Bondar A. Ways to optimize the treatment of patients with locally advanced breast cancer.

The dissertation presents the integrated phased neoadjuvant treatment of patients with locally advanced breast cancer based on selective intraarterial chemotherapy, regional antibiotic therapy and radiotherapy (patent number 119770 of 08.12.2019), which increased the quality and quantity of life, and reduce the number of required courses of chemotherapy and reduce the incidence of adverse reactions compared with the system and endolymphatic neoadjuvant management. As a result of the study it is proved that the use of selective intra- arterial polychemotherapy in combination with regional antibiotic therapy at the neoadjuvant stage effectively contributes to the reduction of the linear cell size of neoplasia and pericancrosis infiltration, as well as reduces the local and systemic sign of infections. The effectiveness of complex neoadjuvant treatment based on systemic, endolymphatic and intra- arterial routes of PCT administration was determined on the large factual material, and correlation with immunohistochemical parameters of tumor type and its proliferative activity was monitored. The levels of Ki -67 cell proliferation nuclear markers for the first time were investigated (utility model patent No. 136691 of 27.08. 2 019) and also for PCNA (utility model patent No. 136692 of 27.08. 2 019) for luminal type B of locally advanced breast cancer. The author proposes a system of predictive evaluation of tumor susceptibility of LEBC to neoadjuvant polychemotherapy based on immunohistochemical type of BC and markers of cell proliferation Ki -67, PCNA and MSI. In the course of work, a method of eccentric compression bandage of the chest after radical mastectomy was developed (patent for utility model No. 114347 from 10.03.2017). The paper presents the evidence in favor of the importance of adherence to the stage and continuity in the application of the proposed set of measures of neoadjuvant treatment in patients with locally advanced BC, as well as the timeliness and correct interpretation of immunohistochemical parameters of the tumor to reproduce these results in practice. Keywords: locally advanced breast cancer, clinic, diagnostics, selective intra atrerial chemotherapy, nuclear proliferation markers, quality of life, surgery, prognosis, effectiveness of therapy.