The purpose of the study was to assess the feasibility of using the propeller flap to cover a large axillary fossa defect following lymph node dissection in breast cancer patients.Material and Methods. One hundred breast cancer patients underwent surgery. Out of them, 64 underwent Madden modified radical mastectomy and 36 radical breast resection using a propeller muscle flap. Out of 100 patients, 61 were followed up (50 after mastectomy and 11 after radical resection using a propeller flap). Fifteen patients were randomly selected for examination of the flap using ultrasound (2 patients after radical resection, 13patients after radical mastectomy). The follow-up time was from 3 to 6 months. We studied the following: bleeding in the postoperative period, hematoma, duration of lymphorrhea, duration of hospitalization, ultrasound findings, hand function, size of the upper limb, and physical activity.Results. No statistically significant differences in the number of complications related to the surgery extent were found. Here was no bleeding. Small hematoma was observed in one patient who underwent breast resection. Forty-three (70.49 %) patients did not have lymphorrhea after drainage removal. Lymphorrhea was observed for a month in 9 (14.75 %) patients, for 1–2 months in 4 (6.56 %) patients, and for 3 months or more in 5 (8.2 %) patients – 3 months or more. Twelve (19.67 %) patients developed lymphoedema of the arm. Hospitalization period was 7 bed-days in 90.0 % of cases. The flap viability reached 100.0 %. In 54 (88.53 %) of 61 patients, the active function of the arm recovered. Thirty-eight (62 %) patients had ECOG 1 status 3 years after surgery.Conclusion. The flap made it possible to solve the local problems of covering the axillary neurovascular bundle during lymphadenectomy for breast cancer and eliminating a large axillary fossa defect. The results obtained demonstrated high engraftment rates with a small number of complications, regardless of the surgery extent.

Purpose. Determine efficacy of a drug in patients with pain syndrome in mastopathy. Objectives. Evaluate the efficacy of the drug by measuring its effect on the pain intensity in the mammary glands, tissue density of the mammary glands, changes in size of existing cysts and fibroadenomas performed after 3and 6-month administration of the drug, and 12-month discontinuation of treatment, provided that the prophylactic 3-month course of Indinol Forto was taken.Material and methods. We examined 60 patients, who applied to the Breast Pathology Department of the National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakova, and complained of pain in the mammary glands, mainly in the second phase of the menstrual period. The age of the patients ranged from 21 to 55 years (median, 36.3 years).Results: 3-month use of the drug showed a decrease in pain intensity in half of the patients (51%), a decrease in palpation density in 58% of patients, a decrease in cyst size in 24 patients, a decrease in echo density in 27% of patients. The size of fibroadenodoimas did not change in 100% of cases. The drug showed efficacy in all age groups. During the control examination (third visit), a decrease in pain intensity was observed in 85% of patients 6 months later. Palpation density decreased in 70% of patients. The size of cysts and fibroadenomas did not change in comparison with the third visit. Echo density of the tissue decreased in 55% of women. 3 (5%) of 60 patients refused to take the drug during the 4th month, due to dyspeptic disorders, 2 (3%) patients of reproductive age complained of lengthening of the menstrual period also after the 4th month of taking the drug. No recurrence of the disease was detected as a result of a 6-month follow-up of 11 patients receiving Indinol Forto after surgical treatment of fibroadenomas. 57 patients made the fourth visit 12 months later. All patients received a preventive 3-month course of Indinol Forto. 17 (30%) patients had no pain in the mammary glands no longer. 18 patients reported a periodic pain in the mammary glands. 38% of women reported that soreness was rare and completely absent while taking the drug. 11 patients showed no recurrence of fibroadenomas after surgery. There was no significant change in the size of fibroadenomas in non-operated patients. Slight cystic growth was reported in two patients. After 12 months, punctured cysts did not exceed 1 cm in diameter in six patients, who underwent medical and diagnostic puncture of large cysts. The scheduled mammography and ultrasound imaging showed a steady decrease in echographic and mammographic density.