The site of the Media Sphera Publishers contains materials intended solely for healthcare professionals.
By closing this message, you confirm that you are a certified medical professional or a student of a medical educational institution.

Login
EN
+7 (495) 482-4118
+7 (495) 482-0604
+8 800 250-18-12
  • (toll-free number for subscriptions)
    Mon-Fri from 10 a.m. to 6 p.m.

  • © 1998-2025
+7 (495) 482-43-29
EN
All journals
Journal
Year
Year
Search result: 0

Bozhok A.A.

Saint-Petersburg State Pediatric Medical University;
North-Western District Scientific and Clinical Center named after L.G. Sokolov of the Federal Medical and Biological Agency

Zikiryakhodzhaev A.D.

P. Hertsen Moscow Oncology Research Institute — Branch of the National Medical Radiology Research Centre of the Ministry of Health of the Russian Federation;
People’s Friendship University of Russia, Moscow, Russia (RUDN University);
I.M. Sechenov First Moscow State Medical University (Sechenov University)

Kvetenadze G.E.

The Loginov Moscow Clinical Scientific Center Moscow Health Department

Moshurova M.V.

P. Hertsen Moscow Oncology Research Institute — Branch of the National Medical Radiology Research Centre of the Ministry of Health of the Russian Federation

Timoshkin V.O.

Herzen Moscow Oncology Research Institute

Shomova M.V.

Regional Clinical Oncological Dispensary;
Ryazan State Medical University

Manelov A.E.

Mechnikov North-Western State Medical University

Diagnostic value of fluorescence lymphography for sentinel lymph node biopsy in breast cancer. Summary experience of several specialized centers

Authors:

Bozhok A.A., Zikiryakhodzhaev A.D., Kvetenadze G.E., Moshurova M.V., Timoshkin V.O., Shomova M.V., Manelov A.E.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2024;(10): 49‑61

DOI: 10.17116/hirurgia202410149

Read: 1170 times

Download PDF (RU)
Contact the author
Table of contents

DIAGNOSTIC VALUE OF FLUORESCENCE LYMPHOGRAPHY FOR SENTINEL LYMPH NODE BIOPSY IN BREAST CANCER. SUMMARY EXPERIENCE OF SEVERAL SPECIALIZED CENTERS
DIAGNOSTIC VALUE OF FLUORESCENCE LYMPHOGRAPHY FOR SENTINEL LYMPH NODE BIOPSY IN BREAST CANCER. SUMMARY EXPERIENCE OF SEVERAL SPECIALIZED CENTERS

To cite this article:

Bozhok AA, Zikiryakhodzhaev AD, Kvetenadze GE, Moshurova MV, Timoshkin VO, Shomova MV, Manelov AE. Diagnostic value of fluorescence lymphography for sentinel lymph node biopsy in breast cancer. Summary experience of several specialized centers. Pirogov Russian Journal of Surgery. 2024;(10):49‑61. (In Russ.)
https://doi.org/10.17116/hirurgia202410149

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)
МСФ на ЯМ
Использование инфографики авторами научных работ
Close metadata
Recommended articles:
Comparative analysis of lapa­roscopic cholecystectomy outcomes in acute calculous cholecystitis: impo­rtance of indo­cyanine green, opti­mal dosing regi­men. Piro­gov Russian Journal of Surgery. 2024;(11):72-76
Impact of tumor size on actuarial survival of patients with primary breast sarcoma: a case-control study. Piro­gov Russian Journal of Surgery. 2024;(12):38-43
Free nipple-areolar complex grafting combined with reco­nstruction for unavoidable mastectomy. Plastic Surgery and Aesthetic Medi­cine. 2024;(4):60-64
Breast reco­nstruction after single-stage auto­logous reco­nstruction and subsequent flap lipo­necrosis. Plastic Surgery and Aesthetic Medi­cine. 2024;(4):77-83
NDRG1 protein expression in breast cancer samples, rela­tionship with lymph nodes meta­stasis. Russian Journal of Archive of Pathology. 2024;(6):36-42
Capsular contracture after reco­nstructive plastic surgery for breast cancer. P.A. Herzen Journal of Onco­logy. 2024;(6):78-83
Asse­ssment of risk factors for breast cancer deve­lopment in women living in the Sara­tov region. Russian Bulletin of Obstetrician-Gynecologist. 2024;(6):100-106
Left ventricular myocardial performance index (Tei index) as an early marker of cardiotoxicity in anti­tumor therapy. Russian Cardiology Bulletin. 2024;(4-2):137-143
Nottingham Prognostic Index rela­tion to cyto­kine-producing tumor mole­cular subtypes in breast cancer. Russian Journal of Preventive Medi­cine. 2025;(1):63-68
Abstract:

