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  • Autonomous non-profit scientific and medical organization - Questions of Oncology  (3)
  • 1
    Online Resource
    Online Resource
    Diagnostic Capabilities of Scintimammography in Detecting Multicentric and Minimal Breast Cancer of Various Molecular Subtypes
    Autonomous non-profit scientific and medical organization - Questions of Oncology ; 2023
    In:  Voprosy onkologii Vol. 69, No. 4 ( 2023-09-02), p. 708-714
    Details
    In: Voprosy onkologii, Autonomous non-profit scientific and medical organization - Questions of Oncology, Vol. 69, No. 4 ( 2023-09-02), p. 708-714
    Abstract: Цель. Определение информативности сцинтимаммографии/молекулярной визуализации (МСГ/МВ) при выявлении минимальных форм (МФ) рака молочной железы (РМЖ), а также установление частоты визуализации мультицентричного (МЦ) опухолевого процесса у больных с различными биологическими подтипами РМЖ. Материалы и методы. В анализ вошли результаты МСГ/МВ 1080 женщин (2 154 молочных желез), обследованных в связи с подозрением на наличие РМЖ. Радионуклидные исследования — МСГ/МВ выполнялись через 15-20 минут после введения в вену одной из стоп 370-740 МБк 99mTc-«MIBI». Верификация изменений в 1 060 случаях осуществлялась с помощью морфологического исследования, в остальных — при динамическом наблюдении. К МФ РМЖ относили все гистологически подтвержденные опухолевые очаги размерами до 10 мм. Сцинтиграфическими признаками МЦ опухолевого процесса считали наличие двух или более очагов, локализованных в разных квадрантах и/или одном квадранте, но на расстоянии не менее 30 мм друг от друга. Результаты. Чувствительность МСГ/МВ в диагностике МФ РМЖ в целом составила 82 %. У больных с различными биологическими подтипами РМЖ чувствительность МСГ/МВ составила 76 % при люминальном А; 80 % и 91 % — при люминальных В «-» и «+» подтипах, 90 % и 100 % — при трижды негативном и HER2 позитивном подтипах соответственно. Показатели чувствительности метода в диагностике минимальных форм трижды негативного и HER2 позитивного РМЖ оказались достоверно выше, чем в диагностике люминальных А и В-подтипов (p = 0,02). Частота визуализации МЦ РМЖ в зависимости от биологических подтипов различалась: при HER2 позитивном - 19 случаев (20,2 %), что достоверно выше (р = 0,006), чем при других молекулярно-биологических подтипах: люминальный A — 25 (10,5 %), люминальный B — 41 (11,4 %), люминальный B+ — 19 (12,6 %), трижды негативный — 18 случаев (10,3 %). Выводы. Определяется достоверное увеличение чувствительности МСГ/МВ при диагностике МФ РМЖ наиболее агрессивных биологических подтипов: 90% - при трижды негативном и 100% - при HER2 позитивном РМЖ. Установлена наиболее высокая частота визуализации МЦ РМЖ у больных с HER2+ подтипом РМЖ (20,2 %).
    Type of Medium: Online Resource
    ISSN: 0507-3758
    URL: Issue
    URL: Article
    DOI: 10.37469/0507-3758-2023-69-4
    DOI: 10.37469/0507-3758-2023-69-4-708-714
    Language: Unknown
    Publisher: Autonomous non-profit scientific and medical organization - Questions of Oncology
    Publication Date: 2023
    Location Call Number Limitation Availability
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    Online Resource
  • 2
    Online Resource
    Online Resource
    SPECT-CT topography of sentinel lymph nodes for radiotherapy of breast cancer
    Autonomous non-profit scientific and medical organization - Questions of Oncology ; 2022
    In:  Voprosy Onkologii Vol. 68, No. 3 ( 2022-07-06), p. 313-321
    Details
    In: Voprosy Onkologii, Autonomous non-profit scientific and medical organization - Questions of Oncology, Vol. 68, No. 3 ( 2022-07-06), p. 313-321
    Abstract: Purpose. To evaluate SPECT-CT topography of sentinel lymph nodes (SLNs) in patients with breast cancer and determine the role of this information for radiotherapy planning. SPECT-CT was performed in 268 patients with breast cancer. Date acquisition started 1-1,5 hours after intra- and/or peritumoral injection of 150 MBq of 99mTc-radiocolloids. Finally, we compared topography of visualized SLNs with standard clinical volume designed for irradiation of regional lymph nodes. SPECT-CT visualized 572 SLNs. In most cases (72,4%) SPECT-CT detected 1-2 SLNs, in 27,6% cases SPECT-CT visualized 3 and more LNs with radiocolloid uptake. Despite high variability of SLNs topography, most of them were localized in the axilla region corresponded to axillary level I-II. Surprisingly, 14,9% LNs were detected in the lateral group of axillary LNs, which are usually not covered by standard LNs contours and often spared during LN dissection. SPECT-CT visualization of SLNs can be important for individual planning of surgical and radiotherapy treatment.
