The introduction of breast cancer screening programs worldwide led not only to the increase of non-invasive carcinoma and stage I breast cancer percentage but also to the redistribution of biological tumor subtypes in female population screened. The proportion of stage I breast cancer is only 21,4% in our country; biological and predictive value of tumor size (T1a, T1b and T1c) is still undefined. We analyzed clinical and morphological characteristics as well as tumor size prognostic value (T1a-c) for the recurrence and death from progression risk determination in 1341 breast cancer patients with stage I tumors. We revealed progressive increase of “small” tumors proportion (T1a and T1b) in stage I breast cancer population within the last 25 years. The percentage of microinvasive carcinomas raised from 0,3% to 4,3% while T1bN0M0 proportion increased from 8,7% to 22,1%; this is the evidence of early breast cancer diagnostics improvement. Stage I breast cancer is the heterogeneous group of tumors with favorable prognosis in case of T1a (≤5 mm) and more aggressive behavior in T1b (6–10 mm) and T1c (11–20 mm). Only T1a tumors have favorable biological profile (huge proportion of luminal A subtype) which reflects upon the long-term treatment results (minimum recurrences and cancer deaths, improved overall survival). Biological behavior of T1b and T1c tumors is more aggressive with high rates of ductal carcinoma, luminal B and triple negative subtypes which significantly worsen the prognosis. The biology of “small” tumors should be considered when choosing the optimal adjuvant treatment algorithm for breast cancer patients.

The prognostic value of p53 nuclear expression in Stage 1 (T1N0M0) breast cancer was studied in 315 women treated in Russia (at the N.N.Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, and at the Clinic of the Russian Medical Academy of Postgraduate Education) in 1985 to 2009. An immunohistochemical assay for determining the expression of estrogen receptors (ER), progesterone receptors (PR), and HER2 and the nuclear expression of p53 receptors was carried out at the Leiden University Medical Center. p53 nuclear expression was found in 14,7% of cases and statistically significantly correlated (p 0,05) of p53 expression for the risk of further progression and death. It was suggested that the negative impact of p53 expression in the entire group might be compensated for by the positive role of adjuvant systemic therapy. Subgroup analysis showed that the patients with p53-positive tumors who did not receive any adjuvant drug treatment had the worst relapse-free and cancer-specific survival rates (p<0,05); this was not seen in the patients on adjuvant systemic treatment. Thus, p53 nuclear expression is a negative prognostic factor in Stage I breast cancer; adjuvant systemic therapy can appear to compensate for the unfavorable impact of the expression of this marker.

The paper describes a case with metachronous primary multiple carcinomas of the breast and the thyroid with metastatic involvement of the thyroid. The reported case had an unusual feature of the presence of metastases from breast cancer both in thyroid tissue and in papillary carcinoma.

The investigation involved 30 patients with locally advanced breast cancer (T3-4N1-2M0). Combination therapy comprised two courses: carboplatin 300 mg/m2, i.v., dropwise, on day 1; doxorubicin 30 mg/m2, i.v., bolus-flow, on days 1 and 8; 5-fluorouracil 350 mg/m2, i.v., bolus-flow, on days 1 and 8, and irradiation of the breast and regional metastasis area (single target dose--2 Gy, total target dose--40 Gy). Overall clinical response was 96.7% (29/30), mammography-wise--83.3% (25/30). All patients were found operable and radical mastectomy was performed in 25. Therapeutic effect stage III-IV was histologically confirmed in 40% (25/30), stage I-II--60% (15/25). Median overall and recurrence-free survival was not reached within 36 months in 24/30, relapse-free survival was been reported in 16/24 (66.6%), tumor progression--8/24 (33.4%). Three-year; host-mastectomy recurrence-free survival--68.8 +/- 16.0%.