OBJECTIVE

To study the diagnostic value of fluorescent lymphography for sentinel lymph node biopsy in breast cancer.

MATERIAL AND METHODS

The cohort study, conducted at 4 specilized centers between June 2019 and March 2024, included 333 patients with cT1-4 N0-1M0 breast cancer. 50 patients received neoadjuvant systemic therapy, 14 of them had single metastases, confirmed by cytological or histological methods, which clinically completely regressed after systemic treatment. Immediately before the operation, 1 ml (5mg) of indocyanine green was injected subareolarly or subcutaneously into the tumor projection. Fluorescence imaging was performed using various devices for ICG navigation in the open surgical field — MARS, IC-Flow, Stryker SPY-PHI, IC-GOR. In 78 patients after sentinel lymph node biopsy standard axillary lymphadenectomy was performed.

RESULTS

Detection level was 99.1%. The average number of sentinel lymph nodes was 3.4. Metastatic lesions of sentinel lymph nodes were detected in 54 of 330 patients (16.4%). The average number of metastatic lymph nodes was 1.6; in 90.7% of cases metastases to 1—2 lymph nodes were registered. Intraoperative morphological examination revealed metastases only in 59% of cases. No systemic adverse events were recorded. The false-negative error rate in the group of patients who underwent axillary lymphadenectomy was 6.6%. The overall accuracy of fluorescent lymphography for sentinel lymph node biopsy in breast cancer was 94%.

CONCLUSION

The SLNB technique using fluorescence lymphography is safe and highly accurate as a stand-alone method.

Keywords:

breast cancer
sentinel lymph nodes biopsy
indocyanine green

Authors:

Bozhok A.A.

Saint-Petersburg State Pediatric Medical University;
North-Western District Scientific and Clinical Center named after L.G. Sokolov of the Federal Medical and Biological Agency

Zikiryakhodzhaev A.D.

P. Hertsen Moscow Oncology Research Institute — Branch of the National Medical Radiology Research Centre of the Ministry of Health of the Russian Federation;
People’s Friendship University of Russia, Moscow, Russia (RUDN University);
I.M. Sechenov First Moscow State Medical University (Sechenov University)

Kvetenadze G.E.

The Loginov Moscow Clinical Scientific Center Moscow Health Department

Moshurova M.V.

P. Hertsen Moscow Oncology Research Institute — Branch of the National Medical Radiology Research Centre of the Ministry of Health of the Russian Federation

Timoshkin V.O.

Herzen Moscow Oncology Research Institute

Shomova M.V.

Regional Clinical Oncological Dispensary;
Ryazan State Medical University

Manelov A.E.

Mechnikov North-Western State Medical University

Received:

21.07.2024

Accepted:

10.08.2024

Close metadata

References:

