plasurВопросы реконструктивной и пластической хирургииIssues of Reconstructive and Plastic Surgery1814-1471АНО "НИИ микрохирургии"10.52581/1814-1471/89/01plasur-257Research ArticleПЛАСТИЧЕСКАЯ ХИРУРГИЯPLASTIC SURGERYОнкопластические резекции при раке молочной железы: влияние локализации и морфологических особенностей опухоли на выбор хирургического метода лечения: история вопроса (обзор литературы)Oncoplastic resections for breast cancer: the effect of tumor localization and morphological features on the choice of surgical method: history of the issue (Literature review)https://orcid.org/0000-0001-7154-3326ЗапировГ. М.ZapirovG. M.

Запиров Гаджимурат Магомедович – канд. мед. наук, доцент кафедры онкологии и рентгенорадиологии медицинского института РУДН.

117198, Москва, ул. Миклухо-Маклая, д. 6

Gadgimurad M. Zapirov - Cand. Med. sci., Associate Professor, the Department of Oncology and X-ray Radiology, Medical Institute, RUDN University

6, Mikloukho-Maklay st., Moscow, 117198

zapirov@mail.ruhttps://orcid.org/0000-0001-7141-2502ЗикиряходжаевА. Д.ZikiryahodzhaevA. D.

Зикиряходжаев Азиз Дильшодович – д-р мед. наук, руководитель отделения онкологии и реконструктивнопластической хирургии молочной железы и кожи МНИОИ имени П.А. Герцена – филиала ФГБУ «НМИЦР» Минздрава России; профессор кафедры онкологии и рентгенорадиологии медицинского института РУДН.

125284, Москва, 2-й Боткинский проезд, д. 3; 117198, Москва, ул. Миклухо-Маклая, д. 6

Aziz D. Zikiryahodzhaev - Dr. Med. sci., head of Department of Reconstructive Plastic Surgery of Skin and Breast, P. Hertsen MORI – Branch of the NMRRC of the Ministry of Health of the Russian Federation; Professor, the Department of Oncology and X-ray Radiology, Medical Institute, RUDN University.

3, 2nd Botkinsky proezd, Moscow, 125284, 6, Mikloukho-Maklay st., Moscow, 117198

azizz@mail.ruhttps://orcid.org/0000-0003-1742-3205ОнофрийчукИ. М.OnofriychukI. M.

Онофрийчук Ирина Михайловна – канд. мед. наук, научн. сотрудник отделения онкологии и реконструктивно пластической хирургии.

125284, Москва, 2-й Боткинский проезд, д. 3

Irina M. Onofriychuk - Cand. Med. sci., researcher, the Department of Reconstructive Plastic Surgery of Skin and Breast.

3, 2nd Botkinsky proezd, Moscow, 125284

Shirokikh-Irina1@yandex.ruhttps://orcid.org/0000-0003-4022-6963МихайловС. И.MikhailovS. I.

Михайлов Станислав Игоревич – ординатор отделения онкологии и реконструктивно-пластической хирургии молочной железы и кожи.

125284, Москва, 2-й Боткинский проезд, д. 3

Stanislav I. Mikhailov – resident, the Department of Reconstructive Plastic Surgery of Skin and Breast.

3, 2nd Botkinsky proezd, Moscow, 125284

dr-mih-s@yandex.ruРоссийский университет дружбы народов имени Патриса Лумумбы (РУДН)РоссияPatrice Lumumba Peoples’ Friendship University of Russia (RUDN University)Russian FederationРоссийский университет дружбы народов имени Патриса Лумумбы (РУДН); Московский научно-исследовательский онкологический институт имени П.А. Герцена – филиал Федерального государственного бюджетного учреждения «Национальный медицинский исследовательский центр радиологии» Министерства здравоохранения Российской ФедерацииРоссияPatrice Lumumba Peoples’ Friendship University of Russia (RUDN University); P. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian FederationRussian FederationМосковский научно-исследовательский онкологический институт имени П.А. Герцена – филиал Федерального государственного бюджетного учреждения «Национальный медицинский исследовательский центр радиологии» Министерства здравоохранения Российской ФедерацииРоссияP. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian FederationRussian Federation202427072024272518Copyright © Запиров Г.М., Зикиряходжаев А.Д., Онофрийчук И.М., Михайлов С.И., 20242024Запиров Г.М., Зикиряходжаев А.Д., Онофрийчук И.М., Михайлов С.И.Zapirov G.M., Zikiryahodzhaev A.D., Onofriychuk I.M., Mikhailov S.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://plasur.elpub.ru/jour/article/view/257

Развитие хирургической техники, достижения в лекарственной и лучевой терапии, лечение рака молочной железы (РМЖ) способствуют решению не только медицинской, но и эстетической проблемы. Мультидисциплинарный подход к лечению РМЖ позволил применять менее агрессивную тактику хирургического лечения, дополняя операцию другими методами неоадьювантной и адьювантной терапии.

Несмотря на тот факт, что в современных условиях вопрос реабилитации и сохранения качества жизни больных после хирургического лечения встает как никогда остро, на сегодняшний день не разработано единых рекомендаций по использованию методик органосохраняющего лечения при РМЖ, помогающих адекватно оценить риск рецидива опухоли и целесообразно этому определить объем хирургического лечения. Тем не менее, накопленный хирургами опыт позволяет выделить факторы риска рецидива опухоли в зависимости от особенностей ее локализации и морфологической структуры.

Учитывая возможности современной неоадьювантной химиотерапии, даже при неблагоприятном иммуногистохимическом типе опухоли, мы можем предложить пациенткам выбор органосохраняющего лечения РМЖ. Особенно остро данный вопрос стоит у пациенток молодого возраста, доля которых с каждым годом увеличивается. В этой связи мы можем добиться более быстрого лечения РМЖ, а также достигнуть хорошего эстетического результата минимальными хирургическими вмешательствами, без помощи инородных тел (имплантов или других дополнительных вспомогательных материалов).

The development of surgical technology, advances in a chemotherapy and radiation therapy for the treatment of the breast cancer is a solution of not only medical, but also aesthetic problems. A multidisciplinary approach to the treatment of breast cancer has made it possible to use less aggressive tactics of surgical treatment, complementing the operation with other methods of neoadjuvant and adjuvant therapy.

Despite the fact is a modern conditions the issue of rehabilitation and preservation of the quality of life of patients after surgical treatment is more acute than ever, today there are no collecting recommendations for the use of breast conserving treatment methods for breast cancer, it is can be useful to adequately assess the risk of tumor recurrence and it is advisable to determine the scope of surgical treatment. However, the experience accumulated by surgeons allows us to identify risk factors for tumor recurrence depending on the characteristics of its location and morphological structure of the tumor.

Considering the possibilities of modern neoadjuvant chemotherapy, even with an unfavorable immunohistochemical type of tumor, we can offer patients the choice of breast conserving treatment. This issue is especially acute among young patients, the proportion of whom is increasing every year. In this connection, we can achieve faster treatment of breast cancer, as well as achieve a good aesthetic result with minimal surgical interventions, without the help of foreign materials (implants or other mesh).

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The authors declare that there are no conflicts of interest present.