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© 2020 Elsevier B.V. Brain metastases manifest the advanced stage of breast cancer disease with poor prognosis for patient survival. Recent reports demonstrate that some therapeutic agents can activate the expression of several breast cancer-associated genes, whose products are involved in the onset and development of brain metastases. In this study, we discovered a functional link between KISS1 and E-cadherin that could be observed in both primary brain metastatic lesions and paired cell lines, such as parental CN34TGL and MDA-MB-231 and their respective brain metastatic subclones CN34Brm2Ctgl and MDA-MB-231Br. Remarkably, expression of KISS1 and E-cadherin genes consistently showed an inverse correlation in all of the above cell/tissue types. While E-cadherin expression was strongly upregulated in metastatic clones isolated from blood and brain, the levels of this protein in parental MDA-MB-231 cell line was low. Furthermore, E-cadherin upregulation can be artificially induced in MDA-MB-231Br and CN34Brm2Ctgl cell populations by knocking down KISS1 expression directly or through overexpressing the miR345 mimic. In the aggregate, our data suggest that the tumor microenvironment, which controls breast cancer spreading via miR345-regulated KISS1 expression, might modulate metastatic spreading by a mechanism(s) involving upregulation of E-cadherin production.

© 2019 by the authors. Licensee MDPI, Basel, Switzerland. A growing number of studies are focusing on the associations between human milk (HM) immunological composition and allergic diseases. This scoping review aims to identify statistical methods applied in the field and highlight pitfalls and unmet needs. A comprehensive literature search in MEDLINE and Embase retrieved 13,607 unique records. Following title/abstract screening, 29 studies met the selection criteria and were included in this review. We found that definitions of colostrum and mature milk varied across the studies. A total of 17 out of 29 (59%) studies collected samples longitudinally, but only 12% of these used serial (longitudinal) analyses. Multivariable analysis was used in 45% of the studies, but statistical approaches to modelling varied largely across the studies. Types of variables included as potential confounding factors differed considerably between models. Discrimination analysis was absent from all studies and only a single study reported classification measures. Outcomes of this scoping review highlight lack of standardization, both in data collection and handling, which remains one of the main challenges in the field. Improved standardization could be obtained by a consensus group of researchers and clinicians that could recommend appropriate methods to be applied in future prospective studies, as well as already existing datasets.

© 2019, Pediatria Ltd. All rights reserved. Objective of the research: To study the effect of different temperature conditions and shelf life of expressed mother and donor breast milk (BM) on its microbiological safety. Materials and methods: N open prospective study was performed, which included 120 lactating women. BM samples were microbiologically evaluated under various storage conditions. Seeding of biological material was performed by a semi-quantitative method. Species identification of the obtained microorganisms was performed using a MALDI-TOF-MS Biotyper MicroFlex mass spectrometer and a VITEK bacteriological analyzer. Results: In 66% of women, samples of expressed BM showed an increase (103–105 CFU/ml) of conditionally pathogenic bacteria (CPB) with a predominance of S. epidermidis (55%). None of the samples of the expressed BM stored for 3 hours at room temperature (t° + 23°C) during the day in the refrigerator (t° + 4–6°C) and for 1 month in the freezer (t ° –18°C), the growth of CPB was not recorded. However, a decrease in the growth of bacteria total number was revealed, including S. epidermidis, when storing expressed milk for 24 hours at t° + 4–6°С and for 1 month at t° –18°С. It was found that BM pasteurization leads to a significant decrease in the number of CPB. The study revealed no increase in the total number of bacteria during storage of donor milk at t° –18°C for both 1 and 3 months.

