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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">vmireaviz</journal-id><journal-title-group><journal-title xml:lang="ru">Вестник медицинского института «РЕАВИЗ». Реабилитация, Врач и Здоровье</journal-title><trans-title-group xml:lang="en"><trans-title>Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH)</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2226-762X</issn><issn pub-type="epub">2782-1579</issn><publisher><publisher-name>РЕАВИЗ</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.20340/vmi-rvz.2026.1.CLIN.4</article-id><article-id custom-type="elpub" pub-id-type="custom">vmireaviz-1470</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Клиническая медицина</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>Clinical medicine</subject></subj-group></article-categories><title-group><article-title>Первично-множественный рак молочной железы и тела матки: клинико-морфологические особенности</article-title><trans-title-group xml:lang="en"><trans-title>Multiple primary cancers of the breast and endometrium: clinical and morphological features</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4460-9136</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Титов</surname><given-names>К. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Titov</surname><given-names>K. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Титов Константин Сергеевич, Д-р мед. наук, профессор, ведущий научный сотрудник; профессор кафедры онкологии и рентгенорадиологии имени академика В.П. Харченко Медицинского института</p><p>AuthorID: 921470</p><p>2-й Боткинский проезд, д. 5, г. Москва, 125284, Россия</p><p>ул. Миклухо-Маклая, д. 6, г. Москва, 117198, Россия</p></bio><bio xml:lang="en"><p>Konstantin S. Titov, Dr. Sci. (Med.), Professor, Leading Researcher; Professor of the Department of Oncology and Roentgenology named after Academician V.P. Kharchenko of the Medical Institute</p><p>AuthorID: 921470</p><p>2nd Botkinsky proezd, 5, Moscow, 125284, Russia</p><p>Miklukho-Maklaya str., 6, Moscow, 117198, Russia </p></bio><email xlink:type="simple">ks-titov@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0001-5071-9916</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Арутюнян</surname><given-names>А. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Arutyunyan</surname><given-names>A. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Арутюнян Анна Меружановна, Канд. мед. наук, врач-онкогинеколог отделения диагностики и лечения заболеваний молочной железы и женской  репродуктивной системы ЦАОП</p><p>Россия, 125284, г. Москва, 2-й  Боткинский проезд, д. 5.</p></bio><bio xml:lang="en"><p>Anna M. Arutyunyan, Cand. Sci. (Med.), oncogynecologist of the department of diagnostics and treatment of the mammary gland and female reproductive system diseases, outpatient oncology care center</p><p>2nd Botkinsky proezd, 5, Moscow, 125284, Russia</p></bio><email xlink:type="simple">dr.arutyunyana@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5366-1281</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лебедев</surname><given-names>С. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Lebedev</surname><given-names>S. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Лебедев Сергей Сергеевич, Д-р мед. наук, доцент, заместитель главного врача по онкологии,ведущий научный сотрудник; профессор кафедрыхирургии хирургического факультета</p><p>Россия, 125284, г. Москва, 2-й  Боткинский проезд, д. 5</p><p>ул. Баррикадная, д. 2/1, стр. 1, г. Москва, 125993, Россия</p></bio><bio xml:lang="en"><p>Sergey S. Lebedev, Dr. Sci. (Med.), Docent, Deputy Chief Physician for Oncology, Leading Researcher; Professor,  Department of Surgery, Faculty of Surgery</p><p>2nd Botkinsky proezd, 5, Moscow, 125284, Russia</p><p>Barrikadnaya str., 2/1, building 1, Moscow, 125993 Russia </p><p> </p></bio><email xlink:type="simple">lebedevssd@yandex.