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 <front>
  <journal-meta>
   <journal-id journal-id-type="publisher-id">Clinical Medicine and Pharmacology</journal-id>
   <journal-title-group>
    <journal-title xml:lang="en">Clinical Medicine and Pharmacology</journal-title>
    <trans-title-group xml:lang="ru">
     <trans-title>Клиническая медицина и фармакология</trans-title>
    </trans-title-group>
   </journal-title-group>
   <issn publication-format="print">2409-3750</issn>
  </journal-meta>
  <article-meta>
   <article-id pub-id-type="publisher-id">93299</article-id>
   <article-id pub-id-type="doi">10.12737/2409-3750-2025-10-3-25-34</article-id>
   <article-categories>
    <subj-group subj-group-type="toc-heading" xml:lang="ru">
     <subject>Обзоры</subject>
    </subj-group>
    <subj-group subj-group-type="toc-heading" xml:lang="en">
     <subject>reviews</subject>
    </subj-group>
    <subj-group>
     <subject>Обзоры</subject>
    </subj-group>
   </article-categories>
   <title-group>
    <article-title xml:lang="en">WAYS TO IMPROVE THE EFFECTIVENESS OF SURGICAL TREATMENT OF NON-PALPABLE BREAST FORMATIONS  (literature review)</article-title>
    <trans-title-group xml:lang="ru">
     <trans-title>ПУТИ ПОВЫШЕНИЯ ЭФФЕКТИВНОСТИ   ХИРУРГИЧЕСКОГО ЛЕЧЕНИЯ НЕПАЛЬПИРУЕМЫХ ОБРАЗОВАНИЙ МОЛОЧНОЙ ЖЕЛЕЗЫ (обзор литературы)</trans-title>
    </trans-title-group>
   </title-group>
   <contrib-group content-type="authors">
    <contrib contrib-type="author">
     <name-alternatives>
      <name xml:lang="ru">
       <surname>Гусейнов</surname>
       <given-names>Ариф Зиядович</given-names>
      </name>
      <name xml:lang="en">
       <surname>Guseynov</surname>
       <given-names>Arif Ziyadovich</given-names>
      </name>
     </name-alternatives>
     <xref ref-type="aff" rid="aff-1"/>
    </contrib>
    <contrib contrib-type="author">
     <name-alternatives>
      <name xml:lang="ru">
       <surname>Федорищев</surname>
       <given-names>В. И.</given-names>
      </name>
      <name xml:lang="en">
       <surname>Fedorischev</surname>
       <given-names>V. I.</given-names>
      </name>
     </name-alternatives>
     <xref ref-type="aff" rid="aff-2"/>
    </contrib>
    <contrib contrib-type="author">
     <name-alternatives>
      <name xml:lang="ru">
       <surname>Гусейнов</surname>
       <given-names>Т. А.</given-names>
      </name>
      <name xml:lang="en">
       <surname>Guseynov</surname>
       <given-names>T. A.</given-names>
      </name>
     </name-alternatives>
     <xref ref-type="aff" rid="aff-3"/>
    </contrib>
    <contrib contrib-type="author">
     <name-alternatives>
      <name xml:lang="ru">
       <surname>Муравьева</surname>
       <given-names>С. С.</given-names>
      </name>
      <name xml:lang="en">
       <surname>Murav'eva</surname>
       <given-names>S. S.</given-names>
      </name>
     </name-alternatives>
     <xref ref-type="aff" rid="aff-4"/>
    </contrib>
   </contrib-group>
   <aff-alternatives id="aff-1">
    <aff>
     <institution xml:lang="ru">Тульский государственный университет</institution>
     <country>Россия</country>
    </aff>
    <aff>
     <institution xml:lang="en">Тульский государственный университет</institution>
     <country>Russian Federation</country>
    </aff>
   </aff-alternatives>
   <aff-alternatives id="aff-2">
    <aff>
     <institution xml:lang="ru">Клиническая больница «РЖД-Медицина Тула&quot;</institution>
     <city>Тула</city>
     <country>Россия</country>
    </aff>
    <aff>
     <institution xml:lang="en">Клиническая больница «РЖД-Медицина Тула&quot;</institution>
     <city>Тула</city>
     <country>Russian Federation</country>
    </aff>
   </aff-alternatives>
   <aff-alternatives id="aff-3">
    <aff>
     <institution xml:lang="ru">Тульский государственный университет</institution>
    </aff>
    <aff>
     <institution xml:lang="en">Tula State University</institution>
    </aff>
   </aff-alternatives>
   <aff-alternatives id="aff-4">
    <aff>
     <institution xml:lang="ru">Первый Московский государственный медицинский университет имени И.М. Сеченова </institution>
    </aff>
    <aff>
     <institution xml:lang="en">I.M. Sechenov First Moscow State Medical University</institution>
    </aff>
   </aff-alternatives>
   <pub-date publication-format="print" date-type="pub" iso-8601-date="2025-01-09T16:19:36+03:00">
    <day>09</day>
    <month>01</month>
    <year>2025</year>
   </pub-date>
   <pub-date publication-format="electronic" date-type="pub" iso-8601-date="2025-01-09T16:19:36+03:00">
    <day>09</day>
    <month>01</month>
    <year>2025</year>
   </pub-date>
   <volume>10</volume>
   <issue>3</issue>
   <fpage>25</fpage>
   <lpage>34</lpage>
   <history>
    <date date-type="received" iso-8601-date="2025-01-09T00:00:00+03:00">
     <day>09</day>
     <month>01</month>
     <year>2025</year>
    </date>
   </history>
   <self-uri xlink:href="https://naukaru.ru/en/nauka/article/93299/view">https://naukaru.ru/en/nauka/article/93299/view</self-uri>
   <abstract xml:lang="ru">
    <p>В связи с прогрессом современных методов визуализации значительно увеличилось количество выявленных непальпируемых очаговых образований молочной железы, в том числе узлового рака малых размеров и рака in situ.&#13;
