[Results of a prospective randomized investigation [Russia (St.Petersburg)/WHO] to evaluate the significance of self-examination for the early detection of breast cancer]. / Rezul'taty prospektivnogo randomizirovannogo isledovaniia [Rossiia (Sankt-Peterburg)/VOZ] znacheniia samoobsledovaniia v rannem vyiavlenii raka molochnoi zhelezy.

Indications for puncture or excision biopsy were significantly higher in the study group (7.5%) as compared with control (3.5%) (p < 0.01) in a randomized prospective controlled trial of a comprehensive breast cancer screening (123,748) carried out in the framework of a self-examination education program. In the self-examination group, detection rates were higher both for benign (1.1%) and malignant (0.85%) tumors than in control (0.5% and 0.69%, respectively) (p < 0.05). Early stage (T1NOMO, Tis) distribution difference in the study group and controls was insignificant--23 and 17.6%, respectively. Compliance with the program requirements including monthly or bimonthly self-examination was followed by higher 15-year survival rates (53.2%) in 70-75% as compared with controls(45.8%) (p = 0.05105): yet it did not affect mortality.

[Adjuvant chemotherapy with anthracyclines in comparison with the standard combination of CMF in breast cancer with high risk of relapse]. / Antratsiklin-soderzhashchaia ad''iuvantnaia khimioterapiia v sravnenii s klassicheskoi skhemoi CMF u bol'nykh rakom molochnoi zhelezy s vysokim riskom retsidiva.

The effectiveness of adjuvant therapy with adriablastin and doxorubicin for breast cancer has been compared to that of standard CMF. During 1985-1990, the study included 349 patients with T1-2N2M0 and T3N0-2M0 tumors; mean age--46 yrs; mean follow-up--96.7 months. Overall survival rate in the doxorubicin group was 73%, CMF--62%; relapse-free survival--62.1 and 55%, respectively. The absolute difference in overall survival rates (11%) proved barely significant (p = 0.056). However, the difference in overall survival (p < 0.05) after anthracyclines and CMF in patients with tumors T1-2N2M0 and T3N1M0 was significant and in favor of the former. As far as frequency and degree of side-effects is concerned, their patterns were practically identical in both groups, except for the significantly higher frequency of cardiotoxity and complete alopecia in doxorubicin therapy. Cardiotoxic complication rate was significantly reduced from 13.8 to 3.9% by cardioxane treatment.

[Interim results of a prospective randomized study of self-examination for early detection of breast cancer (Russia/St.Petersburg/WHO)]. / Promezhutochnye rezul'taty prospektivnogo randomizirovannogo issledovaniia (Rossiia/Sankt-Peterburg/VOZ) znacheniia samoobsledovaniia v rannem vyiavlenii raka molochnoi zhelezy.

Training in breast self-examination (BSE) technique involved 57,712 women, aged 40-64, at 14 out of randomly selected out-patient hospitals in St. Petersburg (1985-1989). Another 64,759 women selected at another 14 out-patient hospitals were in control. All patients with detected tumor pathology of the breast were biopsied and treated at the Institute's Clinic. The study focused on breast cancer incidence, survival and mortality. More women in the BSE group sought medical advice for suspected pathology (4,300) than those in control (2,438; p < 0.05). There were 493 cases of breast cancer in the BSE group with 157 fatalities, 446 cases of breast cancer with 167 fatalities in the control group. There was no significant difference in tumor stage. Nine-year survival (after Kaplan-Meyer) from the time of tumor detection was 65% in the study group and 55% in control (log rank 0.774; p > 0.05). There has been no significant difference in death rates in both groups for the past ten years. The study is to continue until the year 2001.

[The effectiveness of adjuvant chemotherapy with anthracyclines (adriablastin, doxorubicin) for stage-IIb-IIIa breast cancer]. / Effektivnost' ad''iuvantnoi khimioterapii antratsiklinami (adriablastinom, doksorubitsinom) u bol'nykh rakom molochnoi zhelezy IIb-IIIa stadii.