  1. Fisher B, Jeong JH, Anderson S, Bryant J, Fisher ER, Wolmark N. Twenty-five-year follow-up of a randomized trial comparing radical mastectomy, total mastectomy, and total mastectomy followed by irradiation. The New England Journal of Medicine. 2002;347(8):567-575.  https://doi.org/10.1056/NEJMoa020128
  2. Veronesi U, Orecchia R, Zurrida S, Galimberti V, Luini A, Veronesi P, Gatti G, D’Aiuto G, Cataliotti L, Paolucci R, Piccolo P, Massaioli N, Sismondi P, Rulli A, Lo Sardo F, Recalcati A, Terribile D, Acerbi A, Rotmensz N, Maisonneuve P. Avoiding axillary dissection in breast cancer surgery: a randomized trial to assess the role of axillary radiotherapy. Annals of Oncology. 2005;16(3):383-388.  https://doi.org/10.1093/annonc/mdi089
  3. Shakhzadova AO, Starinsky VV, Lisichnikova IV. State of oncological care for the population of Russia in 2022. Siberian journal of oncology. 2023;22(5):5-13. (In Russ.).
  4. Veronesi U, Paganelli G, Viale G, Luini A, Zurrida S, Galimberti V, Intra M, Veronesi P, Robertson C, Maisonneuve P, Renne G, De Cicco C, De Lucia F, Gennari R. A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. The New England Journal of Medicine. 2003;349(6):546-553.  https://doi.org/10.1056/NEJMoa012782
  5. Cabanas RM. An approach for the treatment of penile carcinoma. Cancer. 1977;39(2):456-466.  https://doi.org/10.1002/1097-0142(197702)39:2<456::aid-cncr2820390214>3.0.co;2-i
  6. Giuliano AE, Kirgan DM, Guenther JM, Morton DL. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Annals of Surgery. 1994;220(3):391-398; discussion 398-401.  https://doi.org/10.1097/00000658-199409000-00015
  7. Krag DN, Weaver DL, Alex JC, Fairbank JT. Surgical resection and radiolocalization of the sentinel lymph node in breast cancer using a gamma probe. Surgical Oncology. 1993;2(6):335-339; discussion 340.  https://doi.org/10.1016/0960-7404(93)90064-6
  8. Zavagno G, De Salvo GL, Scalco G, Bozza F, Barutta L, Del Bianco P, Renier M, Racano C, Carraro P, Nitti D; GIVOM Trialists. A Randomized clinical trial on sentinel lymph node biopsy versus axillary lymph node dissection in breast cancer: results of the Sentinella/GIVOM trial. Annals of Surgery. 2008;247(2):207-213.  https://doi.org/10.1097/SLA.0b013e31812e6a73
  9. Veronesi U, Viale G, Paganelli G, Zurrida S, Luini A, Galimberti V, Veronesi P, Intra M, Maisonneuve P, Zucca F, Gatti G, Mazzarol G, De Cicco C, Vezzoli D. Sentinel lymph node biopsy in breast cancer: ten-year results of a randomized controlled study. Annals of Surgery. 2010;251(4):595-600.  https://doi.org/10.1097/SLA.0b013e3181c0e92a
  10. Canavese G, Catturich A, Vecchio C, Tomei D, Gipponi M, Villa G, Carli F, Bruzzi P, Dozin B. Sentinel node biopsy compared with complete axillary dissection for staging early breast cancer with clinically negative lymph nodes: results of randomized trial. Annals of Oncology. 2009;20(6):1001-1007. https://doi.org/10.1093/annonc/mdn746
  11. Krag DN, Anderson SJ, Julian TB, Brown AM, Harlow SP, Costantino JP, Ashikaga T, Weaver DL, Mamounas EP, Jalovec LM, Frazier TG, Noyes RD, Robidoux A, Scarth HM, Wolmark N. Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial. Lancet Oncology. 2010;11(10):927-933.  https://doi.org/10.1016/S1470-2045(10)70207-2
  12. Petrelli F, Lonati V, Barni S. Axillary dissection compared to sentinel node biopsy for the treatment of pathologically node-negative breast cancer: a meta-analysis of four randomized trials with long-term follow up. Oncology Reviews. 2012;6(2):e20.  https://doi.org/10.4081/oncol.2012.e20
