Search

This study aimed to compare the results of free MS-TRAM and DIEP-flap based on the volume of the transplant and the unique characteristics of blood flow in the tissues. The study included 83 patients, 42 in the MS-TRAM-flap reconstruction group and 41 in the DIEP-flap breast reconstruction group. In the MS-TRAM-flap group, 35 patients received delayed reconstruction, and 7 received one-stage breast reconstruction, including one case of bilateral transplantation. In the DIEP-flap group, 5 patients received one-stage reconstruction, and 36 received delayed reconstruction. Complications associated with the flap tissue were observed in 7 (16.67%) in the MS-TRAM-flap group and 8 (19.51%) cases in the DIEP-flap group. The total level of fat necrosis in MS-TRAM-flap was 7.14% (p=0.033), and in DIEP-flap, it was 9.75% (p=0.039) (2 patients had a substantial amount of fat necrosis, while 2 patients had a modest amount of focal fat necrosis). The number and diameter of perforators (including veins), as well as the transplant volume, are the primary determinants of whether to use a DIEP- or MS-TRAM-flap. DIEP-flap is preferred if there are 1-2 large artery perforators (≥1 mm) and tissue volume of 700-800 grams, while MS-TRAM-flap is used when the tissue volume is significant (>2/3 of standard TRAM-flap)., Competing Interests: The authors declare no conflict of interest., (©2022 JOURNAL of MEDICINE and LIFE.)

Expression of pro-malignant factors (VEGF) and cytokines like inflammatory components support breast cancer development. We examined 46 patients with stage IIIB inflammatory breast cancer (IBC) and 24 with stage IIA-IIIB breast cancer (BC) without secondary edema. Hormone receptors, Her-2/neu, Ki-67 index, VEGF, and IL-6, were determined for all patients before and after neoadjuvant treatment. They associated the expression of VEGF for IBC patients with an unfavorable prognosis. VEGF level for IBC lymph node metastases was higher than in patients without such lesions (1.4 times), and there was a significant increase in VEGF levels in the G3 category of malignancy (1.54-fold increase). In IBC patients with positive HER2/neu status, VEGF levels were 1.51 times higher compared to those with negative HER2/neu status (r=0.36, p<0.05). IL-6 level during therapy in IBC patients remained high, which occurs in active tumor development. Comparative analysis of the VEGF/IL-6 ratio during treatment of patients with IBC was higher vs . IIIB stage breast cancer without edema (1.4 vs . 0.7), indicating the aggressiveness of the tumor process and confirmed by an objective response to treatment (regression<30%)., Competing Interests: The authors declare no conflict of interest., (©2022 JOURNAL of MEDICINE and LIFE.)

We aimed to analyze the frequency of breast cancer relapses and their relationship with molecular and biological tumor characteristics. We studied 6,136 breast cancer patients, including 146 with relapses (Group 1) and 455 without relapses (Group 2). We divided the patients based on age, menstrual function, disease stage, histology form and grade, and molecular-biological subtype. The 5-year relapse-free rate for Group 1 was longer for Lum A and TN subtypes (60% and 40%, respectively) but shorter for Lum B and HER-2/neu-amplified subtypes (38% and 31%, respectively). Disease stage, tumor histology, and grade did not significantly affect relapse frequency in these patients. Relapses were more common in premenopausal patients and the Lum B subtype., Competing Interests: The authors declare no conflict of interest., (©2022 JOURNAL of MEDICINE and LIFE.)

