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Complex breast cysts (CBC) are characterized by a high (up to 31.0%) oncological potential and the need for a biopsy. In some clinical situations, navigating a biopsy using mammography (MG), ultrasound (US), endoscopy, and magnetic resonance imaging (MRI) may be difficult. The first case of stereotaxic core-needle biopsy (sCNB) under pneumocystography (PCG) guide is presented.

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Objective: The purpose of this study was to analyze the capabilities of ductography (DG) to navigate stereotactic core-needle biopsy (sCNB) for localizing and differentiating intraductal benign and malignant proliferations of the breast in patients with pathological nipple discharge (PND). Materials and Methods: Patients underwent physical, radiological, ultrasound, endoscopic and histopathological examinations. Results: The study included 183 patients. In 51, traditional DG was performed and in eight patients DG was performed using endoscopic mammoductoscopy (EMDS). A routine ductectomy labeled with methylene blue or propylene thread was performed in 81 patients. In 77 cases, a ductectomy was performed after double wire marking of intraductal proliferations (IDP) through the nipple and through the skin. In 26 patients, a preoperative sCNB under guidance of DG was performed. After sCNB 23/26 patients had benign IDP and three (11.5%) had invasive cancer. Breast surgery confirmed histology to be the gold standard in all patients, with the exception of 7 (26.9%) under the age of 45 years with benign IDP. These patients had watchful waiting and after 35 months of follow-up no signs of malignant growth were detected.DG was characterized by high (87.9%) sensitivity and low (33.3%) specificity. False positive rate was 25.9% and the cause was peripheral location of IDP (>3 cm from the nipple) in 57.1% and inadequate excision with leaving them outside the resection. Conclusion: This initial study on sCNB under the guidance of traditional or selective DG reports promising findings. Further studies are needed to determine whether preoperative histological assessment of pathologic intraductal lesions at DG would reduce the number of open surgeries with benign histology at sCNB.

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AIM: The analysis and popularization of the own experience of ultrasonic diagnostics and minimal invasive interventions for inflammatory diseases of the mammary ducts. PATIENTS AND METHODS: 249 women were observed: 182 (73.1%) cases of periductal mastitis and 67 (26.9%) cases of purulent galactophoritis. Patients with purulent galactophoritis were divided into 2 groups (main and control). The main group consisted of 50 patients after minimal invasive interventions, control - 17 women after traditional surgery. RESULTS: The main US signs of periductal mastitis and purulent galactophoritis were detected. Purulent galactophoritis is associated with the diameter of mammary duct less than 4 mm, ductal content flotation and stream-effect (coloring of dilated duct in Doppler mode). It was proposed the method of US-assisted mini-invasive retrograde drainage of mammary ducts with aspiration of purulent content through the natural orifice in the nipple. This method doesn't demand hospital stay, reduces duration of treatment by 14 days and doesn't cause the cosmetic defects in comparison with traditional surgical approach. CONCLUSION: Inflammatory diseases of the mammary ducts are represented by the different nosological forms - periductal mastitis (73.1%) and purulent galactophoritis (26.9%). In view of typical ultrasonic picture in patients with purulent galactophoritis US-assisted mini-invasive retrograde drainage of mammary ducts with aspiration of purulent content through the natural orifice in the nipple is advisable. This method has significant advantages in comparison with traditional surgery and may be recommended for widespread clinical use.

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The results of 143 ultrasound investigations (UI) of the mammary glands (MG) in 86 patients with lactic mastitis (LM) are presented. The techniques for performance of common UI of MG, and as well in combination with pharmacologic pituitrin assay are described. The echographic signs of the different forms of LM are systemized, their dynamics traced in the process of treatment, peculiarities of UI of MG in common and complicated course of the postoperative period are reflected.

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The results of treatment of 129 patients with acute suppurative lactic mastitis are presented. In severe forms of the disease, the use of combined antibiotic therapy+ permits to shorten the duration of in-patient treatment from 13.5 to 10.3 days, prevent the disease recurrence.

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In the experiment on 75 white rats, the reactogenicity and strength of catgut, dexon, kacelon and PGL (native analogue of vicryl) were studied 10, 20 and 30 days after their implantation into parenchyma of the lactating mammary gland (MG). Around a catgut thread, the cellular-tissue reaction according to the type of purulent inflammation occurred. A danger of oncogenic effect of catgut which manifested itself in proliferation and atypical hyperplasia of epithelium of the MG ducts was noted. Dexon, kacelon and PGL were characterized by similar low reactogenicity, but kacelon strength reduced considerably in moistening. Dexon and PGL due to their reactogenicity and strength properties are the materials of choice in surgical treatment of MG diseases.

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In elderly and senile patients with acute cholecystitis, the decrease in the content of T-lymphocytes and their functional activity, number of B-lymphocytes and IgG level, increase in the IgM and IgA content were noted. The attenuation of non-specific protective mechanisms was revealed. In patients, who underwent the purposeful immunocorrection with prodigiosan, proper-myl, methyluracil and staphylococcal adsorbed anatoxin, the number and activity of T-lymphocytes normalized, number of B-lymphocytes increased at the time of operation and after it. This contributed to reduction of the incidence of the inflammatory complications 3-fold.

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