  13. Montgomery LL, Thorne AC, Van Zee KJ, Fey J, Heerdt AS, Gemignani M, Port E, Petrek J, Cody HS 3rd, Borgen PI. Isosulfan blue dye reactions during sentinel lymph node mapping for breast cancer. Anesthesia & Analgesia. 2002;95(2):385-388, table of contents. https://doi.org/10.1097/00000539-200208000-00026
  14. Gumus M, Gumus H, Jones SE, Jones PA, Sever AR, Weeks J. How long will I be blue? Prolonged skin staining following sentinel lymph node biopsy using intradermal patent blue dye. Breast Care. 2013;8(3):199-202. 
  15. Hojo T, Nagao T, Kikuyama M, Akashi S, Kinoshita T. Evaluation of sentinel node biopsy by combined fluorescent and dye method and lymph flow for breast cancer. Breast. 2010;19(3):210-213.  https://doi.org/10.1016/j.breast.2010.01.014
  16. Kitai T, Inomoto T, Miwa M, Shikayama T. Fluorescence navigation with indocyanine green for detecting sentinel lymph nodes in breast cancer. Breast Cancer. 2005;12(3):211-215.  https://doi.org/10.2325/jbcs.12.211
  17. Xiong L, Gazyakan E, Yang W, Engel H, Hünerbein M, Kneser U, Hirche C. Indocyanine green fluorescence-guided sentinel node biopsy: a meta-analysis on detection rate and diagnostic performance. European Journal of Surgical Oncology. 2014;40(7):843-849.  https://doi.org/10.1016/j.ejso.2014.02.228
  18. Ballardini B, Santoro L, Sangalli C, Gentilini O, Renne G, Lissidini G, Pagani GM, Toesca A, Blundo C, del Castillo A, Peradze N, Caldarella P, Veronesi P. The indocyanine green method is equivalent to the ⁹⁹mTc-labeled radiotracer method for identifying the sentinel node in breast cancer: a concordance and validation study. European Journal of Surgical Oncology. 2013;39(12):1332-1336. https://doi.org/10.1016/j.ejso.2013.10.004
  19. Boughey JC, Ballman KV, Le-Petross HT, McCall LM, Mittendorf EA, Ahrendt GM, Wilke LG, Taback B, Feliberti EC, Hunt KK. Identification and Resection of Clipped Node Decreases the False-negative Rate of Sentinel Lymph Node Surgery in Patients Presenting With Node-positive Breast Cancer (T0-T4, N1-N2) Who Receive Neoadjuvant Chemotherapy: Results From ACOSOG Z1071 (Alliance). Annals of Surgery. 2016;263(4):802-807.  https://doi.org/10.1097/SLA.0000000000001375
  20. Kahler-Ribeiro-Fontana S, Pagan E, Magnoni F, Vicini E, Morigi C, Corso G, Intra M, Canegallo F, Ratini S, Leonardi MC, La Rocca E, Bagnardi V, Montagna E, Colleoni M, Viale G, Bottiglieri L, Grana CM, Biasuz JV, Veronesi P, Galimberti V. Long-term standard sentinel node biopsy after neoadjuvant treatment in breast cancer: a single institution ten-year follow-up. European Journal of Surgical Oncology. 2021;47(4):804-812.  https://doi.org/10.1016/j.ejso.2020.10.014
  21. Kim T, Giuliano AE, Lyman GH. Lymphatic mapping and sentinel lymph node biopsy in early-stage breast carcinoma. A metaanalysis. Cancer. 2006;106(1):4-16. 
  22. Kang B, Lee JH, Lee J, Jung JH, Kim WW, Chu G, Chae Y, Lee SJ, Lee IH, Yang JD, Lee JS, Park HY. Comparative Study Between Radioisotope Uptake and Fluorescence Intensity of Indocyanine Green for Sentinel Lymph Node Biopsy in Breast Cancer. Journal of Breast Cancer. 2022;25(3):244-252.  https://doi.org/10.4048/jbc.2022.25.e27
  23. Semiglazov VF, Krivorotko PV, Zhiltsova EK, Kanaev SV, Trufanova ES, Krzhivitskiy PI, Komyakhov AV, Tabagua TT, Nikolaev KS, Bessonov AA, Ivanov VG, Gigolaeva LP, Ivanova OA, Zernov KYu, Dashyan GA, Semiglazov VV, Emelyanov AS, Busko EA, Chernaya AV, Artemyeva AS, Novikov SN. Twenty-year experience of examining biopsies of signal lymph nodes in breast cancer. Tumors of female reproductive system. 2020;16(1):12-20. (In Russ.). https://doi.org/10.17650/1994-4098-2020-16-1-12-20