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8887-5789</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Соколов</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Sokolov</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Соколов Егор Андреевич, Д-р мед. наук, доцент, руководитель ЦАОП; профессор кафедры урологии и хирургической андрологии </p><p>Россия, 125284, г. Москва, 2-й  Боткинский проезд, д. 5</p><p>ул. Баррикадная, д. 2/1, стр. 1, г. Москва, 125993, Россия</p></bio><bio xml:lang="en"><p>Egor A. Sokolov, Dr. Sci. (Med.), Docent, head of the outpatient oncology care center; Professor, Department of urology and surgical andrology</p><p>2nd Botkinsky proezd, 5, Moscow, 125284, Russia</p><p>Barrikadnaya str., 2/1, building 1, Moscow, 125993 Russia </p></bio><email xlink:type="simple">info@drsokolov.ru</email><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Московский многопрофильный научно-клинический центр имени С.П. Боткина;&#13;
Российский университет дружбы народов имени Патриса Лумумбы</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Moscow S.P. Botkin Multidisciplinary Scientific-Clinical Center;&#13;
Peoples` Friendship University of Russia named after Patrice Lumumba</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Московский многопрофильный научно-клинический центр имени С.П. Боткина</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Moscow S.P. Botkin  Multidisciplinary Scientific-Clinical Center</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Московский многопрофильный научно-клинический центр имени С.П. Боткина;&#13;
Российская медицинская академия непрерывного профессионального образования</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Moscow S.P. Botkin Multidisciplinary Scientific-Clinical Center;&#13;
Russian Medical Academy of Continuous Professional Education</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>20</day><month>05</month><year>2026</year></pub-date><volume>16</volume><issue>1</issue><fpage>36</fpage><lpage>45</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Титов К.С., Арутюнян А.М., Лебедев С.С., Соколов Е.А., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Титов К.С., Арутюнян А.М., Лебедев С.С., Соколов Е.А.</copyright-holder><copyright-holder xml:lang="en">Titov K.S., Arutyunyan A.M., Lebedev S.S., Sokolov E.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://vestnik.reaviz.ru/jour/article/view/1470">https://vestnik.reaviz.ru/jour/article/view/1470</self-uri><abstract><p>Актуальность: за последнее десятилетие наблюдается тенденция роста первично-множественных злокачественных образований. Частота первично-множественного рака в мире колеблется от 2 до 17% по данным ESMO, в частности частота синхронного рака составляет около 6%. Среди больных первично-множественным раком основную долю составляют пациенты с двумя опухолями. Самые частые гинекологические заболевания, ассоциированные с раком молочной железы - рак яичников, рак эндометрия и рак шейки матки. Цель исследования: изучить клинико-морфологические характеристики пациентов с первично-множественным раком молочной железы и тела матки. Материал и методы исследования: ретроспективный анализ историй болезни пациентов с первично-множественным раком, состоящих на учете в ЦАОПе ММНКЦ им. С. П. Боткина. Результаты: у 35,0% пациенток был диагностирован ПМСР с медианой временного промежутка между выявлением опухолей 2,0 месяца (Q1-Q3 1,0-1,3). У 65,0% - ПММР с медианой времени между выявлением опухолей 90,0 месяцев (Q1-Q3 37,5-179,5). Возраст пациентов с ПМСР на момент диагностики первой опухоли составил 38-78 лет, в среднем - 61,7 ± 11,4 лет, а возраст пациентов с ПММР на момент диагностики первой опухоли был 33-83 лет, в среднем - 57,9 ± 11,1 лет (р &gt; 0,05). Превалировала IA стадия РМЖ и РТМ – 46,3% и 53,8% наблюдений соответственно; протоковая карцинома РМЖ – 87,5%, люминальный В HER2-отрицательный – 37,5% наблюдения и эндометриоидный РТМ – 85,0% наблюдений. Выводы: у пациентов с первично-множественным раком молочной железы и раком тела матки преимущественно опухоли выявляются на I стадии, с менее агрессивным гистологическим типом, наиболее благоприятным молекулярным типом РМЖ. В большинстве случаев методом выбора лечения обеих опухолей является операция. Проведение лучевой терапии по поводу РМЖ статистически значимо повышает риск развития рака тела матки в 2,6 раза.