© 2019 John Wiley  &  Sons Ltd Background: Human milk (HM) transforming growth factor beta (TGF-β) is critical for inflammation regulation and oral tolerance promotion. Previous reports suggested that variations in HM TGF-β levels are associated with allergic outcomes. Objective: We undertook a systematic review (PROSPERO 2017 CRD42017069920) to reassess the evidence on the relationships between HM TGF-β and allergic outcomes in children. Methods: Electronic bibliographic databases (MEDLINE, EMBASE and Cochrane Library) were systematically searched. Two independent reviewers screened reference lists, extracted the data and assessed risk of bias using the National Institute for Clinical Excellence methodological checklist. Results: A total of 21 studies were identified. Sixteen studies assessed relationships between HM TGF-β and risk of eczema; 14, allergic sensitization; nine, wheezing/asthma; six, food allergy; three, allergic rhinitis/conjunctivitis. Five cohorts (5/18, 28%) reported a protective effect of TGF-β1, while 3 (3/10, 30%) suggested increased risk of allergic outcomes development and 1 (1/10, 10%), a protective effect of TGF-β2 on eczema. Meta-analysis was not possible due to significant heterogeneity in methodology, age of outcome assessment and differing statistical approaches. 71% (15/21) of studies carried a high risk of bias. Conclusion and clinical relevance: In contrast with previous findings, we did not find strong evidence of associations between HM TGF-β and allergic outcomes. Differences in studies' methodology and outcomes do not allow unconditional rejection or acceptance of the hypothesis that HM TGF-β influences the risk of allergy development. Future studies on diverse populations employing standardized methods, accurate phenotyping of outcomes and evaluation of the effect of TGF-β in combination with other HM immune markers, microbiome and oligosaccharides are required.

© 2019 by the authors. Real-time molecular navigation of tissue surgeries is an important goal at present. Combination of electrosurgical units and mass spectrometry (MS) to perform accurate molecular visualization of biological tissues has been pursued by many research groups. Determination of molecular tissue composition at a particular location by surgical smoke analysis is now of increasing interest for clinical use. However, molecular analysis of surgical smoke is commonly lacking molecular specificity and is associated with significant carbonization and chemical contamination, which are mainly related to the high temperature of smoke at which many molecules become unstable. Unlike traditional electrosurgical tools, low-temperature electrosurgical units allow tissue dissection without substantial heating. Here, we show that low-temperature electrosurgical units can be used for desorption of molecules from biological tissues without thermal degradation. The use of extractive electrospray ionization technique for the ionization of desorbed molecules allowed us to obtain mass spectra of healthy and pathological tissues with high degree of differentiation. Overall, the data indicate that the described approach has potential for intraoperative use.

© 2018 by the authors. Licensee MDPI, Basel, Switzerland. Colostrum is produced in the first days postpartum. It is a known source of immune mediators for a newborn within the first week of life. Although it is still unclear if colostrum composition varies between populations, recent data suggest differences. Hepatocyte growth factor (HGF); transforming growth factor-β (TGF-β) 1, 2, and 3; and immunoglobulin A (IgA) are key immunological components of colostrum that stimulate neonatal gastrointestinal and immune system development. We aimed to investigate the differences in the concentration between immune markers in the colostrum of mothers living in Burundi and Italy, and to identify the factors associated with differences. In this cross-sectional birth cohort study, a total of 99 colostrum samples from Burundian (n = 23) and Italian (n = 76) women were collected at 0 to 6 days postpartum. A clinical chemistry analyser was used for IgA quantification and electro-chemiluminescence, for HGF and TGFβ1-3 assessment. A univariate analysis and multivariate linear regression model were used for statistical testing. The concentrations of TGF-β2 (p = 0.01) and IgA (p < 0.01) were significantly higher in the colostrum from the women residing in Burundi than in Italy, both in a univariate analysis and upon the adjustment for confounding factors. A similar trend is seen for HGF, reaching statistical significance upon a multivariate analysis. We found a moderate to strong positive correlation between the TGF-β isoforms and IgA concentration in both countries (p < 0.01), with stronger concentration in the colostrum from Burundi. The results of this study are in support of previous data, suggesting that concentration of the immune active molecules is higher in the human milk of women residing in developing countries. However, with a small sample size, caution must be applied, as the findings require further confirmation. Future work should also be focused on other factors (e.g., lipid and microbial composition), as well as the investigation into colostrum and between populations comparison, adjusting for potential confounders.