  24. Busko EA, Krivorotko PV, Semiglazov VF, Novikov SN. Methodological problems of sentinel lymph node biopsy in patients with breast cancer. Issues of oncology. 2015;61(3):418-423. (In Russ.).
  25. Lyew MA, Gamblin TC, Ayoub M. Systemic anaphylaxis associated with intramammary isosulfan blue injection used for sentinel node detection under general anesthesia. Anesthesiology. 2000;93:145-146. 
  26. Rescigno J, Zampell JC, Axelrod D. Patterns of axillary surgical care for breast cancer in the era of sentinel lymph node biopsy. Annals of Surgical Oncology. 2009;16(3):687-696.  https://doi.org/10.1245/s10434-008-0195-5
  27. Kang B, Lee JH, Lee J, Jung JH, Kim WW, Chu G, Chae Y, Lee SJ, Lee IH, Yang JD, Lee JS, Park HY. Comparative Study Between Radioisotope Uptake and Fluorescence Intensity of Indocyanine Green for Sentinel Lymph Node Biopsy in Breast Cancer. Journal of Breast Cancer. 2022;25(3):244-252.  https://doi.org/10.4048/jbc.2022.25.e27
  28. Sugie T, Kassim KA, Takeuchi M, Hashimoto T, Yamagami K, Masai Y, Toi M. A novel method for sentinel lymph node biopsy by indocyanine green fluorescence technique in breast cancer. Cancers. 2010;2(2):713-720.  https://doi.org/10.3390/cancers2020713
  29. Hirche C, Murawa D, Mohr Z, Kneif S, Hünerbein M. ICG fluorescence-guided sentinel node biopsy for axillary nodal staging in breast cancer. Breast Cancer Research and Treatment. 2010;121(2):373-378. 
  30. Abe H, Mori T, Umeda T, Tanaka M, Kawai Y, Shimizu T, Cho H, Kubota Y, Kurumi Y, Tani T. Indocyanine green fluorescence imaging system for sentinel lymph node biopsies in early breast cancer patients. Surgery Today. 2011;41(2):197-202. 
  31. Wishart GC, Loh SW, Jones L, Benson JR. A feasibility study (ICG-10) of indocyanine green (ICG) fluorescence mapping for sentinel lymph node detection in early breast cancer. European Journal of Surgical Oncology. 2012;38(8):651-656. 
  32. Murawa D, Hirche C, Dresel S, Hünerbein M. Sentinel lymph node biopsy in breast cancer guided by indocyanine green fluorescence. Br J Surg. 2009;96:1289-1294.
  33. Guo J, Yang H, Wang S, Cao Y, Liu M, Xie F, Liu P, Zhou B, Tong F, Cheng L, Liu H, Wang S. Comparison of sentinel lymph node biopsy guided by indocyanine green, blue dye, and their combination in breast cancer patients: a prospective cohort study. World Journal of Surgical Oncology. 2017;15(1):196.  https://doi.org/10.1186/s12957-017-1264-7
  34. Liu J, Huang L, Wang N, Chen P. Indocyanine green detects sentinel lymph nodes in early breast cancer. Journal of International Medical Research. 2017;45(2):514-524.  https://doi.org/10.1177/0300060516687149
  35. Papathemelis T, Jablonski E, Scharl A, Hauzenberger T, Gerken M, Klinkhammer-Schalke M, Hipp M, Scharl S. Sentinel Lymph Node Biopsy in Breast Cancer Patients by Means of Indocyanine Green Using the Karl Storz VITOM® Fluorescence Camera. BioMed Research International. 2018;2018:6251468. https://doi.org/10.1155/2018/6251468
  36. Ngô C, Sharifzadehgan S, Lecurieux-Lafayette C, Belhouari H, Rousseau D, Bonsang-Kitzis H, Crouillebois L, Balaya V, Oudard S, Lécuru F, Elaidi RT. Indocyanine green for sentinel lymph node detection in early breast cancer: Prospective evaluation of detection rate and toxicity-The FLUOBREAST trial. Breast Journal. 2020;26(12):2357-2363. https://doi.org/10.1111/tbj.14100
  37. Verbeek FP, Troyan SL, Mieog JS, Liefers GJ, Moffitt LA, Rosenberg M, Hirshfield-Bartek J, Gioux S, van de Velde CJ, Vahrmeijer AL, Frangioni JV. Near-infrared fluorescence sentinel lymph node mapping in breast cancer: a multicenter experience. Breast Cancer Research and Treatment. 2014;143(2):333-342.  https://doi.org/10.1007/s10549-013-2802-9
