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  • 1
    Online Resource
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    Twenty-year experience of examining biopsies of signal lymph nodes in breast cancer
    Publishing House ABV Press ; 2020
    In:  Tumors of female reproductive system Vol. 16, No. 1 ( 2020-06-09), p. 12-20
    Details
    In: Tumors of female reproductive system, Publishing House ABV Press, Vol. 16, No. 1 ( 2020-06-09), p. 12-20
    Abstract: Biopsy of signal (sentinel) lymph nodes (LN) has been performed at the N.N. Petrov National Medical Research Oncology Center, Ministry of Health of Russia, for almost 20 years. In the first few years, contrast-visual method (1 % blue isosulfan and triphenyl methane control) was used in 640 patients with early (T1–2N0M0) breast cancer. In 150 patients from this cohort, standard axillary dissection was performed irrespectively of the results of signal (sentinel) biopsy. The rate of false positive responses varied between 4.6 and 6.6 %. Since 2012, radioisotope method of visualization of signal LN with intratumor administration of 99m Тс-technephyte colloid particles has been used (in 708 patients with T1–3N0M0 breast cancer). This type of signal LN biopsy had the following diagnostic characteristics: sensitivity was 58.9 %, specificity was 96.2 %, diagnostic accuracy was 87.1 %. In parallel with this study, in 2016 a study of diagnostic accuracy and safety of biopsy of axillary LN after neoadjuvant systemic therapy was started. The study included 263 patients with T1N1–3M0, T2–3N0–3M0, T4N0–1M0 breast cancer. To evaluate clinical status of axillary LN, ultrasound, single-photon emission computed tomography, mammography at baseline and after completion of neoadjuvant chemotherapy ± targeted therapy (trastuzumab) were performed. In some patients, in the recent years a double method of signal LN labeling (radioisotope and fluorescent methods) was used. In patients with baseline cN + -status, the rate of false positive signal LN biopsy conclusions was 13.6 %, in patients with baseline cN0-status it was 7.7 %. The study of double contrast of axillary LN and targeted label of metastatic LN prior to neoadjuvant systemic therapy continues. In total, various modifications of biopsy of signal LN were performed in 2,000 patients with breast cancer. The study protocol was approved by the biomedical ethics committee of N.N. Petrov National Medical Research Oncology Center, Ministry of Health of Russia. All patients gave written informed consent to participate in the study.
    Type of Medium: Online Resource
    ISSN: 1999-8627 , 1994-4098
    URL: Issue
    URL: Article
    DOI: 10.17650/1994-4098-2020-16-1
    DOI: 10.17650/1994-4098-2020-16-1-12-20
    Language: Unknown
    Publisher: Publishing House ABV Press
    Publication Date: 2020
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  • 2
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    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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    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
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  • 4
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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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  • 5
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    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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  • 6
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    Immediate breast reconstruction using titanised mesh
    Publishing House ABV Press ; 2020
    In:  Tumors of female reproductive system Vol. 16, No. 2 ( 2020-11-17), p. 13-18
    Details
    In: Tumors of female reproductive system, Publishing House ABV Press, Vol. 16, No. 2 ( 2020-11-17), p. 13-18
    Abstract: Additional covering of the lower pole with allomaterial or its synthetic analogues during immediate breast reconstruction is being performed at the N. N. Petrov National Medical Research Oncology Center, Ministry of Health of Russia, for last 7 years. Initially, epidermal flap was the only option for lower pole coverage; later acellular dermal matrix was used as part of clinical approbation. Average complication rate ranges from 20–35 % due to blood circulatory (supply) disorders. Since 2018, a titanised mesh been used as an additional coverage of the lower pole in the department of breast tumors. Through coating characteristics and its structure the frequency of fatal complications significally decreased.