© 2018, Pediatria Ltd.. All rights reserved. The article presents data of a systematic review of observational and interventional studies on possible associations between the level of macro-and micronutrients consumption by lactating mothers and their breast milk composition. Authors present the results of a 3-week prospective medical observation in assessing the tolerability of specialized products for lactating mothers, as well as the dynamics of the physical development of their children who are exclusively breastfed.

© 2018 by the authors. Licensee MDPI, Basel, Switzerland. Breastfeeding rates are low in the UK, where approximately one quarter of infants receive a breastmilk substitute (BMS) in the first week of life. We investigated the reasons for early BMS use in two large maternity units in the UK, in order to understand the reasons for the high rate of early BMS use in this setting. Data were collected through infant feeding records, as well as maternal and midwife surveys in 2016. During 2016, 28% of infants received a BMS supplement prior to discharge from the hospital maternity units with only 10% supplementation being clinically indicated. There was wide variation in BMS initiation rates between different midwives, which was associated with ward environment and midwife educational level. Specific management factors associated with non-clinically indicated initiation of BMS were the absence of skin-to-skin contact within an hour of delivery (p = 0.01), and no attendance at an antenatal breastfeeding discussion (p = 0.01). These findings suggest that risk of initiating a BMS during postnatal hospital stay is largely modifiable. Concordance with UNICEF Baby Friendly 10 steps, attention to specific features of the postnatal ward working environment, and the targeting of midwives and mothers with poor educational status may all lead to improved exclusive breastfeeding rates at hospital discharge.

© 2017 Elsevier B.V. KISS1 tumor suppressor protein regulates cancer cell invasion via MMP9 metalloproteinase. Downregulation of KISS1 gene expression promotes progression of breast cancer and melanoma, resulting in the development of distant metastases. In the current study, we investigated whether restoration of KISS1 expression in KISS1-deficient human metastatic breast cancer cells holds potential as an advanced anticancer strategy. To this end we engineered an infectivity-enhanced conditionally-replicative human adenovirus type 5 encoding KISS1 as an “arming” transgene in the Ad5 E3 region for an ectopic KISS1 expression in transduced cancer cells. The oncolytic potential of the vector was examined using brain-invading metastatic clones of CN34 and MDA-MB-231 breast cancer cells, which supported high levels of AdKISS1 replication, correlating with a robust CRAd-mediated cytotoxicity. Secretion of cellular factors responsible for tumor angiogenesis, cell-to-cell communication and anti-tumoral immune responses upon KISS1 expression in breast cancer cells was analyzed by a RayBiotech Kiloplex Quantibody array. Overall, our results indicate that KISS1 transgene expression provides an important benefit for CRAd-mediated cytotoxicity in breast cancer cells and holds potential as an anticancer treatment in conjunction with oncolytic virotherapy of breast and other metastatic cancers.

Nowadays, the breast-feeding, despite the approved advantages, is not a standard in many communities. The multi-factorial determinants determining its prevalence need to be supported at various levels - from legal and legislative one to views and values of society, conditions of women's labor and also health care system that can develop a favorable environment for breast-feeding. The breast-feeding effects positively on health, economic development and ecology and therefor it is a benefit for children, women and whole society in short-term and long-term perspective. The defense, propaganda and support of breast-feeding need a political will, and financial investments to implement its advantages.

