Relationship between PD-L1 expression and tumor-infiltrating lymphocytes in canine mammary tumor

Background: Studies pointed out that the tumor-infiltrating lymphocytes (TILs) have considerable importance in caninemammary tumor (CMT). On the other hand, cancer cells sometimes find ways to use immune checkpoint proteins as ashield to avoid being identified and attacked by the immune system as programmed death 1 ligand 1 (PD-L1). In this study,it was investigated the relationship between PD-L1 expression, stromal tumor-infiltrating lymphocytes (TILs) in caninemammary tumor (CMT), and the association with clinical and pathological characteristics of the tumors.Materials, Methods & Results: PD-L1 expression and TILs were assessed in 23 female dogs with CMT. The tumors weregrouped into simple carcinoma (CA, n = 8) and complex carcinoma (CC, n = 15). Stromal TILs were assessed using twothresholds as TILs-Low representing < 50% of infiltrate within stromal area and TILs-High representing ≥ 50% of stromalarea. Clinicopathological data of CMT was characterized according to key parameters, as well as survival rates. TILs evaluation within tumor stroma revealed that 65.2% (n = 15) of tumors had TILs-Low. PD-L1 expression and stromal TILs weresignificantly associated (P = 0.009). PD-L1 expression was observed in 39% (n = 9) of all tumors of which 17.4% (n = 4)were from CA group and 21.7% (n = 5) were from CC group. PD-L1 expression within TILs was observed in 39% (n =9) of the tumors. PD-L1 in malignant epithelium was present in all lymph node metastasis (n = 5). PD-L1 was associatedwith involvement of regional lymph nodes (P = 0.034). Survival curves demonstrated TILs-Low had higher (P = 0.010)overall survival (OS) compared with TILs-High, and PD-L1+ and PD-L1– (P = 0.06) did not differed. The clinicopathological variables significantly correlated with OS by univariate analysis were the histological grade (P = 0.009), lymphnode involvement (P = 0.004), stromal...

Relationship between PD-L1 expression and tumor-infiltrating lymphocytes in canine mammary tumor

Background: Studies pointed out that the tumor-infiltrating lymphocytes (TILs) have considerable importance in caninemammary tumor (CMT). On the other hand, cancer cells sometimes find ways to use immune checkpoint proteins as ashield to avoid being identified and attacked by the immune system as programmed death 1 ligand 1 (PD-L1). In this study,it was investigated the relationship between PD-L1 expression, stromal tumor-infiltrating lymphocytes (TILs) in caninemammary tumor (CMT), and the association with clinical and pathological characteristics of the tumors.Materials, Methods & Results: PD-L1 expression and TILs were assessed in 23 female dogs with CMT. The tumors weregrouped into simple carcinoma (CA, n = 8) and complex carcinoma (CC, n = 15). Stromal TILs were assessed using twothresholds as TILs-Low representing < 50% of infiltrate within stromal area and TILs-High representing ≥ 50% of stromalarea. Clinicopathological data of CMT was characterized according to key parameters, as well as survival rates. TILs evaluation within tumor stroma revealed that 65.2% (n = 15) of tumors had TILs-Low. PD-L1 expression and stromal TILs weresignificantly associated (P = 0.009). PD-L1 expression was observed in 39% (n = 9) of all tumors of which 17.4% (n = 4)were from CA group and 21.7% (n = 5) were from CC group. PD-L1 expression within TILs was observed in 39% (n =9) of the tumors. PD-L1 in malignant epithelium was present in all lymph node metastasis (n = 5). PD-L1 was associatedwith involvement of regional lymph nodes (P = 0.034). Survival curves demonstrated TILs-Low had higher (P = 0.010)overall survival (OS) compared with TILs-High, and PD-L1+ and PD-L1(P = 0.06) did not differed. The clinicopathological variables significantly correlated with OS by univariate analysis were the histological grade (P = 0.009), lymphnode involvement (P = 0.004), stromal...(AU)

Uso do sulfato de magnésio (mgso4) na anestesia total intravenosa como adjuvante anestésico e analgésico em cadela submetida à mastectomia parcial bilateral – relato de caso / Use of magnesium sulfate (MgSO4) in total intravenous anesthesia as anesthetic and analgesic adjuvant in a dog submitted to bilateral partial mastectomy - Case report