</p></abstract><trans-abstract xml:lang="en"><p>Introduction. Over the past decade, there has been an increase in the number of multiple primary malignant tumors. The incidence of multiple primary cancers in the world ranges from 2% to 17%, with a synchronous cancer incidence of approximately 6%. Among patients with multiple primary cancers, the majority have two tumors. The most common gynecological diseases associated with breast cancer are ovarian cancer, endometrial cancer and cervical cancer. Aim: to study the clinical and morphological characteristics of patients with multiple primary breast and endometrial cancer.Material and methods. A retrospective analysis of patients with multiple primary cancers registered at the Moscow S.P. Botkin multidisciplinary research and clinical center was conducted. Results. 35,0% of patients were diagnosed with SMPC, with a median time interval of 2,0 months between tumors detection (Q1-Q3 1,0–1,3), 65,0% had MMPC with a median time between tumor detection of 90,0 months (Q1-Q3 37,5–179,5). The age of patients with SMPC at the time of diagnosis of the first tumor was 38-78 years, with an average of 61,7±11,4 years, and the age of patients with MMPC at the time of diagnosis of the first tumor was 33-83 years, with an average of 57,9±11,1 years (p &gt; 0,05). IA stage of breast cancer and endometrial cancer prevailed – 46,3% and 53,8% of cases, respectively; as well as breast ductal carcinoma – 87,5%, luminal B HER2 negative – 37,5% of cases and endometrial cancer – 85,0% of cases. Conclusions. In patients with multiple primary breast and endometrial cancer, tumors are predominantly detected at stage I, with a less aggressive histological type and the most favorable molecular type of breast cancer. In most cases, surgery is the treatment of choice. Radiation therapy for breast cancer increased the risk of developing endometrial cancer by 2,6 times.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>первично-множественные новообразования [D009370]</kwd><kwd>рак молочной железы [D001943]</kwd><kwd>рак эндометрия (рак тела матки) [D016889]</kwd><kwd>эндометриоидная карцинома [D018269]</kwd><kwd>протоковая карцинома молочной железы [D018270]</kwd><kwd>синхронные новообразования [D013997]</kwd><kwd>метахронные новообразования [D008679]</kwd><kwd>градация опухолей [D060787]</kwd><kwd>стадирование опухолей [D009367]</kwd><kwd>прогноз [D011379]</kwd><kwd>ретроспективные исследования [D012189]</kwd><kwd>адъювантная лучевая терапия [D018714]</kwd><kwd>факторы риска [D012307]</kwd><kwd>гормон-рецепторпозитивное злокачественное новообразование [D020249]</kwd><kwd>HER2-негативная карцинома [D000077298]</kwd><kwd>новообразования матки [D016889]</kwd><kwd>клинические наблюдения [D002363]</kwd></kwd-group><kwd-group xml:lang="en"><kwd>Neoplasms</kwd><kwd>Multiple Primary [D009370]</kwd><kwd>Breast Neoplasms [D001943]</kwd><kwd>Endometrial Neoplasms [D016889]</kwd><kwd>Carcinoma</kwd><kwd>Endometrioid [D018269]</kwd><kwd>Carcinoma</kwd><kwd>Ductal</kwd><kwd>Breast [D018270]</kwd><kwd>Synchronous Neoplasms [D013997]</kwd><kwd>Metachronous Neoplasms [D008679]</kwd><kwd>Neoplasm Grading [D060787]</kwd><kwd>Neoplasm Staging [D009367]</kwd><kwd>Prognosis [D011379]</kwd><kwd>Retrospective Studies [D012189]</kwd><kwd>Radiotherapy</kwd><kwd>Adjuvant [D018714]</kwd><kwd>Risk Factors [D012307]</kwd><kwd>Hormone Receptor Positive Malignancy [D020249]</kwd><kwd>HER2 Negative Carcinoma [D000077298]</kwd><kwd>Uterine Neoplasms [D016889]</kwd><kwd>Case Reports [D002363]</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Каприн А.Д., Старинский В.В., Шахзадова А.О. 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