© 2018 Russian Electronic Journal of Radiology.All right reserved. In plastic surgery we often have the need for soft tissue volume restoration of different localization, to close congenital or acquired defects as well as associated with agerelated changes in soft tissue. Autologous adipose tissue in many properties is the ideal filler for the correction of the body contour defects. However, despite its advantages, this minimally invasive technique has been secondary to more complex methods of reconstruction - flap transplantation. The main significant drawback of fat grafting is the unpredictable and ineffective survival of transplanted fat (20 to 60%, according to different authors). Currently, factors that can influence the degree of survival of adipose tissue and make it more predictable are being actively studied, in particular, the effect of Leucocyte and Platelet Rich Plasma (L-PRP). Purpose: To prove the stability of transplanted adipose tissue survival with the addition of L-PRP in breast surgery via multispiral computed tomography (MSCT) with the calculation of resorption rate of adipose tissue before transplantation in the early and in late postoperative stages. Materials and methods: In the period from 2013 to 2016, a total of 48 patients underwent surgery at the plastic surgery clinic in I.M. Sechenov First Moscow State Medical University. All patients complained of dissatisfactory appearance of the breast. Patients underwent breast lipofilling in order to correlate contour deformities. Monitoring of adipose autografts consisted of the following methods: MSCT was performed in 12 cases (5 patients after transplantation of pure adipose tissue and 7 patients after transplantation of adipose tissue enriched with L-PRP). Results: The study of the sample volumes and thickness of soft tissues after the transplantation was performed both with and without the addition of L-PRP. A steady increase in the soft tissue thickness in the breast region was revealed and an increase in volume was noted in the main group. At the same time, in patients of the control group three months after surgery a decrease in the volume and thickness of the breast soft tissues was revealed. Conclusions: The results of the study show that the improvement of breast contour after transplantation of adipose tissue both with and without the addition of L-PRP provides a steady increase in the thickness and volume of breast soft tissues. The average loss of adipose tissue after transplantation ranges from 11.62% to 17.13%. The results also confirm that MSCT is an adequate method of visualization of adipose autografts and volumetric changes in the late postoperative period.

© Bionika Media Ltd. Objective. To carry out a systems analysis of the data available in the current literature on the impact of vitamin D deficiency on the risk of endometriosis and reproductive cancer, as well as on the possibilities of vitamin D supplementation in order to treat and prevent these diseases. Material and methods. The review includes the data of foreign and Russian articles published in the past 10 years and found in Pubmed on this topic. Results. The paper describes the mechanisms by which vitamin D is involved in the processes of inflammation, immunomodulation, and proliferation, as well as the role of its deficiency in pathogenesis of pathological proliferation and inflammation in endometriosis, breast cancer, and ovarian cancer. It gives the data of clinical trials confirming the role of vitamin D deficiency in the progression and negative effects of endometriosis and carcinogenesis, the possibility of vitamin D supplementation for the prevention and adjunct therapy of reproductive cancer and endometriosis. Conclusion. It is necessary to conduct further studies to experimentally and clinically evaluate vitamin D deficiency in endometriosis and cancer. Currently, vitamin D supplements should be prescribed to patients with this pathology if they have been found to have a low blood level of 25(OH)D3.

© 2018, Dynasty Publishing House. All rights reserved. The objective. Assessment of the practice of breastfeeding support in a department of neonatal and premature infant pathology of the Tambov Regional Children’s Clinical Hospital (TRCCH) after 3–4 years of becoming a WHO/UNICEF Baby Friendly Hospital. Patients and methods. Mothers were questioned using specially designed questionnaires at their admission to the department and at discharge from hospital. Overall, 356 mothers were questioned at admission and 327 at discharge. The results were processed on the SPSS.19 statistical programme. Frequency distribution, mean values (± standard deviation) and Student’s t-coefficient were determined. Results. The practice of supporting breastfeeding in the department consisted in observance of the 10 steps of successful breastfeeding: mother and infant remaining together (98.2%), breastfeeding on an infant’s demand (91.3%), breastfeeding at night (98.6%), breast milk extraction for infant feeding and lactation stimulation (88.6%), informing mothers about the benefits and technique of breastfeeding (90.5%). The percentage of breastfed infants significantly increased by the time of discharge from the department – to 89.4% (at admission – 71.9%; p < 0.0001), among them exclusively breastfed infants – to 66.5% (at admission – 45.3%; p < 0.0001). Conclusion. The practice of breastfeeding based on current international recommendations is successfully supported in the neonatal department of TRCCH. Nevertheless, breastfeeding parameters might be considerably improved due to attainment of continuity in the work of maternity clinics and TRCCH and optimization of the practices of breast milk extraction, storage and use in the department.

