A PATIENT WITH A RARE BREAST TUMOUR WAS SAVED AT THE NATIONAL MEDICAL RESEARCH RADIOLOGICAL CENTRE

The breast tumour in a 48-year-old patient from Orenburg had been growing for almost fifteen years. Over these years, Elena repeatedly sought help at various clinics. The results of the examinations indicated a benign phyllodes tumour, a rare formation that can remain stable for a long time and then suddenly start to grow rapidly. Against the backdrop of a serious medical history — a previous stroke, an artificial mitral valve, and the need to take high doses of anticoagulants — the decision for surgical treatment became particularly risky.

When the patient arrived at the P. Hertsen Moscow Oncology Research Institute branch of the National Medical Research Radiological Centre the situation was almost critical. The tumour began ulcerating during the investigations, and each day could have become critical, explains Ayzhan Zaripbekova, a postgraduate of the Department of Oncology and Reconstructive-Plastic Surgery of the Breast and Skin. The patient’s attending physician, Natalya Ablitsova, an oncologist-mammologist of the department, recalls the first moments of meeting: “Elena came to us in an extremely severe condition. During further examinations, literally within ten days, the tumour increased sharply in size. Bleeding occurred, and it became clear that waiting any longer was impossible — delay was simply life-threatening”.

The tumour tissue had filled the entire breast. Partial removal was not considered. But the main challenge was not so much the technical complexity of the surgery as its tolerability: switching from warfarin to low molecular weight heparins, monitoring coagulation, preparing the patient considering her severe cardiac history — all of this required special coordination between surgeons, anesthetists and intensivists.

The head of the department, Aziz Zikiryakhodjaev, speaks about this case as follows: “There was no doubt — the patient needed help. Yes, the surgery was complicated, but the main task was not only to remove the tumour, but also to safely guide the patient through the postoperative period. This was one of those cases where the team literally had to ‘bring the person through”.

The operation was performed according to the standard radical mastectomy procedure. After morphological examination, it became clear that the tumour was malignant. However, the treatment strategy remained the same: surgery is the primary method for such types of disease.

The real difficulties began after the procedure. Against the backdrop of anticoagulants, the patient’s hemoglobin levels dropped rapidly. To stabilize her condition, transfusions were required, along with additional wound revision and meticulous monitoring of blood clotting. While most patients are discharged after three days, she remained under observation for almost two weeks, with each day bringing hope that the crisis was over. Elena was discharged in stable condition. Later, at home, she continued to share photos of her recovery with the doctors, as if afraid to believe that it was all behind her. Then the unexpected happened: she returned to her musical career. Recordings of her performances became a true symbol of gratitude for our doctors and a reminder that a patient’s resilience and a doctor’s dedication can change destinies even when the odds seem very slim.