A utilização do sulfato de magnésio (MgSO4) está crescendo gradativamente na Medicina Veterinária, principalmente na anestesiologia, pois é um fármaco que possui propriedades analgésicas e sedativas com potencial para neuro e cardioproteção. Apresenta um grande papel na anestesia e analgesia multimodal, principalmente para controle de dor no trans e pós-operatório, reduzindo a necessidade e a dose de outros fármacos analgésicos, sendo efetivo para o tratamento do controle de dor. Este relato descreve o caso de um cão, fêmea, da raça fox paulistinha, com onze anos de idade, que foi submetido à mastectomia parcial bilateral, tendo sido anestesiada com o emprego da técnica total intravenosa com o Propofol, associada à infusão contínua do sulfato de magnésio com o objetivo de avaliar a eficácia do mesmo em relação à analgesia no transoperatório e pós-operatório, redução na taxa de infusão do fármaco indutor e necessidade de resgate analgésico.

The use of magnesium sulfate (MgSO4) is gradually increasing in Veterinary Medicine, mainly in anesthesiology, as it is a drug that has analgesic and sedative properties with potential for neuro and cardioprotection. It plays a great role in anesthesia and multimodal analgesia, mainly for pain control in the trans and postoperative period, reducing the need and dose of other analgesic drugs, being effective for the treatment of pain control. This report describes the case of a female fox paulistinha dog, 11 years old, who underwent bilateral partial mastectomy where she was anesthetized using the Total Intravenous Technique with Propofol associated with the continuous infusion of magnesium sulphate with objective of evaluating the efficacy of the same in relation to analgesia in the intraoperative and postoperative period, reduction in the rate of infusion of the inducing drug and need for analgesic rescue.

Uso do sulfato de magnésio (mgso4) na anestesia total intravenosa como adjuvante anestésico e analgésico em cadela submetida à mastectomia parcial bilateral relato de caso / Use of magnesium sulfate (MgSO4) in total intravenous anesthesia as anesthetic and analgesic adjuvant in a dog submitted to bilateral partial mastectomy - Case report

A utilização do sulfato de magnésio (MgSO4) está crescendo gradativamente na Medicina Veterinária, principalmente na anestesiologia, pois é um fármaco que possui propriedades analgésicas e sedativas com potencial para neuro e cardioproteção. Apresenta um grande papel na anestesia e analgesia multimodal, principalmente para controle de dor no trans e pós-operatório, reduzindo a necessidade e a dose de outros fármacos analgésicos, sendo efetivo para o tratamento do controle de dor. Este relato descreve o caso de um cão, fêmea, da raça fox paulistinha, com onze anos de idade, que foi submetido à mastectomia parcial bilateral, tendo sido anestesiada com o emprego da técnica total intravenosa com o Propofol, associada à infusão contínua do sulfato de magnésio com o objetivo de avaliar a eficácia do mesmo em relação à analgesia no transoperatório e pós-operatório, redução na taxa de infusão do fármaco indutor e necessidade de resgate analgésico.(AU)

The use of magnesium sulfate (MgSO4) is gradually increasing in Veterinary Medicine, mainly in anesthesiology, as it is a drug that has analgesic and sedative properties with potential for neuro and cardioprotection. It plays a great role in anesthesia and multimodal analgesia, mainly for pain control in the trans and postoperative period, reducing the need and dose of other analgesic drugs, being effective for the treatment of pain control. This report describes the case of a female fox paulistinha dog, 11 years old, who underwent bilateral partial mastectomy where she was anesthetized using the Total Intravenous Technique with Propofol associated with the continuous infusion of magnesium sulphate with objective of evaluating the efficacy of the same in relation to analgesia in the intraoperative and postoperative period, reduction in the rate of infusion of the inducing drug and need for analgesic rescue.(AU)

Mastite e necrose periareolar por azul de metileno 1% após linfadenectomia axilar e mastectomia regional em cadela / Mastitis and periareolar necrosis by 1% methylene blue after axilar lymphadenectomy and regional mastectomy in a bitch

