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Оn March 27, 2023, а multidisciplinary Advisory Board meeting was held in Moscow with the participation of Е.V. Artamonova, Е.А. Busko, V.V. Didenko, А.D. Zikiryakhodzhaev, М.S. Karpova, G.Е. Kvetenadze, P.V. Krivorot’ko, М.L. Mazo, А.V. Petrovsky, О.S. Puchkova, S.V. Serebryakova under the chairmanship of I.Е. Tyurin and N.I. Rozhkova. The participants discussed different issues of early diagnostics and treatment planning of breast cancer. We present the conclusion made by the Advisory Board.

Purpose of the study. Evaluation of the diagnostic value of vacuum-assisted biopsy (VAB) based on pathomorphological studies in patients with breast cancer (BC) who have achieved a complete clinical response (cCR) after neoadjuvant polychemotherapy (NACT).Patients and methods. In the study, conducted from 2021 to 2023 at the P. A. Hertsen Moscow Oncology Research Institute – a branch of the National Medical Research Radiology Center of the Ministry of Health of Russia, 35 patients with BC cT1–3N0–3M0 of various molecular-biological types who were diagnosed with cCR after NACT were included. All patients underwent VAB (needle size 7–10 G) of the breast followed by histological examination, after which surgical treatment was performed. Subsequently, histological conclusions of VAB and surgical materials were compared with each other for the presence and degree of pathomorphological response.Results. According to the pathomorphological conclusion when conducting VAB, the following results were obtained: 1 – true positive, 29 – true negative, 3 – false negative, and 0 – false positive. No statistically significant results of the association between complete pathomorphological response and the molecular-biological type of breast cancer were obtained (p > 0.05), however, there is a tendency towards the greatest number of complete pathomorphological responses in Her2-neu-positive (luminal – 100 %, non-luminal – 90.9 %) and triple-negative (87.50 %) types of breast cancer. The overall sensitivity of the method was 25.0 % (CI 6.8–60.2 %); specificity – 100 % (CI 88.1–100 %); false-negative result (presence of tumor cells in the surgical material and a negative result of VAB) – 9.1 % (CI 3.4–20.2 %); false-positive result (absence of tumor cells in the surgical material and a positive result of VAB) – 0 % (CI 0–10.6 %). The overall diagnostic accuracy of the method was 90.9 % (CI 79.8–96.6 %).Conclusion. The results of the conducted research allow for the consideration of excluding surgical treatment when a complete pathomorphological response is obtained by VAB. However, further research is required with the inclusion of a larger number of patients.

Introduction. Amidst a steady increase in hyperplastic processes in uterus and mammary glands, numerous studies have shown that women with dyshormonal pathology of mammary glands had a range of gynecological diseases: external or internal endometriosis, hyperplastic processes of the endometrium and myometrium, polyps, polycystic ovary syndrome (PCOS), etc.Objective. To assess the mammary gland condition in premenopausal women with endometrial hyperplasia during indole-3-car-binol (I3C) therapy.Materials and methods. A total of 42 premenopausal patients aged 45-52 years (48.54 ± 1.83) were enrolled in an open-label prospective study. All patients received I3C 400 mg a day for 12 months. The examination included clinical laboratory, ultrasound imaging and mammographic examination of the mammary glands, cytologic examination of a nipple discharge. The examinations were carried out at the baseline, 6 and 12 months after starting treatment. The study findings were evaluated using descriptive statistics. Differences were considered significant at p

Diagnostic efficiency of breast cancer screening remains one of the most important issues in oncology and radiology. Artificial intelligence technologies are widely used in clinical medicine to effectively solve a number of technological and diagnostic problems. The aim. To develop segmentation neural network model for breast plain radiographs analysis with subsequent study of its clinical effectiveness. Materials and methods. The artificial intelligence-based system was developed to analyze X-ray mammography, аnd included a segmentation neural network with the U-Net architecture, a classification neural architecture ResNet50 with outputting the result using gradient boosting. 15486 X-ray cases were used for training, estimation of diagnostic accuracy and validation of the developed segmental model. All cases were labeled in specially developed software environment LabelCMAITech. The segmentation accuracy was determined by Intersection over Union (IoU) similarity coefficient, the probability of malignancy was calculated using the binary classification metrics. Results. The developed system is represented by a segmentation model based on neural network architecture. The model allows, with high accuracy of 0.8176 and higher, at threshold values on the output neurons of the network of 0.1 and 0.15, to localize X-ray findings that have diagnostic value for determining the likelihood of the presence of breast cancer signs in an X-ray mammographic study — focus, architecture distortion, local asymmetry, calcifications. When comparing the results of machine segmentation and marking of images by a radiologist, it was found that the model is not inferior to the doctor in the accuracy of determining the formations, extra-focal calcifications and intraglandular lymph nodes. Conclusion. The results of this study allow considering the model as an intelligent assistant to a radiologist in the analysis of screening mammographic cases.