Хирургическое лечение непальпируемых образований молочной железы направлено на их удаление с целью уточнения характера патологии. &#13;
В клинической практике с этой целью выполняются вмешательства в объеме секторальной резекции молочной железы и вакуумной аспирационной биопсии (ВАБ). &#13;
При проведении резекционных операций необходимо проведение предоперационной маркировки образования для повышения эффективности операции и исключения ситуации, когда образование или часть его не удаляются.&#13;
Стандартом предоперационной маркировки является установка проволочной иглы внутри образования под контролем УЗИ, рентгеномаммографии (РМГ) либо магнитно-резонансной томографии (МРТ) с последующей резекцией участка молочной железы вместе с иглой.&#13;
В последние годы из-за недостатков проволочного метода наблюдается переход к применению беспроволочных технологий.&#13;
Наиболее простым и доступным методом является кожная маркировка после визуализации образования при УЗИ либо РМГ.&#13;
Использование красящих веществ, в частности метиленового синего, индоцианина зеленого, суспензии древесного угля является оптимальным методом из-за высокой эффективности при малых затратах.&#13;
Применение методов радиоактивных меток (RSL и ROLL), магнитных и парамагнитных меток, локализация с помощью радиолокационного отражателя RRL, представляют собой новые эффективные подходы в локализации непальпируемого образования молочной железы.&#13;
Интраоперационное УЗИ является высокоэффективным методом локализации непальпируемых образований молочной железы, но требует соблюдения условий интраоперационного проведения УЗИ и привлечения к операции врача УЗ-диагностики. &#13;
ВАБ имеет преимущество перед секторальной резекцией из-за точной визуализации образования под УЗИ до и во время операции, что обеспечивает полное удаление образования.&#13;
Применение ВАБ ограничено обязательной визуализацией образования при УЗИ и отсутствием необходимого оборудования во многих крупных многопрофильных медицинских учреждениях.</p>
   </abstract>
   <trans-abstract xml:lang="en">
    <p>Due to the progress of modern imaging methods, the number of detected non-palpable focal breast formations, including small nodular cancer and in situ cancer, has increased significantly. &#13;
Surgical treatment of non-palpable breast formations is aimed at their removal in order to clarify the nature of the pathology. &#13;
In clinical practice, interventions in the volume of sectoral breast resection and vacuum aspiration biopsy (VAB) are performed for this purpose. &#13;
During resection operations, preoperative marking of the formation is necessary to increase the effectiveness of the operation and eliminate the situation when the formation or part of it is not removed.&#13;
The standard for preoperative marking is the installation of a wire needle inside the formation under the supervision of ultrasound, X-ray mammography (RMG) or magnetic resonance imaging (MRI), followed by resection of the breast area together with the needle. &#13;
In recent years, due to the disadvantages of the wire method, there has been a transition to the use of wireless technologies.&#13;
The simplest and most accessible method is skin labeling after imaging of the formation with ultrasound or RMG.&#13;
The use of coloring agents, in particular methylene blue, indocyanine green, charcoal suspension is the optimal method due to its high efficiency at low cost.&#13;
The use of methods of radioactive labels (RSL and ROLL), magnetic and paramagnetic labels, localization using the radar reflector RRL, represent new effective approaches in the localization of non-palpable breast formation. &#13;
Intraoperative ultrasound is a highly effective method of localization of non-palpable breast formations, but requires compliance with the conditions of intraoperative ultrasound and the involvement of an ultrasound diagnostic doctor in the operation.&#13;
VAB has an advantage over sectoral resection due to the accurate visualization of the formation under ultrasound before and during surgery, which ensures complete removal of the formation.&#13;
The use of VAB is limited by the mandatory imaging of education during ultrasound and the lack of necessary equipment in many large multidisciplinary medical institutions.</p>
   </trans-abstract>
   <kwd-group xml:lang="ru">
    <kwd>молочная железа</kwd>
    <kwd>непальпируемые образования</kwd>
    <kwd>тактика ведения</kwd>
    <kwd>предоперационная маркировка</kwd>
    <kwd>проволочная игла</kwd>
    <kwd>беспроволочные технологии</kwd>
    <kwd>секторальная резекция</kwd>
    <kwd>вакуумная аспирационная биопсия.</kwd>
   </kwd-group>
   <kwd-group xml:lang="en">
    <kwd>mammary gland</kwd>
    <kwd>non-palpable formations</kwd>
    <kwd>management tactics</kwd>
    <kwd>preoperative labeling</kwd>
    <kwd>wire needle</kwd>
    <kwd>wireless technologies</kwd>
    <kwd>lumpectomy</kwd>
    <kwd>vacuum aspiration biopsy.</kwd>
   </kwd-group>
  </article-meta>
 </front>
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  <p></p>
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