    Type of Medium: Online Resource
    ISSN: 0507-3758
    URL: Issue
    URL: Article
    DOI: 10.37469/0507-3758-2022-68-3
    DOI: 10.37469/0507-3758-2022-68-3-313-321
    Language: Unknown
    Publisher: Autonomous non-profit scientific and medical organization - Questions of Oncology
    Publication Date: 2022
    Location Call Number Limitation Availability
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    Online Resource
  • 3
    Online Resource
    Online Resource
    Axillary surgery after neoadjuvant chemotherapy in breast cancer patients downstaging from cN+ to ycN0
    Autonomous non-profit scientific and medical organization - Questions of Oncology ; 2022
    In:  Voprosy Onkologii Vol. 68, No. 3 ( 2022-07-06), p. 322-332
    Details
    In: Voprosy Onkologii, Autonomous non-profit scientific and medical organization - Questions of Oncology, Vol. 68, No. 3 ( 2022-07-06), p. 322-332
    Abstract: Relevance. Axillary lymph node dissection is a redundant method of surgical treatment and axillary staging for a large number of patients receiving neoadjuvant therapy with positive lymph nodes before NCT. Purpose of research. Improving the technique of axillary lymph node staging after neoadjuvant systemic therapy using targeted axillary dissection with I-125 microseed in addition to SLNB. Materials and methods. The study included 212 patients with breast cancer (cT1-3N1M0) who received treatment at the breast tumors department of the N.N. Petrov NMRC of Oncology from 2019 to 2021. All patients included in the study had the cN1 initial status of the axillary lymph nodes. All patients underwent neoadjuvant systemic therapy and subsequent sentinel lymph node biopsy (SLNB). In patients with pathomorphologically proven metastatic lymph nodes (cN1) even at the initial diagnosis, lymph node marking was performed before the start of NCT and targeted axillary lymph node dissection after the completion of neoadjuvant systemic therapy. In the same patients, after SLNB and targeted axillary lymph node dissection, a complete (standard) axillary lymph node dissection was performed to determine the false-negative rate and the oncological safety of the procedure. Results. The identification rate of only one sentinel lymph node was 21% (40 out of 193 patients), two sentinel lymph nodes - 30% (58 out of 193 patients), more than 3 - 49% (95 out of 193 patients). When only 1 sentinel lymph node was found, the false-negative rate of SLNB was 20.0% (4 of 20) (95% CI, 5.7 to 43.7). When two sentinel lymph nodes were found, the false-negative rate of SLNB was 20.0% (6 of 30) (95% CI, 7.7 to 38.6). When three sentinel lymph nodes were found, the false negative rate of SLNB was 4.7% (2 of 43) (95% CI, 0.0 to 15.8). Among 45 patients who had a microseed with the iodine-125 radioisotope installed before the start of treatment, the frequency of identifying a marked node was 100%. In 19 patients, tumor cells were found in the lymph nodes. The false-negative rate of targeted axillary dissection in combination with SLNB was 5.3% (1 of 19) (95% CI, 0.0 to 26.0). Conclusion. Targeted axillary dissection and sentinel lymph nodes biopsy, provided that 3 SLNs are removed, are reliable methods for identifying patients in whom systemic therapy is guaranteed to achieve complete response of regional lymph nodes (ypN0), thereby relieving patients of the need to perform a crippling complete axillary lymph node dissection.  
    Type of Medium: Online Resource
    ISSN: 0507-3758
    URL: Issue
    URL: Article
    DOI: 10.37469/0507-3758-2022-68-3
    DOI: 10.37469/0507-3758-2022-68-3-322-332
    Language: Unknown
    Publisher: Autonomous non-profit scientific and medical organization - Questions of Oncology
    Publication Date: 2022
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
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