A brief review of current data on the generality of the epidemiology and molecular pathogenesis of breast cancer and benign breast diseases is presented. Currently, a type of mastopathy, fibrosclerosis/sclerosing adenosis, ac­companied by the formation of microcalcifications, is considered as a benign pathological condition with a high risk of malignancy, and also as a pre-start condition of a possible transition of mastopathy to cancer. In the review is discussed the fundamental biological process of the epithelial-mesenchymal transition (EMT) as a molecular pathogenetic basis of this phenomenon. Identification of the above mentioned pathological changes using mam­mography and refined diagnostics using a vacuum aspiration biopsy allow timely treatment of fibrosclerosis and sclerosing adenosis with Indinol® Forto, a drug of pathogenetic action based on indole-3-carbinol, due to its mul­tiple anticancer and oncoprophylactic activity, including ability to reverse at the epigenetic level the EMT process abnormally proceeding in these benign breast diseases.

El pensamiento crítico y sus habilidades deberían ser un componente fundamental de la educación universitaria; especialmente en la administración. En este documento se analizarán las competencias y habilidades del pensamiento crítico y su utilidad para la enseñanza, la investigación y el desempeño profesional en administración de empresas. Al final se concluye que el pensamiento crítico podría manifestarse como el sexto modo de ser de los gerentes en las organizaciones; modo de ser crítico. Y se sugiere ahondar en estudios que busquen su plena implementación y desarrollo en este campo del conocimiento.

The purpose of the study wasto examine the effectiveness of the drug Mastodynon® for the treatment of mastopathy in pre - and perimenopausal women. Materials and methods. The research was carried out within 12 months. Patient presenting complaints of pain in the breast, passed a comprehensive examination (clinical and Х-ray and/or sonographic) and questionnaires at the first visit and every 6 months. The plant-based drug Mastodynon®. Results. We examined 38 patients aged 45-56 years. Most women in this group for many years were observed due to mastopathy of different forms and degrees of severity. After 6 months after start of treatment with Mastodynon® the majority of patients reported decrease or absence of pain in the breasts, improvement of psycho-emotional condition. The positive effect of various degree was observed in 71.05% of the patients. After 1 year revealed a stabilization of the therapeutic effect of the drug Mastodynon® in 83.3% of cases. Mastodynon® has shown high effectiveness, good tolerability in the treatment of mastopathy in women of pre - and perimenopausal age, it has improved thepatients quality of life.

Objective: to assess the capabilities of and the first experience with an ACUSON S2000 automated breast volume scanner (ABVS) (Siemens, Germany) to detect abnormal breast lumps. Material and methods. Examinations were made in 97 patients who underwent radiological studies encompassing digital mammography, B-mode ultrasonography of the breast, and its pathomorphological examination. All the cases were classified according to the BI-RADS system. Abnormal breast lumps (BI-RADS 1) were not found in 27 cases; clearly defined benign masses (BI-RADS 2) were detected in 18, and pathomorphologically verified breast cancer (BC) (BI-RADS 5) in 29 cases. All the patients also underwent breast ultrasonography using an ACUSON S2000 system (Siemens, Germany). The results of ABVS examination were compared with those of standard comprehensive breast radiologic examination. Having no preliminary additional information on each patient, an independent expert – a radiologic diagnostician appraised all ultrasound scanning data at a special review station. Results. The sensitivity of the automated scanning assay in detecting breast abnormalities was 100%; its specificity and diagnostic accuracy were 40 and 88%, respectively. The independent expert established the diagnosis of BC in 26 (90%) of the 29 cases. According to the results of automated breast scanning, pre-examination using a set of radiation methods was recommended in 66 (66%) cases. The hyperdiagnosis was 24%. Conclusion. Taking into consideration the fact that none of the BC case was overlooked, the first experience with ABVS showed encouraging results and the need for further clinical tests of the automated breast scanning system.