  38. Yin R, Ding LY, Wei QZ, Zhou Y, Tang GY, Zhu X. Comparisons of ICG-fluorescence with conventional tracers in sentinel lymph node biopsy for patients with early-stage breast cancer: A meta-analysis. Oncology Letters. 2021;21(2):114. 
  39. Schaafsma BE, Verbeek FP, Rietbergen DD, van der Hiel B, van der Vorst JR, Liefers GJ, Frangioni JV, van de Velde CJ, van Leeuwen FW, Vahrmeijer AL. Clinical trial of combined radio and fluorescence guided sentinel lymph node biopsy in breast cancer. British Journal of Surgery. 2013;100:1037-1044.
  40. Borgstein PJ, Meijer S. Guidelines for sentinel node biopsy and lymphatic mapping of patients with breast cancer. Annals of Surgery. 1998;228(5):720-723.  https://doi.org/10.1097/00000658-199811000-00016
  41. Grischke EM, Röhm C, Hahn M, Helms G, Brucker S, Wallwiener D. ICG Fluorescence Technique for the Detection of Sentinel Lymph Nodes in Breast Cancer: Results of a Prospective Open-label Clinical Trial. Geburtshilfe Frauenheilkd. 2015;75(9):935-940.  https://doi.org/10.1055/s-0035-1557905
  42. Kulikov EP, Shomova MV, Titov DS, Demko AN, Maistrenko MA. Pharmacoeconomic study of fluorescent lymphography and radionuclide diagnostics methods for sentinel lymph node detection in breast cancer. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2023;16(4):596-606. (In Russ.). https://doi.org/10.17749/2070-4909/farmakoekonomika.2023.219
  43. Zikiryakhodjaev AD, Saribekyan EK, Bagdasarova DV, Malishava LE, Usov FN, Starkova MV. Sentinel lymph node biopsy in breast cancer using indocyanine green fluorescence imaging. Biomedical Photonics. 2019;8(4):4-10. (In Russ.). https://doi.org/10.24931/2413-9432-2019-8-4-4-10
  • Bekki Y, Von Ahrens D, Takahashi H, Schwartz M, Gunasekaran G. Recurrent Intrahepatic Cholangiocarcinoma — Review. Frontiers in Oncology. 2021;11:776863. https://doi.org/10.3389/fonc.2021.776863
  • Ge Y, Jeong S, Luo GJ, Ren YB, Zhang BH, Zhang YJ, Shen F, Cheng QB, Sui CJ, Wang HY, Xia Q, Chen L. Transarterial chemoembolization versus percutaneous microwave coagulation therapy for recurrent unresectable intrahepatic cholangiocarcinoma: Development of a prognostic nomogram. Hepatobiliary & Pancreatic Diseases International. 2020;19(2):138-146.  https://doi.org/10.1016/j.hbpd.2020.02.005
  • Edeline J, Lamarca A, McNamara MG, Jacobs T, Hubner RA, Palmer D, Groot Koerkamp B, Johnson P, Guiu B, Valle JW. Locoregional therapies in patients with intrahepatic cholangiocarcinoma: A systematic review and pooled analysis. Cancer Treatment Reviews. 2021;99:102258. https://doi.org/10.1016/j.ctrv.2021.102258
    • Contact the author
    Email
    Message
    The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.

    Email Confirmation

    An email was sent to test@gmail.com with a confirmation link. Follow the link from the letter to complete the registration on the site.

    Email Confirmation

    Contact us
    If you have any questions, complaints or suggestions, please use this feedback form.
    Email
    Message
    The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.
    Submit Application

    You can become an author of one of our magazines, send a request and we will consider it in during the day.

    Name
    Phone
    E-mail
    Message
    Login
    Registration
    E-mail
    Password
    Forgot Password?

    Log in to the site using your account in one of the services

    Password recovery
    E-mail
    Login
    Register

    We use cооkies to improve the performance of the site. By staying on our site, you agree to the terms of use of cооkies. To view our Privacy and Cookie Policy, please. click here.