Diversity of non-palpable breast cancer. Timely diagnosis, adequate treatment and prevention

The goal. To show the variety of manifestations of non-palpable breast cancer, which create difficulties in diagnostics and the choice of treatment tactics, to focus on the need to accelerate the introduction of the latest organ-saving treatment and diagnostic technologies and prevention into the system of mammary cancer screening. The main provisions. The epidemiology of cancer, risk factors, positive trends in mammary cancer screening in Russia are presented. A description is given of the diversity of X-ray sonographic and molecular biological manifestations of non-palpable breast cancer based on the results of the analysis of a complex clinical X-ray sonographic pathomorphological and molecular genetic examination of 1,212 patients with clinically latent breast diseases, including 708 patients with non-palpable cancer of various molecular subtypes, manifested by a variety of options – a nodular growth (40.1%), an accumulation of microcalcifications (17.5%), a site of local heavy rearrangement of the structure (31.2%), cancer accompanied by pathological secretion (6.6%), X-ray negative cancer (4.6%). When distributed by stages, 70.3% had T1N0M0, 25% had TisN0M0 and microinvasive cancer. For differential diagnosis, high-tech radiological techniques were used – 3D X-ray and ultrasound tomosynthesis. Effective preoperative diagnostics allowed for adequate organ-saving treatment, including oncoplastic surgery, high-power radiation therapy and modern targeted drug treatment, timely rehabilitation and prevention. Conclusion. Non-palpable breast cancer has many faces. Knowledge of the variants of its manifestations and the use of modern diagnostic methods are necessary for mammary cancer screening, which creates the preconditions for adequate timely organ-saving treatment that preserves the life of patients and its quality.

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