Breast cancer patients (BC) have a high risk of cardiotoxicity (CT) due to a combination of cancer treatments.Cardiovascular (CV) complications lead to delay or withdrawal of BC therapy and worsen the survival. Therefore, it isimportant to detect CT at the early stages before the occurrence of cardiac dysfunction and heart failure (HF) signs., Objective: to study the dynamic changes of high-sensitivity (hs) troponin (Tn) T (hs-TnT) level in BC patients during cancer treatment with the use of chemotherapy and radiation therapy (RT) to predict and prevent CV complications during individualized management., Material and Methods: 40 BC patients were included in the pilot study. The analysis of the dynamic changes of hs-TnT and ejection fraction (EF) of the left ventricle (LV) was performed before and within 6 months of cancer treatment. Based on the data analysis, a definition of a significant increase in hs-TnT was developed and proposed. Therise of hs-TnT was calculated by the difference (%) between its baseline level and in the 6 months of cancer treatment. BC patients are grouped into tertiles according to the hs-TnT increase: group 1 - low level (0-50 %), group 2 -moderate level (> 50-100 %), and group 3 - high level (> 100 %)., Results: Before the start of cancer treatment, LVEF did not differ significantly between groups (mean EF (62.6 ± 1.0) %)and the hs-TnT level was also within normal values (0.008±0.001 ng/ml). In 6 months of cancer treatment, LVEF waswithin the normal ranges and did not differ significantly in patients of group 1. However, in patients of groups 2and 3 - LVEF drop (δLV EF) was 5.7 % (р < 0.01) and 10.8 % (р < 0.01), consequently. According to the correlationanalysis, the percentage of increase in hs-TnT (δhs-TnT) was associated with δEF LV (r = 0.39, р < 0.05) and the useof anthracyclines (AC) (r = 0.37, р < 0.05). Using logistic regression and ROC analysis, the diagnostic threshold valueof the hs-TnT increase > 165 % was defined, which can be considered as a reliable marker of early biochemical CT,with a sensitivity of 99 % and a specificity of 56 %., Conclusions: In BC patients, based on the level of hs-TnT increase, proposed a new early biochemical CT detectionmethod. Under the new approach, BC patients with hsTnT increase of > 165 % from baseline can be considered as areliable marker of early biochemical CT, with a sensitivity of 99 % and a specificity of 56 %., (N. V. Dovganych, S. M. Kozhukhov, I. I. Smolanka, O. F. Lygyrda, О. Ye. Bazyka, S. A. Lyalkin, O. M. Ivankova, О. A. Yarynkina, N. V. Tkhor.)

This study aimed to investigate the impact of HER2-low on the risk of recurrence in individuals with inflammatory breast cancer (IBC). 60 females with HER2-low and HER2-positive IBC underwent surgery between July 2020 and July 2022. Patients were divided into three groups of 20 patients: (1) HRplus/HER2-, (2) HRplus/HERplus, and (3) HR-/HER2plus. All patients underwent chemotherapy in adjuvant mode, following this scheme: TCH=docetaxel and carboplatin plus Herceptin (HER2 target - 4 mg/kg as the loading dose and 6 mg/kg as subsequent doses throughout every 21 days, entire 52 weeks of Herceptin therapy). HRplus/HERplus group had an OS of 76.9% compared with 77.0% in the group with the HRplus/HER2plus subtype and 74.4% in the HR-/HER2plus group. Moreover, recurrence-free survival was 19.1% for the HRplus/HER2- group, 21.3% for the HRplus/HERplus group, and 11.7% for the HR-/HER2plus group. In our study, patients with HER2-low IBC could acquire a perfect response with preliminary systemic therapy, without disease progression or with stable disease on target alone. Further examination is important to decide on the most effective treatment regimens, in addition to mixing chemotherapy with HER2-low-focused on agents., Competing Interests: The authors declare no conflict of interest., (©2022 JOURNAL of MEDICINE and LIFE.)

Breast cancer patients receive combined antitumor treatment (surgery, chemotherapy, targeted drugs and radia-tion), so they are considered to be the patients with potentially high risk of cardiotoxicity (CT). Risk stratificationof cardiovascular complications before the beginning and during the cancer treatment is an important issue., Objective: to develop a CT risk model score taking into account cardiological, oncological and individual risks., Material and Methods: The study included 52 breast cancer patients with retrospective analysis of their medicalhistory, risk factors, and echocardiographic parameters before the onset and in 12 months follow up. Based on theanalysis of the data, a CT risk model score was developed and recommended. The patients were divided into groupsaccording to the score: Group 1 - low risk of CT development - score < 4 points, Group 2 - moderate risk - 5-7points, Group 3 - high risk > 8 points. According to the scale, BC patients with a total of > 8 points are consideredto be at high risk for CT complications. Radiation therapy and anthracyclines, as well as associated cardiovasculardiseases were the most important risk factors of CT., Results: Based on the study of retrospective analysis of risk factors, data of heart function monitoring during follow-up,the risk model score of cardiotoxicity has been developed for the BC patients' stratification. According to the proposedscore risk model, BC patients with a total score of > 8 points considered to have high risk of cardiotoxic complications., Conclusions: Using of the proposed risk model score with calculation of CT risk factors both before the beginningand during cancer therapy is important, because it allows predicting the risk of CT development - to identify high-risk patients, accordingly, to develop an individualized plan for cardiac function monitoring and to start timely cardioprotective therapy., (S. M. Kozhukhov, N. V. Dovganych, I. I. Smolanka, O. F. Lygyrda, О. Ye. Bazyka, S. A. Lyalkin, O. M. Ivankova, O. A. Yarinkina, N. V. Tkhor.)