Background: Mammary neoplasms are frequent in dogs, and surgical excision by radical unilateral mastectomy is thefirst-choice treatment for most cases. Typically, inguinal lymphadenectomy is performed during mammary inguinal excision, whereas axillar lymphadenectomy is performed using dyes to guide surgical dissection and avoid iatrogenic trauma.This study reports the case of a bitch that underwent axillar lymphadenectomy and regional mastectomy. In this way, thiswork has the objective of reporting the case of a bitch referred to mastectomy and lymphadenectomy, which presentedcomplications due to the use of 1% methylene blue.Case: A 15-year-old female intact poodle weighing 6.2 kg presented with mammary nodules. Cytological examinationconfirmed malignant neoplasm in the mammary gland classified as Grade II (World Health Organization). Radical unilateralmastectomy and regional lymphadenectomy were performed. The surgical procedure involved intradermic injection of 0.5mL of sterile 1% methylene blue solution around the right cranial thoracic mammary gland divided in four sites beforeskin incision. Following right axillar lymphadenectomy, instead of radical unilateral mastectomy, regional mastectomywas performed in two ulcerated nodules at the right cranial abdominal gland to shorten the surgery time after the bitchdemonstrated severe trans-operative hypotension. The bitch was monitored during anesthetic recovery and was dischargedafter stabilization. At fourteen days after surgery, the patient was re-examined. Increased volume and pain in the mammaryglands of both chains were observed. In addition, a whitish liquid secretion was noted primarily from the thoracic caudalleft and thoracic cranial right mammary glands. The last mammary gland also presented a periareolar black area where thedye was applied. Progressive remission of the clinical signs was observed after therapy with...

Mastite e necrose periareolar por azul de metileno 1% após linfadenectomia axilar e mastectomia regional em cadela / Mastitis and periareolar necrosis by 1% methylene blue after axilar lymphadenectomy and regional mastectomy in a bitch

Background: Mammary neoplasms are frequent in dogs, and surgical excision by radical unilateral mastectomy is thefirst-choice treatment for most cases. Typically, inguinal lymphadenectomy is performed during mammary inguinal excision, whereas axillar lymphadenectomy is performed using dyes to guide surgical dissection and avoid iatrogenic trauma.This study reports the case of a bitch that underwent axillar lymphadenectomy and regional mastectomy. In this way, thiswork has the objective of reporting the case of a bitch referred to mastectomy and lymphadenectomy, which presentedcomplications due to the use of 1% methylene blue.Case: A 15-year-old female intact poodle weighing 6.2 kg presented with mammary nodules. Cytological examinationconfirmed malignant neoplasm in the mammary gland classified as Grade II (World Health Organization). Radical unilateralmastectomy and regional lymphadenectomy were performed. The surgical procedure involved intradermic injection of 0.5mL of sterile 1% methylene blue solution around the right cranial thoracic mammary gland divided in four sites beforeskin incision. Following right axillar lymphadenectomy, instead of radical unilateral mastectomy, regional mastectomywas performed in two ulcerated nodules at the right cranial abdominal gland to shorten the surgery time after the bitchdemonstrated severe trans-operative hypotension. The bitch was monitored during anesthetic recovery and was dischargedafter stabilization. At fourteen days after surgery, the patient was re-examined. Increased volume and pain in the mammaryglands of both chains were observed. In addition, a whitish liquid secretion was noted primarily from the thoracic caudalleft and thoracic cranial right mammary glands. The last mammary gland also presented a periareolar black area where thedye was applied. Progressive remission of the clinical signs was observed after therapy with...(AU)

Anestesia convencional e técnica de tumescência em cadelas submetidas à mastectomia. Avaliação da dor pós-operatória / Conventional anesthesia and tumescent technique in bitches which underwent mastectomy. Evaluation of postoperative pain