© 2018 Russian Electronic Journal of Radiology. All Rights Reserved. Purpose. To present abilities and limitations of Whole body MRI and FDG-PET/CT in the setting of sarcoid reaction and to stress the importance of use of broader differential diagnosis during interpreting its results. Materials and methods. The observation is introduced from clinical practice, examination was performed on 1.5 Tesla MRI scanner with the acquisition of four regions of interest: head and neck, thorax, abdomen, pelvis and upper thigh. Scanning protocol included diffusion-weighted imaging sequence. Results. The examination has let us exclude the presence of the active tumor tissue in breast cancer patient after systemic neoadjuvant treatment and drew our attention to false positive PET/CT result, which in turn led to change of further treatment strategy. Conclusions. Interpretation of FDG-PET/CT should be done in a complex manner with clinical, laboratory and radiological data correlation.

© 2018, Dynasty Publishing House. All rights reserved. The objective. To study the quality of life of feeding mothers and toe establish whether the adherence to breastfeeding influences physical and mental health of women. Patients and methods. We conducted a questionnaire survey of 151 mothers who had small infants. Their quality of life was studied with the help of the SF-36 questionnaire. Results. As we have found, the higher is the material wellbeing of the family, the less women adhere to breastfeeding (per capita income of the family of breastfeeding mothers are almost 2 times lower than in nonbreastfeeding women – 22500 ± 3.800 and 43958.33 ± 4.240 rubles, respectively, р < 0.05). Subjective perceptions of physical health (functioning), parameters of life activity (Vitality – VT) and subjective assessment of their health (General Health – GH) were similar in both breastfeeding and nonbreastfeeding mothers (VT 56.48 ± 3.77 and 58.33 ± 2.91; GH 68.52 ± 4.13 and 65.83 ± 1.95, р > 0.05). Irrespective of breastfeeding adherence, women after childbirth did not report of worsening of their health (50.93 ± 4.01 and 44.79 ± 2.61, respectively, р > 0.05). But in breastfeeding mothers parameters of the quality of life were demonstrative of a higher endurance (physical functioning 73.89 ± 1.66 and 85.22 ± 3.19, role functioning 52.78 ± 2.16 and 65.63 ± 3.73, р < 0.05). Breastfeeding mothers more rarely had difficulties in routine activities due to their physical condition and pain (bodily pain 73.89 ± 3.77 and131.35 ± 2.16, р < 0.05), physical and emotional condition did not interfere with communication and social activity (social functioning 67.13 ± 1.93 and 139.8 ± 6.92, р < 0.05, mental health 95.11 ± 7.18 and 58.17 ± 8.11, р < 0.05). They are less prone to depression and have higher values of the positive emotions parameter (role emotional functioning 64.08 ± 3.98 and 215.73 ± 12.67, р < 0.01). Conclusion. The results of the study can be used in programmes aimed at expanding breastfeeding.

