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The analysis of long-term researches of the pathological changes arising in soft tissues at patients with a breast cancer as a result of radical surgical treatment and adjuvant radiotherapy is carried out in work. The article shows that the standard approach to postoperative radiation therapy, which is based only on the prevalence of the primary tumor process is not always justified. Very often it leads to excessive radiation load on the patient's body and the development of local acute and chronic radiation reactions of the skin, subcutaneous tissue and other soft tissues.In this regard, the question of differentiated purpose of radiotherapy acquires special value first of all at patients with small primary prevalence of tumor process. The paper presents the results of studies to study changes in the anterior chest wall in patients with breast cancer. In relation to the conduct of adjuvant radiotherapy more often need to use the concept of personalized radiation therapy. Radical operation, post-radiation early and late pathological changes in soft tissues, disturbance of microcirculation of lymph and blood, disturbance of innervation of vessels of an upper extremity, peripheral nerves in system of a cervical and plexus plexus, leads to intensive degen-erative and dystrophic changes in soft tissues of the upper. and causes morphological changes in them and further progression of reflex neurovascular and neurodystrophic disorders. Based on the data of adverse effects of radio-therapy on the skin and surrounding tissues, as well as to reduce excessive radiation exposure to the patient's body, a differentiated approach to the appointment of adjuvant radiation therapy.V roboti provedeno analiz bagatorichnykh doslidzhen' patologichnykh zmin, shcho vynykaiut' v m’iakykh tkanynakh u khvo-rykh na rak molochnoï zalozy v rezul'tati radykal'nogo khirurgichnogo likuvannia ta ad’iuvantnoï promenevoï te-rapiï. Pokazano, shcho standartnyĭ pidkhid do provedennia pisliaoperatsiĭnoï promenevoï terapiï, iakyĭ bazuiet'siatil'ky na rozpovsiudzhenosti pervynnogo pukhlynnogo protsesu, ie ne zavzhdy vypravdanym. Duzhe chasto tse pryzvo-dyt' do nadmirnogo promenevogo navantazhennia na organizm patsiientky i rozvytku mistsevykh gostrykh ta khronichnykhpromenevykh reaktsiĭ shkiry, pidshkirnoï klitkovyny ta inshykh m’iakykh tkanyn, tomu pytannia dyferentsiĭovanogopryznachennia promenevoï terapiï nabuvaie osoblyvogo znachennia nasampered u khvorykh z nevelykoiu pervynnoiurozpovsiudzhenistiu pukhlynnogo protsesu. V statti navedeno rezul'taty doslidzhen' z vyvchennia zmin u diliantsi pe-redn'oï grudnoï stinky u khvorykh na rak molochnoï zalozy. Shchodo ad’iuvantnoï promenevoï terapiï zaznacheno, shchochastishe potribno vykorystovuvaty poniattia personalizovanoï promenevoï terapiï. Radykal'na operatsiia, pisliap-romenevi ranni i pizni patologichni zminy v m’iakykh tkanynakh, porushennia mikrotsyrkuliatsiï limfy i krovi, porushen-nia innervatsiï sudyn verkhn'oï kintsivky, peryferychnykh nerviv u diliantsi shyĭno-plechovogo spletennia pryzvodiat'do intensyvnykh degeneratyvno-dystrofichnykh zmin v m’iakykh tkanynakh verkhn'oï kintsivky, sprychyniaiut' v nykh mor-fologichni zminy ta podal'she progresuvannia reflektornykh nervovo-sudynnykh i neĭrodystrofichnykh porushen'.Zvazhaiuchy na dani shchodo nespryiatlyvoï diï promenevoï terapiï na shkiru i otochuiuchi tkanyny, a takozh zadlia zny-zhennia nadmirnogo promenevogo navantazhennia na organizm patsiientky, pidkhid do pryznachennia ad’iuvantnoï pro-menevoï terapiï povynen buty dyferentsiĭovanym. |