    Type of Medium: Online Resource
    ISSN: 1999-8627 , 1994-4098
    URL: Issue
    URL: Article
    DOI: 10.17650/1994-4098-2020-16-2
    DOI: 10.17650/1994-4098-2020-16-2-13-18
    Language: Unknown
    Publisher: Publishing House ABV Press
    Publication Date: 2020
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  • 7
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    Diagnostic capabilities of breast scintigraphy and molecular imaging of the mammary glands in the detection of various biological subtypes of breast cancer
    Publishing House ABV Press ; 2022
    In:  Tumors of female reproductive system Vol. 18, No. 3 ( 2022-12-01), p. 14-23
    Details
    In: Tumors of female reproductive system, Publishing House ABV Press, Vol. 18, No. 3 ( 2022-12-01), p. 14-23
    Abstract: Background. The accurate and early diagnosis of breast cancer can improve efficacy of the treatment. The standard diagnostic methods such as mammography, ultrasound, and magnetic resonance tomography have a pivotal role in the detection of breast tumors, however, in some cases, they have low diagnostic accuracy. Mammoscintigraphy (MSG) / molecular breast imaging (MBI) with tumor-specific radiopharmacy 99m Tc-Technetril in patients with breast cancer can considerably increase the accuracy of diagnosis. However, the diagnostic performance of MSG / MBI in the detection of different biological subtypes of breast cancer is still under investigation. Aim. To evaluate the accuracy of MSG / MBI with 99m Tc-Technetril in diagnosis of different biological subtypes of breast cancer. Materials and methods. The analysis included the results of MSG / MBI of 1080 patients (2154 mammary glands), who were examined for suspected breast cancer. MSG / MBI were performed 5–15 min after intravenous injection into the vein of one of the feet of 370–740 MBq of tumor-specific radiopharmacy 99m Tc-Technetril. Examinations performed from 2007–2020 was carried out on the emission computed tomography Forte (Philips); since 2020 the molecular visualization has been providing on the special gamma-camera Discovery NM750b (General Electric). The obtained data were evaluated by 2 experienced radiologists. Verification of changes in breasts was provided by morphological examination (1060 cases) or dynamic observation. Results. The sensitivity, specificity and overall accuracy of MSG / MBI were 90 %, 98 %, 95 % correspondingly. When diagnosing tumors with a diameter of up to 10 mm, the sensitivity of MSG / MBI was decreased to 83 %. In patients with various biological subtypes, the sensitivity of MSG / MBI was as follows: luminal A – 88 %; luminal B– – 91 %; luminal B+ – 92 %; triple negative – 93 %; HER2-positive – 96 %. The intensity of tumor uptake depended on the biological subtype of breast cancer. The average values of the 99m Tc-Technetril uptake coefficient were as follows: luminal A – 1.59; luminal B– – 1.71; luminal B+ – 1.95; triple negative – 1.93; HER2-positive – 2.22. Conclusion. Retrospective analysis indicate high diagnostic performance of MSG / MBI: sensitivity – 90 %, specificity – 98 %, accuracy – 95 %. There are significant differences in the intensity of 99m Tc-Technetril accumulation in tumors in patients with different biological subtypes of breast cancer ( p = 0.01–0.004). MSG / MBI characterized by significant differences in the sensitivity in the diagnosis of luminal A and HER2+ breast cancer subtypes: 88 % and 96 %, respectively ( p = 0.02).
    Type of Medium: Online Resource
    ISSN: 1999-8627 , 1994-4098
    URL: Issue
    URL: Article
    DOI: 10.17650/1994-4098-2022-18-3
    DOI: 10.17650/1994-4098-2022-18-3-14-23
    Language: Unknown
    Publisher: Publishing House ABV Press
    Publication Date: 2022
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  • 8
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    Difficulties of Differential Diagnostics of Idiopathic Granulomatous Mastitis with Contrast Enhanced Visualization Methods
    Non-profit partnership Society of Interventional Oncoradiologists ; 2020
    In:  Journal of oncology: diagnostic radiology and radiotherapy Vol. 3, No. 3 ( 2020-09-30), p. 83-92
    Details
    In: Journal of oncology: diagnostic radiology and radiotherapy, Non-profit partnership Society of Interventional Oncoradiologists, Vol. 3, No. 3 ( 2020-09-30), p. 83-92
    Abstract: Mastitis is an inflammatory condition of the breast, which may or may not be accompanied by infection (WHO 2000).Idiopathic granulomatous mastitis is one of the forms of non-infectious mastitis. Granulomatous lobular mastitis is a rare inflammatory disease of the breast that was first described by Kessler and Wolloch in 1972.Idiopathic granulomatous mastitis (IGM) or granulomatous lobular mastitis is chronic inflammatory breast disease of unknown etiology, the clinical manifestation and radiological features of which may mimic other nosological entities.We report a case of 29 year old woman who was diagnosed with breast carcinoma by radiological methods, such as contrast enhanced spectral mammography (CESM), magnetic resonance imaging with dynamic contrast enhancement (MRI with DCE), SPECT/CT. However, performed core needle biopsy of a lesion shows no tumor cells. The conservative treatment was suggested, based on obtained information.Aim is a review of radiological features of IGM with contrast enhanced visualization methods, based on our clinical case; description of differential radiological features in comparison with similar diseases of the breast, such as inflammatory breast carcinoma, tuberculosis etc.