As neoplasias mamárias são as mais comuns em cadelas e geralmente acometem fêmeas de meia-idade a idosas, não castradas ou que foram submetidas ao procedimento de ovario-histerectomia tardiamente. A principal forma de tratamento é a excisão cirúrgica, sendo a ressecção unilateral das glândulas mamárias o procedimento mais realizado na prática veterinária. O objetivo do presente estudo foi comparar a dor pós-operatória em cadelas submetidas ao procedimento de mastectomia unilateral sob efeito das técnicas anestésicas de tumescência ou convencional. Foram utilizadas 20 cadelas, divididas em dois grupos: um grupo recebeu apenas a anestesia geral inalatória (grupo convencional), e o outro recebeu adicionalmente a anestesia infiltrativa por tumescência (grupo tumescência). Elas foram avaliadas nas primeiras 24 horas do período pós-operatório, e o processo álgico foi avaliado pela escala de dor da Universidade de Melbourne. As médias dos escores obtidos ao longo do tempo foram submetidas ao teste de Tukey a um nível de 5 por cento de significância (p<0,05). Não foram observadas diferenças significativas entre os grupos com relação à dor pós-operatória. A técnica anestésica infiltrativa por tumescência apresentou a vantagem da redução do sangramento transoperatório e mostrou-se exequível em pequenos animais, entretanto seu uso está relacionado à experiência e à preferência do cirurgião e do anestesista.(AU)

Mammary tumors are the most common neoplasm in bitches. Intact, mild to advanced aged female dogs are generally more affected. The main treatment is surgical excision and unilateral mastectomy is the most performed procedure in veterinary practice. The aim of this study was to compare the postoperative pain in dogs which underwent unilateral mastectomy and were anesthetized with tumescence and conventional anesthesia. Twenty bitches were randomly divided into two groups: Conventional Group (GC), which received only general inhalational anesthesia and Tumescence Group (GT), which also received tumescence anesthesia. All dogs were evaluated during the first 24 hours postoperatively. The scale of Pain from the University of Melbourne was used for the evaluation. The tukey test at a 5 percent level of significance (p <0.05) was used. There were no significant differences between groups related to postoperative pain. The technique of tumescent anesthesia reduced bleeding during surgery and is feasible in dogs. Its use is related to the surgeon and anesthesiologist's experience and preferences.(AU)

Oncoplastic approach in the conservative treatment of breast cancer: analysis of costs / Abordagem oncoplástica no tratamento conservador do câncer mamário: análise de custos

PURPOSE: To analyze the direct costs of conservative surgical treatment of breast cancer, performed in a university hospital, to the Brazilian National Health Care Public System (SUS), checking the impact of the oncoplastic approach on these costs. METHODS: One hundred thirty eight breast cancer patients who had undergone conservative treatment with oncoplastic approach (n=36) or not (control group, n=102), in the period from 2005 to 2010, were enrolled. Sociodemographic and clinical data were recorded. The direct costs of the surgical procedure were obtained and analyzed. RESULTS: Groups did not differ in regard to age (p=0.963), and patients in oncoplastic group had a longer time of hospital stay (p=0.000). The median direct cost for the oncoplastic group was R$461.00 and for the control group was R$229.00 (p=0.000). CONCLUSION: The oncoplastic approach has generated higher direct costs in conservative surgical treatment of breast cancer to SUS.(AU)

OBJETIVO: Analisar os custos diretos do tratamento cirúrgico conservador do câncer mamário, realizado pelo Sistema Único de Saúde (SUS) em um hospital universitário, verificando o impacto da abordagem oncoplástica sobre estes custos. MÉTODOS: Foram incluídas 138 pacientes submetidas ao tratamento conservador do câncer mamário pelo SUS, com abordagem oncoplástica (n=36) ou não (grupo controle, n=102), no período de 2005 a 2010. Foram registrados dados sócio-demográficos e da operação. Os custos diretos do procedimento cirúrgico foram obtidos e analisados. RESULTADOS: Não houve diferença entre os grupos quanto à idade (p=0.963), e o tempo de internação hospitalar foi maior no grupo oncoplástica (p=0,000). A mediana dos custos diretos do grupo oncoplástica foi de R$461,00 e do grupo controle foi de R$229,00 (p=0,000). CONCLUSÃO: A abordagem oncoplástica gerou custos diretos maiores para o tratamento cirúrgico conservador do câncer mamário pelo SUS.(AU)