 %). Based on these results, a prospective clinical trial has commenced in which breast surgery is omitted in patients with a breast pCR after NST according to image-guided biopsy.
    Type of Medium: Online Resource
    ISSN: 1999-8627 , 1994-4098
    URL: Issue
    URL: Article
    DOI: 10.17650/1994-4098-2022-18-3
    DOI: 10.17650/1994-4098-2022-18-3-29-39
    Language: Unknown
    Publisher: Publishing House ABV Press
    Publication Date: 2022
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  • 3
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    Intraoperative evaluation of the resection margin with the usage of digital two-point sectorography (Faxitron PathVision)
    Publishing House ABV Press ; 2023
    In:  Tumors of female reproductive system Vol. 18, No. 4 ( 2023-04-29), p. 43-51
    Details
    In: Tumors of female reproductive system, Publishing House ABV Press, Vol. 18, No. 4 ( 2023-04-29), p. 43-51
    Abstract: Background . Surgery is fundamental in complex and combined approach in the treatment of the early breast cancer. It is a common fact, that absence of tumor cells in the resection margin is the main indicator of oncological safety of the breast-conserving surgery (BCS). The presence of tumor cells in examined margin is the predictor of local recurrence after BCS for breast cancer. Currently the clinical need for precise and fast method of intraoperative assessment of the resection margin status is kept. Intraoperative evaluation of the resection margin with the usage of digital two-point sectorography (Faxitron PathVision) appeared as the alternative to intraoperative histological examination, providing the optimum size of the information about adequacy of the carried out surgical treatment. Aim . To evaluate diagnostic features of the digital two-point sectorography Faxitron PathVision in the intraoperative assessment of the resection margin status after the surgical treatment in comparison with planned histologic examination. Materials and methods . 368 conducted conservative surgeries were analyzed; patients were divided in two groups depending on neoadjuvant chemotherapy. The first group of patients included 236 patients, who didn't receive neoadjuvant chemotherapy before surgery; second group included 132 patients, who received neoadjuvant chemotherapy. Subset analysis of detection rate of the positive resection margin (R1) was carried out with the usage of the intraoperative assessment of the resection margin on the X-ray device Faxitron PathVision or without this method. After each BCS resection margin status was assessed on planned histologic examination for the presence of the tumor cells, with subsequent analysis of the frequency of reoperations when R1 was found. Results . In 368 tested surgical specimens after BCS R1 was found in 25 cases, which is 6.8 %. From 236 patients in the first group after BCS R1 was found in 20 cases, which is 8.5 %; from 132 conducted operations in the second group in 5 (3.8 %) cases the presence of R1 is found. Reoperations were performed in 13 cases and tumor cells were found in 3 cases in the sub-group which didn't receive intraoperative assessment with X-ray device Faxitron PathVision. Conclusions . Assessing the results of our study we can make a conclusion about the positive experience of performing BCS and intraoperative evaluation of the resection margin with the usage of the digital two-point sectorography (Faxitron PathVision) and low frequency of R1 (3.8 %) in comparison with absence of this method (8.5 %).
    Type of Medium: Online Resource
    ISSN: 1999-8627 , 1994-4098
    URL: Issue
    URL: Article
    DOI: 10.17650/1994-4098-2022-18-4
    DOI: 10.17650/1994-4098-2022-18-4-43-51
    Language: Unknown
    Publisher: Publishing House ABV Press
    Publication Date: 2023
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  • 4
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    Online Resource
    The role of platinum-based antineoplastic drugs and their impact on complete pathological response and prognosis in patients with BRCA-associated triple-negative breast cancer after neoadjuvant treatment: a single institution experience
    Publishing House ABV Press ; 2023
    In:  Tumors of female reproductive system Vol. 19, No. 1 ( 2023-06-25), p. 48-55
    Details
    In: Tumors of female reproductive system, Publishing House ABV Press, Vol. 19, No. 1 ( 2023-06-25), p. 48-55
    Abstract:    Background.  BRCA-associated triple negative breast cancer (TNBC) is considered one of the most aggressive subtypes of breast cancer with high sensitivity to chemotherapy, which leads to increased interest in finding new treatment options for patients with this subtype of breast cancer.    Aim.  To determine the role of adding a platinum drug to standard systemic neoadjuvant therapy (NAC) for patients with primary BRCA-associated TNBC with clinical stage T1–3N0–3M0, and to evaluate the effect of platinum-based drugs on recurrence-free survival in patients of this category.    Materials and methods.  The study included 75 patients diagnosed with primary BRCA-associated TNBC. They were divided into 2 groups depending on the NAC provided, and then they were subdivided depending on the completion of the course of ongoing NAC, the final pathomorphological result and the presence of recurrence.    Results.  Group I included 48 (64 %) patients who received the AC–T regimen; in group II (n = 27 (36 %)) patients received NAC according to the AC–TCarb regimen. Patients of group II showed a higher frequency of achieving pathological complete response (pCR) compared with patients of group I (73.7 % versus 41.2 %, respectively, p = 0.0433). Taking into account the NAC regimens being carried out, patients of group I had a slightly higher risk of recurrence compared to patients of group II (p = 0.099).    Conclusion.  In patients with primary BRCA-associated TNBC, the addition of platinum compounds to the systemic NAC resulted in achieving of pCR in 73.7 % cases compared with 41.2 % pCR after the standard anthracycline-taxane NAC, which entails a reduced risk recurrence in this category of patients. Performing a full course of planned NAC has a positive trend in achieving pCR in patients of this category.
    Type of Medium: Online Resource
    ISSN: 1999-8627 , 1994-4098
    URL: Issue
    URL: Article
    DOI: 10.17650/1994-4098-2023-19-1
    DOI: 10.17650/1994-4098-2023-19-1-48-55
    Language: Unknown
    Publisher: Publishing House ABV Press
    Publication Date: 2023
    Library Location Call Number Volume/Issue/Year Availability
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    Online Resource
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