The effectiveness of adjuvant treatment with anthracyclins (adriablastin, doxorubicin) and standard CMF regimens for breast tumors has been compared. The study included 349 patients with stage IIB-IIIA tumors (T1-2N2M0, T3N0-2M0) (mean age-46 years) during 1985-1990 follow-up-60.38 months. In the doxorubicin group, overall 5-year survival was 73 +/- 8%, in the CMF group-62 +/- 8%. Recurrence-free 5-year survival was 62 +/- 8 and 55 +/- 8%, respectively. The differences are not significant. A stage-related analysis established a significant difference in overall survival in patients with T1-2N2M0 tumors (c-sqare 9.92, p < 0.01). However, due to a small number of cases, the phenomenon requires further study. Although adriablastin treatment involved a significantly higher frequency of carciotoxic symptoms, complete alopecia and dyspeptic complication, a systemic administration of cardioxan and effective antiemetic drugs was lacking.

The role of breast self-examination in early breast cancer detection (results of the 5-years USSR/WHO randomized study in Leningrad).

A randomized population-based study has been carried out since 1985 in Leningrad in order to evaluate the efficacy of breast self-examination (BSE) in early breast cancer detection. The population under study covers 120,310 women aged 40-64 years with no history of breast cancer. About half of these women were exposed to BSE training (60,221) and 60,098 women constituted the control group. BSE teaching was carried out on a person-to-person basis and each patient received the BSE calendar. BSE education sessions resulted in a higher frequency of visits to specialists with complaints about "pathology" of the breast, a higher rate of referral to a specialized institution for an examination, and a higher number of excision biopsies due to a benign lesion (RR = 1.5; 95% C.I. = 1.1 - 1.9) as compared with the control group. As a result of examination, 190 breast cancer patients in the BSE group and 192 patients in the control group were detected. Comparisons of patients from both groups with regard to the size of primary tumor and the incidence of metastatic lesion in the regional lymph nodes showed no differences. The study is ongoing and all cases of breast cancer in the BSE group will be registered up to 1994 and followed-up to 1999; information will then be available on the impact of BSE upon breast cancer mortality.

[Work experience of the WHO International Reference Center in assessing the effectiveness of self-examination for the early diagnosis of breast cancer (results of 2 years' research)]. / Opyt raboty Mezhdunarodnogo referativnogo tsentra VOZ po otsenke éffektivnosti samoobsledovaniia dlia rannei diagnostiki raka molochnoi zhelezy (rezul'taty dvukh let issledovaniia).

A prospective controlled study of the effectiveness of self-examination for early detection of breast cancer has been conducted in Leningrad since 1985. The study was carried out in a cohort of 90,000 females at 28 in- and outpatient clinics within 24 months. As a result, breast cancer was identified in 82 cases. Mean size of primary tumor proved 1.0 cm less and tumor detected 4.8 months earlier than those with standard diagnostic procedures. The cohort is planned to expand to 150,000 by the end of 1988. Data on correlation between application of self-examination and breast cancer mortality are expected by 1994.

[Adjuvant mono- and polychemotherapy in breast cancer (a randomized study)]. / Ad''iuvantnaia mono- i polikhimioterapiia pri rake molochnoi zhelezy (randomizirovannoe issledovanie).

A clinical study started at the Institute in 1975 embraced 1,228 patients with breast tumors of stages I, II and III. Adjuvant monochemotherapy (six courses of 200 mg Thio-TEPA) was followed by a 24.3% decrease in the death rates for the patients with stage I-II tumors (pT0-2N0-1M0), whereas polychemotherapy (six courses of TMF and CMF)-by 32.4%. A 7.8-9.8% increase in corrected survival (as compared with control) was registered in those patients with less advanced malignancies of the breast (pT0-2N0M0) who had received mono- and polychemotherapy. In patients with pT0-2N0-1M0 tumors treated after the TMF or CMF modalities, survival rates showed a 12.0-16.6% increase, as compared with controls, after 6, 7 and 8 years. The beneficial effect of adjuvant chemotherapy (lower mortality rate matched by higher survival) was reliably established in patients under 50 only.