    Type of Medium: Online Resource
    ISSN: 2713-167X , 2587-7593
    URL: Issue
    URL: Article
    DOI: 10.37174/2587-7593-2020-3-3
    DOI: 10.37174/2587-7593-2020-3-3-83-92
    Language: Unknown
    Publisher: Non-profit partnership Society of Interventional Oncoradiologists
    Publication Date: 2020
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  • 9
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    Online Resource
    Radionuclide imaging of breast cancer: experience of FSBI “N.N. Petrov National Medical Research Centre of Oncology” of the Ministry of Healthcare of Russian Federation
    Vidar, Ltd. ; 2022
    In:  Medical Visualization Vol. 27, No. 1 ( 2022-12-28), p. 35-45
    Details
    In: Medical Visualization, Vidar, Ltd., Vol. 27, No. 1 ( 2022-12-28), p. 35-45
    Abstract: Abstract. Breast cancer is one of the most common malignant neoplasms among women nowadays. Timely diagnosis is the basis for effective and successful treatment of this disease. The existing classical methods of X-ray examination (MG, ultrasound, MRI) play a major role in the detection of breast cancer, but in some cases, the diagnosis of breast cancer can be difficult. Therefore, diagnostic performance of scintimammography with specialized gamma camera called molecular breast imaging (MBI) is now of particular clinical interest. Materials and methods. 312 patients with a preliminary clinical diagnosis of breast cancer were examined in the department of radionuclide diagnostics of N.N. Petrov Research Center of Oncology. They underwent scintimammography (MBI) with a specialized gamma camera manufactured by GE (Discovery 750b). Images of both breasts were obtained 15 min after intravenous injection of 500 MBq activity of 99mTc-MIBI. The foci of moderate and intensive radiopharmaceutical accumulation in breast were considered as a sign of a tumor. The diagnostic performance of MBI and the sensitivity in detection of various biological subtypes of cancer were calculated by comparing with the results of morphological and immunohistochemically studies. Results. The sensitivity, specificity and accuracy of the MBI in the diagnostics of breast cancer were 88, 75 and 87%, respectively. Sensitivity of this method in detection of different biological subtypes ranged from 89% to 95% with lowest performance found in luminal A subtype. Conclusion. Scintimammography (MBI) is an informative way of breast cancer diagnostics. The revealed differences in the sensitivity of the method in patients with different biological subtypes of breast cancer confirm the need for further study of this topic.
    Type of Medium: Online Resource
    ISSN: 2408-9516 , 1607-0763
    URL: Article
    DOI: 10.24835/1607-0763-1157
    Language: Unknown
    Publisher: Vidar, Ltd.
    Publication Date: 2022
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  • 10
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    Utility of dual-energy contrast-enhanced spectral mammography for the diagnosis of multicentric breast cancer
    Publishing House ABV Press ; 2022
    In:  Tumors of female reproductive system Vol. 17, No. 4 ( 2022-01-19), p. 20-28
    Details
    In: Tumors of female reproductive system, Publishing House ABV Press, Vol. 17, No. 4 ( 2022-01-19), p. 20-28
    Abstract: Background . Breast cancer (BC) can be unifocal, multifocal, multicentric (MCBC) and bilateral according to number and localization of tumors. MCBC has different clinical and biological characteristics compared to unifocal BC, for example, a higher risk of lymph node involvement, a more aggressive natural history and a worse prognosis. Therefore, accurate diagnosis and detection of MCBC is one of the main tasks of imaging. Objective : to compare diagnostic accuracy of contrast enhanced spectral mammography (CESM) and digital mammography (DM) in the diagnosis of MCBC. Materials and methods . The study included 438 women with suspected BC. The results of DM and CESM were compared with the results of a pathomorphological study performed after surgery or biopsy to assess the effectiveness of imaging modalities. DM was performed for all women using a Senographe DS (GE, USA) unit. CESM was performed after intravenous injection of non-ionic contrast agents using injector with breast compression in the craniocaudal and mediolateral projections. The study was performed for both glands regardless of the location of the suspicious lesion in order to timely diagnose clinically asymptomatic bilateral cancer. The final diagnosis was made based on the results of the pathomorphological examination. MCBC was diagnosed when two or more tumors at a distance of 3 cm or more from each other were detected. Visualization of additional grouped calcifications of malignant type occupying a small portion of breast tissue (more than 15 pieces per 1 sq. cm) was considered as another mammographic sign of MCBC. Results . According to the pathomorphological examination BC was diagnosed in 154 (35 %) women out of 438 examined patients. MCBC was identified in 25 (16 %) of 154 patients. CESM was more effective than DM in detecting MCBC with sensitivity of 88.0 % vs 48.0 % ( p = 0.002), accuracy of 92.2 % vs 90.9 %, negative predictive value of 97.6 % vs 90.8 % ( p = 0.02), respectively. But the specificity was significantly higher in DM than in CESM – 99.2 % vs 93.0 % ( p = 0.009), respectively, and the positive predictive value did not differ significantly ( p = 0.12). Conclusion . CESM is a more sensitive method for diagnosing MCBC compared to DM with sensitivity of 88.0 % vs 48.0 %. The high negative predictive value of CESM (97.6 %) confirms the fact that this modality is an effective method for planning surgery and radiation therapy.
    Type of Medium: Online Resource
    ISSN: 1999-8627 , 1994-4098
    URL: Issue
    URL: Article
    DOI: 10.17650/1994-4098-2021-17-4
    DOI: 10.17650/1994-4098-2021-17-4-20-28
    Language: Unknown
    Publisher: Publishing House ABV Press
    Publication Date: 2022
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