[Postmastectomy syndrome after the radical treatment of the breast cancer with the preservation of the intercostal nerve].

Postmastectomy syndrome often follows the radical surgery oа the breast cancer. The intersection of the branches of the intercostal nerve is an infrequent cause of the postmastectomy syndrome development. We studied the long-term follow up results in 30 patients after radical mastectomy by Madden with preservation of the branches of the intercostal nerve on the level of Th1-Th3. The method demonstrated the decrease of the postmastectomy syndrome and the improvement of quality of life.

[Complications after reconstructive implantation of silicone endoprostheses in patients with breast cancer].

Radical mastectomy, though is considered to be the main method of the breast cancer treatment, influences the physical and psychological rehabilitation of patients extremely negatively. Reconstructive silicone endoprosthesing alternates radical mastectomy. Complications of the procedure analysed using the experience of 120 women with breast cancer. The on-time detection of complications drastically improves long-term aesthetic results.

[Stewart-Treves syndrome--lymphangiosarcoma in sever lymphostasis of arm after mastectomy]. / Sindrom Stiuarta-Trivsa--limfangiosarkoma na fone vyrazhennogo limfostaza ruki posle mastéktomii.

Stewart-Treves Syndrome ('STS) is a rare, extremely malignant and quickly progressing tumor. It is angiosarcoma developing in lymphostasis of an arm after radical mastectomy for cancer. The patient aged 80 years was followed-up, in whom STS had developed 19 years after radical mastectomy. Clinical diagnosis was confirmed by pathomorphological examination of dermal biopsy. Advanced age and severe associated diseases made it impossible to carry out specific therapy. The patient died of intoxication and increasing cardio-vascular insufficiency 9 months after the onset of the disease.

[The clinical significance of determining the HLA-DR4 antigen in patients with breast cancer]. / Klinicheskoe znachenie opredeleniia antigena HLA-DR4 u bol'nykh rakom molochnoi zhelezy.

A study of HLA phenotype in 151 cases of breast cancer showed an increased occurrence of DR4 antigen (46.8%) as compared to general population (16.3%). Some clinical parameters of DR4-positive and DR4-negative patients were compared. Estradiol receptor-negative tumor was observed in 40% of DR4-positive patients and only in 18.5% of estradiol receptor-negative ones. DR4 positivity was associated with poorer prognosis.

[Scalp hypothermia as a preventive of alopecia in patients receiving combined chemotherapy including anthracyclines]. / Gipotermiia volosistoi chasti golovy kak profilaktika alopetsii u bol'nykh, poluchaiushchikh kombinirovannuiu khimioterapiiu s ispol'zovaniem antratsiklinov.

Scalp cooling to prevent alopecia was used in 47 patients treated with anthracyclines for various tumors. Good results were obtained though the course included cyclophosphamide which also causes alopecia. Total beneficial (good + satisfactory) effect was recorded in 36 patients (74.4%) who did not need a wig.

[Use of protamine sulfate in a method for determining the hormonal sensitivity of breast cancer]. / Ispol'zovanie sul'fata protamina v metodike opredeleniia gormonal'noi chuvstvitel'nosti raka molochnoi zhelezy.

A new procedure for estrogen receptor assay in breast cancer tissue is discussed. According to the method cytosol receptor level is interpreted as the estradiol binding capacity of protein which is precipitated by protamine sulfate from the cytosol fraction of tumor.

[Bone scintigraphy in the preoperative determination of the stage of breast cancer]. / Osteostsintigrafiia v predoperatsionnom opredelenii stadii raka molochnoi zhelezy.

As for the frequency of metastases to the bones breast cancer ranks third among all tumors, as for the general frequency of metastases it ranks first (25-45%). Early diagnosis of breast cancer metastases to the bones using scintigraphy of the skeleton in the preoperative period gives an opportunity to reveal tumor dissemination and to provide adequate treatment without imposing on patients inappropriate therapeutic measures. The study was performed using 99mTc-pyrophosphate. In revealing the foci of high activity accumulation by more than 20% as compared to symmetrical or adjacent zones, the changes were looked upon as metastatic ones. Out of 85 patients foci of high activity accumulation in the skeleton were noted in 7 (8.3%). In 5 patients, metastases were confirmed directly on roentgenography, and in 2 patients, they manifested themselves 2 and 5 months later. Stage I-IIa disease was observed in 48 (56.5%) out of the 85 patients. Out of the 40 patients with Stage I disease, skeletal metastases confirmed by x-ray were found in 2. All 7 patients were given together with mastectomy adjuvant treatment. Thus scintigraphy of the skeleton together with chest x-ray, liver scintigraphy, physical examination and palpation should become obligatory in the preoperative examination of patients to specify breast cancer stage.

[Evaluation of the effectiveness of treating breast cancer metastases to the bones by the "no-pain index"]. / Otsenka po "bezbolevomu indeksu" éffektivnosti lecheniia metastazov raka molochnoi zhelezy v kosti.

The results of evaluation of treatment of 98 breast cancer patients with bone metastases are presented. Metastases appeared 6 months -- 15 years after treatment; on the average, they appeared 20.2 months after treatment. Patients received complex therapy -- radiation and medication. The results of treatment were assessed on the basis of subjective (abatement or cessation of pain) and objective (bone reparation) criteria. Objective effect was observed in 4%, subjective one -- in 68.3% of cases. Apart from survival time and remission, the results of treatment were evaluated on the basis of the duration of painless period expressed by means of "no-pain index" -- the ratio of the painless period duration to survival time which elapsed since skeletal metastasis detection, multiplied by 100. The study showed that complex therapy has a considerable palliative effect in some cases -- abatement or cessation of pain for over 54--60% of the survival time of patients.