[Results of phase I study of the effectiveness of self-examination in a program of early detection of breast cancer]. / Rezul'taty pervogo étapa issledovaniia po otsenke éffektivnosti samoobsledovaniia v programme rannei diagnostike raka molochnoi zhelezy.

The paper deals with the results of the first phase of a WHO-sponsored study concerned with evaluation of the effectiveness of breast self-examination and carried out in Leningrad. The study was part of a program for early breast cancer diagnosis. 8,000 females were taught the procedure of self-examination. A randomized survey of a representative group of 400 females was conducted during the first 12 months using a special questionnaire. It was intended for evaluating the subjects' comprehension of the aims of the program, their attitude to it and their knowledge on cancer. Due to training as well as regular reminding, the percentage of women who practiced self-examination was as high as 75.1. The results of an analysis of refusals to carry out self-examination are presented.

[Characteristics of the therapeutic measures in breast cancer (based on data of the All-Union Center for the Study of the Effectiveness of Treatment of Cancer Patients)]. / Kharakteristika lechebnykh meropriiatii pri rake molochnoi zhelezy (po materialam Vsesoiuznogo tsentra po izucheniiu éffektivnosti lecheniia onkologicheskikh bol'nykh).

The paper deals with the evaluation of methods of treatment of 13,170 breast cancer patients. Stage I-II tumors were detected in 53.0% of cases. Surgery which still remains to be the basic method of treatment for breast cancer was used alone or in combination with radiation, chemo- and hormonotherapy in 77.6%. Radical treatment was given to 80.0% of patients under 55 years and 44.0% aged 75 and more. The number of cases who received symptomatic therapy decreased from 4.9 to 3.5%, while the percentage of combined (radiosurgical) treatment increased from 21.1 in 1968-1972 to 30.9% in 1974-1978.

[Long-term results of treatment of 3,359 patients with breast cancer]. / Otdalennye rezul'taty lecheniia 3359 bol'nykh rakom molochnoi zhelezy.

The paper presents the data on 3359 cases of breast cancer treated at the Institute. A slight (4.7-7.6%) though significant increase in five-year survival was registered within 20 years (1955-1975). It had gone up to 64.7% by 1971-1975. A significant increase was observed in patients under 50 years who received an adjuvant postoperative chemotherapy (thiotepa and 5-fluorouracil). Mortality from distant metastases within the first 15 years after the beginning of therapy decreased from 89.5 to 68.8% and it was as low as 7.6% at later periods.

[Treatment of breast cancer recurrence with fast electrons]. / Lechenie retsidivov raka molochnoi zhlezy bystrymi élektronami.

During the period from July 1970 to July 1974 in the radiotherapy department of the N. N. Petrov Research Institute of Oncology of the USSR Ministry of Public Health 63 patients with breast cancer were treated with fast electrons. The irradiation technic employed in these patients allowed the occurrence of the early and late local radiation reactions and damages to be avoided. To improve the results of the treatment for local and regional recurrences and breast cancer metastases, it is necessary to elaborate some rational combinations of radiotherapy with general specific therapeutic measures.

[Diagnosis and treatment of villous polyps of the large intestine and rectum]. / O diagnostike i lechenii vorsinchatykh polipov tolstoi i priamoi kishki.

The work is based on the examination of 67 patients with villous tumors of the colon and rectum. The peculiar features of the clinical course have been studied, and the efficacy of different diagnostic measures have been analysed. In the diagnosis of villous tumors great importance is attached to endoscopy in the complex of clinical examination of a patient. Roentgenological investigation with the use of the accessory technics--double contrasting, laterography, "angular" roentgenography seem to be an important step in the investigation. Only after the histological study is completed, one can ultimately judge the fact of the polyp malignification. The classification of villous polyps of the colon and rectum based on the histological principle is suggested. The results of the treatment are analysed, and some practical recommendations are given.