© 2018 State Research Center, Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency. All rights reserved. Purpose: To increase the effectiveness and quality of surgery treatment for patients with early stages of breast cancer. Material and methods: Since 2016, 25 patients with breast cancer were examined and went through surgery. A lymphotropic colloidal radiopharmaceutical labeled with 99mTc was used; it was administered (150 MBq) the day before the operation. 20 patients received this injection intradermally into periareolar zone, 4 patients received it peritumourally (under control of ultrasound), 1 - paratumorally. Lymphoscintigraphy was performed 3 hours after injection, the images were acquired using dualhead gamma camera Symbia E (Siemens, Germany). A static multiplanar imaging (scintigraphy) (anterior, posterior, lateral projections) was performed for the sentinel nodes (SN) mapping. 25 planar examinations were performed. In 3 cases additional SPECT/CT study was performed using a hybrid SPECT/CT Symbia T2 (Siemens, Germany). Surgical intervention was done on the next day after scintigraphy. During the surgery the handheld gamma probe NEO 2000 (Johnson & Johnson, USA) was used to localize radioactivity. The lymph nodes with the highest count (hot lymph nodes) were removed and sent for immediate histological examination. The results of immediate histological examination were evaluated again during next studies of gross specimen and slides. Results: During scintigraphy studies planar and SPECT/CT, 26 SN were detected in 20 women (80 %). In 15 patients only one SN lymph node was found, in 4 patients - 2, and in one case 3 SN were found. Intraoperative search of SN and immediate histological examination was conducted in 22 cases, 33 SN were found, while during planar scintigraphy only 26. In three cases, after histological examination (after obtaining examination results), patient surveillance was changed, these patients did not undergo through intraoperative radiometry and a decision was to conduct a onestage mastectomy with regional lymphadenectomy. 10 out of 22 patients which underwent intraoperative radiometry and sentinel node biopsy, with immediate histological examination had metastases in the removed nodes, therefore lymphadenectomy had been performed. In the rest 12 patients after immediate histological examination of SN no evidence of tumor growth was found, thus lymphadenectomy was not performed. In case of three patients which did not undergo through intraoperative radiometry, lymphadenectomy was performed and after histological examination only two patients had tumorinvolved SN, and one patient was clear. All intraoperative results were confirmed with next followup histological examinations. In 5 out of 25 patients (20 %) sentinel nodes were not founded. In these 5 cases during follow up period metastases were found in regional lymph nodes, and one patient had tumor emboli in lymphatic vessels, this considered being the cause of negative scintigraphy result. In 12 cases out of 25 (48 %) it was possible to minimize surgical management, and 13 (52 %) undergo lymphadenectomy. Conclusion: 1) The integration of SPECT/CT method of sentinel nodes search allows to plan an optimal surgical management, and can positively affect the longterm followup result of treatment of patients with breast cancer, and improve the quality of life. 2) The sensitivity and positive prognostic value (PPV) of planar scintigraphy and intraoperative radiometry of searching for SN are 80, 100 and 73.3, 100 %, respectively. 3) Thanks to the method of lymphoscintigraphy, 12 (48 %) of 25 women it was possible to minimize surgical management without lymphadenectomy.

© Bionika Media Ltd. Objective. To carry out a systematic analysis of the data available in the current literature on the modern view on Trousseau’s syndrome Material and methods. The review included the data of foreign and Russian articles published in the past 10 years and found in e-Library and PubMed on this topic. Results. This paper provides a pathogenetic explanation for the increased thrombotic potential in cancer patients, which underlies tumor growth and metastasis. In addition to direct thrombotic events, the paper also describes hemorrhagic complications resulting from systemic coagulopathy, including disseminated intravascular coagulation, hemolytic thrombotic microangiopathy, and excessive fibrinolysis. Conclusion. At present, any manifestation of thrombohemorrhagic complications in patients with malignant tumors can be classified as a paraneoplastic syndrome (Trousseau’s syndrome). In addition to Virchow’s classic triad, hyperproduction of tissue factor (TF), the main initiator of the extrinsic coagulation pathway, underlies the pathophysiology of Trousseau’s syndrome. At the same time, the substantial release of microparticles from TF-bearing tumor cells is critical not only for clot formation, but also for the progression of tumor growth.