Objective. A study of the effectiveness of drugs Mastopol in the treatment of diffuse benign breast disease and mastodynia. Materials and methods. The patient underwent a comprehensive examination of the breast.Treatment was carried out one of the successfully used medications for the treatment of diffuse benign breast disease, non-hormonal homeopathic remedy plant origin Mastopol. Indications for the use of Mostopol is a comprehensive treatment of fibrocystic mastopathy, mastodynia. Results. We examined 45 women aged 30-44 years, who appealed with complaints of pain in both breast. All the patients underwent a comprehensive examination, which included clinical examination, mammography, sonography of the breast and axillary regions. The entire group was discovered fibrocystic breast disease of different forms and degrees of severity. All the patients had been appointed Mastopol in standard doses. After one course of treatment (8 weeks), 43 (95,5%) patients noted a positive effect. 29 (65%) patients noted marked improvement of health, reduction or disappearance of mastalgia. 14(35%) patients emphasized the reduction of intensity of premenstrual syndrome. Conclusions. The results of these studies showed high efficacy Mastopol in the treatment of mastalgia and diffuse benign changes in the breast.The positive dynamics was achieved quickly and efficiently in most cases (95.5 percent). Signs of mastodynia were resolved after a single course of treatment. Two courses of conservative therapy yielded positive results, confirmed by objective clinical data and research sonography of the breast. The reduction of the size of cysts, reduction in the density and swelling of the breast tissue. The use of the drug Mastopol no identified side effects. Mastopol can be widely recommended for the treatment of mastodynia and diffuse benign disease (mastopathy).

The problem of early diagnosis of a breast cancer is extremely actual. Growth of incidence at women from 19 to 39 years increased for 34% over the last 10 years. It defines need of acceleration of development and deployment of the latest technologies of identification of the earliest symptoms of diseases. The x-ray mammography is the conducting method among of all radiological methods of diagnostics. Nevertheless a number of restrictions of method reduces its efficiency. The technologies increasing informational content of x-ray mammography – the leading method of screening – due to use of artificial contrasting and advantages of digital technologies are constantly developed. In this review it is described works, in which the authors having clinical experience of application of CESM – contrastenhanced spectral mammography on representative group of women. Positive sides and restrictions of new technology in comparison with mammography, ultrasonography and MRT are shown in this article.

Se han preparado 3 vidrios con distinto contenido en SiO2 y de composición similar a los nutrientes necesarios para el crecimiento del alga Spirulina platensis. Se han escogido 2 fracciones con distinto tamaño de partícula para cada uno de los vidrios preparados y la cinética de lixiviación de dichos vidrios ha sido estudiada a través del análisis químico de las aguas de lixiviado, permitiendo obtener las curvas de velocidad para cada uno de los componentes del vidrio. A partir del cálculo de la constante de velocidad y del exponente de la reacción de lixiviado, se ha realizado una aproximación al crecimiento del alga Spirulina platensis en condiciones ambientales normales de luz, pH y temperatura y se ha obtenido que, a través de la modificación de la composición del vidrio de partida o de su tamaño de partícula, es posible ajustar el aporte de nutrientes al medio a la velocidad de crecimiento del alga Spirulina platensis.

Introduction. A diversity of axillary pathologies was a prerequisite for the development of a new differential approach to diagnosing such conditions. There are new technologies (pre- and intraoperative radionuclide studies, molecular genetic techniques), that have shown themselves, along with classical methods (physical examination, mammography, X-ray and ultrasound studies).Materials and methods. The subject of the analysis is the results of a comprehensive examination of 502 women aged 22 to 84 years. Different groups were comprehensively examined using both X-ray, ultrasound, radionuclide, and molecular genetic (polymerase chain reaction) studies.Results. The molecular genetic and cytological studies could provide the actual results in 95 and 84% of cases, respectively; but a com- prehensive clinical study and X-ray ultrasound computed tomography could yield them in marginal metastases in only 65.3%. Conclusion. The authors have proposed the optimal diagnostic algorithm for examination in the ambulatory-outpatient network and specialized institutions.