Yassawi Journal of Health Sciences

RECONSTRUCTION OF THE AREOLARICAL AREA IN THE SURGICAL TREATMENT OF BREAST CANCER (reconstruction of the nipple using the areola's own tissues)

2025-09-30T05:41:10+00:00

Extensive operations with lymph node dissection often lead to the development of a number of physical defects, as well as to the development of persistent mental maladaptation of those operated on. Therefore, in modern oncology, doctors pay special attention to plastic, reconstructive types of surgery that improve the quality of life of patients.

By performing a single-stage mammoplasty operation on a breast resected with the nipple due to cancer, the nipple is created from the residual areola. Achieving a radical operation and a good cosmetic and psychological result at the same time. We give an example of a case where a single-stage breast reconstruction mammoplasty was performed in conjunction with a mastectomy for breast cancer. A 64-year-old patient was diagnosed with "Breast cancer, nodular type St Ia T1N0M0. Luminal type A" on 02.10.2024. MDT No. 2736 and was recommended surgical treatment. The areola is sutured to the nipple shape through a subcutaneous suture and sutured to the skin is cosmetically and psychologically effective and contributes to rapid wound healing. Although the size is somewhat reduced, the shape of the breast is preserved. 6 operations were performed with this method in the Oncology Center of Shymkent. In conclusion, one-stage breast reconstruction surgery for breast cancer is currently a unique cosmetically convenient and effective method. The rapid wound healing and psycho-emotional effectiveness of the surgery allow for an increase in the number of such surgeries.

OSIMERTINIB-BASED COMBINATION THERAPY FOR EGFR-MUTANT NSCLC WITH BRAIN METASTASES: A CLINICAL CASE IN THE CONTEXT OF THE FLAURA2 STUDY

2025-09-30T05:51:33+00:00

This article presents a clinical case of treating a female patient with EGFR-mutant non-small cell lung cancer (NSCLC) with brain metastases using osimertinib-based combination therapy. Following disease progression after afatinib therapy, third-generation tyrosine kinase inhibitor (osimertinib) targeted therapy was initiated, followed by combination treatment in accordance with the FLAURA2 study protocol. This included osimertinib, chemotherapy (carboplatin + pemetrexed), and bevacizumab. Significant regression of cerebral metastases and disease stabilization were observed. The article discusses practical aspects of applying FLAURA2 data in real-world clinical settings and explores the potential for implementing a personalized approach to oncology, even under budget constraints. The importance of molecular diagnostics and physicians' clinical awareness in making therapeutic decisions is emphasized.

MONITORING THE DYNAMICS OF BREAST CANCER HETEROGENEITY THROUGH IMMUNOHISTOCHEMICAL PROFILING: CASE STUDIES FROM CLINICAL PRACTICE

2025-09-30T06:06:13+00:00

Breast cancer is a biologically heterogeneous disease with variable responses to therapy. The aim of this study was to demonstrate the clinical importance of monitoring changes in the immunohistochemical profile.

A retrospective analysis of four patient cases treated at one oncology center was conducted. During therapy, changes in tumor subtypes were identified, including transitions from triple-negative to HER2-low or luminal types, as well as shifts from hormone receptor–positive to hormone receptor–negative disease. These alterations required substantial adjustments in therapeutic strategies, such as discontinuation of endocrine therapy, initiation of CDK4/6 inhibitors, or the addition of HER2/neu-targeted agents.

The results indicate that dynamic monitoring of the IHC profile is a practical and effective method that may enhance personalized therapy in the Republic of Kazakhstan.

ESTIMATING THE PREDICTIVE VALUE OF THE CARDIOVASCULAR DISEASE RISK MODEL “SCORE” AMONG THE KAZAKH PEOPLE

2025-09-30T06:21:32+00:00

Kazakhstan is the country with a high risk of cardiovascular diseases (CVDs) and one of the main reasons for this is the lack of early detection of the risk of CVDs. In this regard, the purpose of our study is to show the reliable CVD risk scale “SCORE” for determining the risk of CVDs, which are widely used in the world.

660 patients participated in the cohort study from 2012 to 2014 and 2019-2020. The diagnostic value and accuracy of SCORE was assessed using ROC/AUC analysis and Pearson correlation test. From these researchers, the main indicators of the scales for determining the risk of CVDs and changes in other risk factors based on 10-year dynamics were analyzed. AUC of SCORE risk score increased. Namely, AUC of SCORE model elevated from 0.88 in 2012 to 0.92 in 2020. The Pearson correlation rate was in the range 0.996 for following model with a p-value≤0.05. The proportion of the high-risk group was increased from 2.5% in 2012 to 4.4% in 2020. Predictive value of SCORE was investigated, and their accuracy was increased.