© 2018 Medical Radiology and Radiation Safety. All rights reserved. Introduction: The highest priority for modern clinical oncology is functionally-sparing and organ-conserving treatment. In Russia, breast cancer (BC), among all malignant tumors, accounted for 21.1 % of women in 2017. Oncoplastic radical resections (OPS-BCS = oncoplastic surgery – breast conserving surgery) have been widely used. This term means resection of the breast for cancer using plastic surgery to restore the shape of the breast, in most cases with one-stage correction of the contralateral breast. Purpose: It was the creation of various techniques of oncoplastic breast surgery, applicable for the appropriate localization of breast cancer and the evaluation of surgical, oncological and aesthetic results. Methods: From 2013 to 2017, in the P.A. Hertsen Moscow Oncology Research Center, organ-conserving surgery were performed in 570 patients with BC with an average age of 54.2. Stage 0 was diagnosed in 4.6 %, I – 5.9 %, IIA – 28.7 %, IIB – 6 %, IIIA – 5.1 %, IIIC – 3.3 %, IIIB – 0.2 %, IV – 0.2 %. Radical resection in the standard version was performed in 290 patients with breast cancer, oncoplastic breast surgery in various modifications – in 280. All patients after the organ-conserving surgical treatment received radiation therapy. Patients received chemotherapy, targeted therapy and hormone therapy according to the indications in depending the disease stage and the immunohistochemical type of the tumor. Results: After an urgent and planned morphological study positive margins of resection were revealed in 10 patients, which required reresection of the edges to a negative state of them in case of an urgent intraoperative response and mastectomy – in case of a planned response. Within 4 years, local recurrences were detected in 4 patients (0.7 %), which required a mastectomy with a one-stage reconstruction. In 1 patient (0.2 %), the disease progressed as metastases to the lung – in this case lobectomy and a necessary chemotherapy were conducted. Cosmetic results were defined as excellent in 70 % cases, good – 25 %, satisfactory – 5 %. Conclusion: If there are indications for organ-conserving treatment of breast cancer and the patient’s decision concerning this surgery, the patient should be offered methods of oncoplastic surgery for the prevention of psychological and emotional stress, effective rehabilitation, and a quick return to active social life.

© 2018 Russian Photodynamic Association. All rights reserved. Currently, reconstructive-plastic surgery is becoming the standard for surgical and combined treatment of breast cancer (BC) patients. With a one-stage reconstruction of the breast, the use of biological implants that can replace muscle autografts and, consequently, reduce trauma, blood loss and operation time, and also to avoid defects in the donor zones is becoming topical. From 2014 to 2017, 151 reconstructive operations on 121 patients with BC (average age 41.5 years) using synthetic and biological materials were carried out in P.Herzen Moscow Oncology Research Institute. 0 stage of BC TisN0M0 was diagnosed in 11 (9.1%) patients, I stage - in 52 (42.9%), IIA - in 41 (33.9%), IIB - in 9 (7.4%), IIIA - in 4 (3.3%), IIIB - in 2 (1.7%), IIIC - in 2 (1.7%). To strengthen the lower slope, a biological implant - Permacol acellular dermal matrix, was used in 34 cases. Cosmetic result was rated as excellent in 20 (58.9%) cases, good in 11 (32.3%), unsatisfactory in 3 (8,8%). Biological materials are an important addition to various options for breast reconstruction. The criterion for selecting the material for strengthening the lower slope of the breast with subcutaneous or cutaneous mastectomy for cancer with a one-stage reconstruction using a silicone endoprosthesis is the pinch-test value.

© 2018, Bionika Media Ltd. All rights reserved. Relative and absolute hyperestrogenism and a change in the estradiol/progesterone (E2/P) ratio are of great importance in the pathogenesis of fibrocystic breast disease, which justifies the choice of progesterones for pathogenetic therapy. Transdermal progesterone gel is recommended in accordance with the instruction for medical use as monotherapy for this disease. Clinical findings show that the transdermal administration of progesterone is effective in reducing not only mastalgia, but also the number of cysts. A survey of physicians has demonstrated that unregistered drugs for this indication are used to treat fibrocystic breast disease. If there are indications, pharmacotherapy should be performed strictly in accordance with the instruction for medical use, which always contains information regarding what specific benign breast disease is treated with this drug, whether it is used as alone or as part of standard combination therapy, and which specific symptom should be eliminated if the drug is used symptomatically.