Combined and complex treatment of patients with breast cancer

Achieved in recent years, advances in the treatment of breast cancer are found mainly early forms of the disease. Almost half of the operated patients sooner or later appear distant metastases, local or regional recurrence. If dissemination in the body and the migration of tumor cells and their complexes in distant organs and tissues can occur even in the earliest phases of development of neoplasms (certainly before treatment), the cause of local and regional recurrences lies in the impossibility of removal in all cases the tumor Smolov affected by lymphangitis skin and subfascial lymph vessels and lymph nodes. Tumor invasion regional lymph nodes, according to the Institute of Oncology, established in 58,3%, according to the observations of Moscow to them. P. A. Herzen, - 54,8% admitted to hospital patients (Bazhenova A. P., Barvinenko P. G., 1978).
Thus, the treatment of patients with breast cancer to a lesser extent due to the solution of surgery problems, but is a complex and still not firmly established combinations combinations and complexes of surgery, radiotherapy, chemohormonal and recently immunological effects.
Before turning to specific studies methods of treatment, will focus on the concepts combined, combined and complex treatment.
Under the combined method of treatment in the Institute of Oncology, as in other medical institutions (Peterson B. E. and others, 1978), understood as the use of several identical methods of influence, mutually reinforcing or acting in parallel. An example of the combined treatment can serve as simultaneous use of preoperative radiotherapy - gamma and elektronaradim, and in the treatment of metastases and several chemotherapy drugs multidirectional action (for example, alkylating agents and antimetabolites, etc.).
The concept of combined treatment invested view on different but identical focus on methods used in sequence or simultaneously. An example of combined treatment can be preoperative radiation therapy and subsequent mastectomy aimed at the destruction and removal of the primary tumor and regional metastases. The simultaneous use of chemotherapy and hormonal therapy for the treatment of patients with distant metastases that have appeared at various times after a mastectomy due to the combined effects on the metabolic processes in the tumor and the body, which changes at different levels may interfere with the growth of distant metastases.
Finally, in recent years the concept of the complex treatment. Under it, as rightly pointed out B. E. Peterson et al. (1978), to understand the use of all types of impacts on both the primary tumor and regional lymph nodes, and metastatic lesions in distant organs. With this aim can be proposed sets of activities consisting of restoregeometry operational radiation effects and their possible combinations) and General - chemohormonal and immunotherapy methods.
Because historically opinion on the leading place in the treatment of breast cancer surgical removal of the primary tumor and regional collectors, all other methods included in the comprehensive treatment, called for more.
It is impossible not to point out that, according to authoritative experts, the given grouping different methods of treatment, in principle, have no meaningful sense, because each case is still lists all the components that make up combination or complex. Due to the fact that most experts still have these groups, often putting them in a different concepts, we recommend to the practical doctor had an idea not only about fundamental principles of treatment, but also about the existing terminology.