RESUMO
OBJECTIVE: To compare the effects of constant rate infusions (CRI) of fentanyl or dexmedetomidine, combined with lidocaine and ketamine, on cardiovascular response during surgery, sevoflurane requirement and postoperative pain in dogs undergoing mastectomy. STUDY DESIGN: Prospective, randomized, blinded, clinical trial. ANIMALS: A total of 29 female dogs with mammary tumors. METHODS: Premedication consisted of intramuscular acepromazine and morphine. General anesthesia was induced with intravenous propofol and maintained with sevoflurane. Dogs were randomized to be administered intravenous DLK [dexmedetomidine 1 µg kg-1 loading dose (LD) and 1 µg kg-1 hour-1; lidocaine 2 mg kg-1 LD and 3 mg kg-1 hour-1; ketamine 1 mg kg-1 LD and 0.6 mg kg-1 hour-1; n = 14] or FLK (fentanyl 5 µg kg-1 LD and 9 µg kg-1 hour-1; same doses of lidocaine and ketamine; n = 15) during anesthesia. Cardiorespiratory variables and end-tidal sevoflurane (Fe'Sevo) were recorded during surgery. The number of dogs administered ephedrine to treat arterial hypotension [mean arterial pressure (MAP) < 60 mmHg] was recorded. Meloxicam was administered to both groups. Postoperative pain and rescue analgesia requirement were assessed for 24 hours using the short form of the Glasgow Composite Measure Pain Scale. Data were compared using a mixed effects model or a Mann-Whitney test. RESULTS: More dogs required ephedrine in FLK than in DLK (67% versus 7%). Heart rate was not significantly different between groups, whereas lower values of MAP (p ≤ 0.01) and Fe'Sevo (p = 0.018) were observed in FLK than in DLK. Rescue analgesia was administered to 2/15 dogs in FLK and 0/14 dogs in DLK. CONCLUSIONS AND CLINICAL RELEVANCE: Based on the cardiovascular response during surgery, intraoperative infusions of FLK and DLK provided adequate antinociception. Infusion of DLK provided greater stability of blood pressure. Both protocols resulted in minimal need for additional analgesia within 24 hours postoperatively.
Assuntos
Dexmedetomidina , Doenças do Cão , Fentanila , Ketamina , Lidocaína , Mastectomia , Dor Pós-Operatória , Sevoflurano , Animais , Cães/cirurgia , Dexmedetomidina/administração & dosagem , Dexmedetomidina/farmacologia , Feminino , Ketamina/administração & dosagem , Ketamina/farmacologia , Dor Pós-Operatória/veterinária , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/prevenção & controle , Mastectomia/veterinária , Sevoflurano/administração & dosagem , Sevoflurano/farmacologia , Lidocaína/administração & dosagem , Lidocaína/farmacologia , Fentanila/administração & dosagem , Fentanila/farmacologia , Doenças do Cão/cirurgia , Anestésicos Intravenosos/administração & dosagem , Anestésicos Intravenosos/farmacologia , Infusões Intravenosas/veterinária , Neoplasias Mamárias Animais/cirurgia , Estudos Prospectivos , Anestésicos Inalatórios/administração & dosagemRESUMO
Mastectomy is the standard treatment for mammary gland tumors in dogs. In addition to traditional therapy, sodium dichloroacetate (DCA) can act as target therapy, as it may promote autophagy, reduce metastatic potential, and tumor proliferation in mammary tumor cell lines. This study aimed to analyze the effects of DCA as preoperative therapy for mammary tumors in bitches. Nineteen animals were selected, and they received DCA at a dose of 10 mg/kg orally every 12 hr, for 15 days. The periodic evaluation included hematological analysis (complete blood count and biochemical markers), evaluation of gastrointestinal adverse effects, evaluation of tumor volume, histopathological analysis, and immunohistochemical evaluation (Ki67 and cyclooxygenase-2/COX-2 markers). After treatment, there was a significant reduction in hematocrit (P=0.02) and leukocyte (P=0.04) means. Despite the variations for these two hematological parameters, the means remained within the reference range for the species. There were two cases of vomiting and one case of diarrhea. Most cases were classified as carcinoma in mixed tumor (n=7, 36.8%), followed by solid carcinoma (n=6, 31.6%). Nine cases (47.4%) showed reduced tumor volume, nine (47.4%) had stable disease, and one showed progressive disease. While there was no sample with a COX-2 score higher than 6, tumor samples with COX-2 scores 3 and 4 were significantly associated with stable disease or progression. DCA preoperative treatment for bitches with mammary gland tumors showed safety and potential cytoreduction in some cases.
Assuntos
Ácido Dicloroacético , Doenças do Cão , Neoplasias Mamárias Animais , Terapia Neoadjuvante , Animais , Cães , Feminino , Neoplasias Mamárias Animais/tratamento farmacológico , Neoplasias Mamárias Animais/cirurgia , Doenças do Cão/tratamento farmacológico , Ácido Dicloroacético/uso terapêutico , Terapia Neoadjuvante/veterináriaRESUMO
Mastectomy is a common and painful procedure in dogs. Wound soaker catheters (WSC) are frequently used to reduce postoperative pain, including pain after mastectomy. The objectives of this case series were to describe the use of WSC for owner administration of postoperative local analgesia in dogs with mammary tumors treated surgically, to identify complications associated with WSC and to determine the frequency of bacterial colonization of the catheters. Twelve WSC were placed in 11 dogs during mastectomy surgery, left in place for three days, protected by a dressing and successfully managed by owners at home. No postoperative antibiotics were administered. No complications were identified in any cases. No bacterial growth was identified on bacteriological analysis of the twelve WSC. These results suggest that the use of WSC is a safe alternative for postoperative analgesia administration following mastectomy in dogs. Future studies comparing dogs with or without WSC with a larger number of dogs are needed to further evaluate efficacy and complications.
Assuntos
Doenças do Cão , Mastectomia , Dor Pós-Operatória , Animais , Cães , Mastectomia/veterinária , Feminino , Dor Pós-Operatória/veterinária , Dor Pós-Operatória/prevenção & controle , Doenças do Cão/microbiologia , Doenças do Cão/cirurgia , Neoplasias Mamárias Animais/cirurgia , Complicações Pós-Operatórias/veterinária , Complicações Pós-Operatórias/prevenção & controle , Catéteres/microbiologia , Catéteres/veterinária , Analgesia/veterinária , Analgesia/métodos , Anestésicos Locais/administração & dosagemRESUMO
Mammary gland tumours are the most common neoplasms in intact bitches. Over the last decades, veterinary oncology has evolved in detecting and determining the lymph nodes to be removed in these patients for an accurate staging and prognosis, as well as to achieve better disease control and higher overall survival time. Our objective was to describe recent advances related to lymphatic drainage in bitches with mammary gland tumours, focusing on surgery, diagnosis, and prognosis. Through a systematic review using PubMed as the database, a thorough multi-step search reduced 316 studies to 30 for analysis. Vital dyes appear to be crucial in reducing the overall surgery time through transoperative staining of the lymph nodes. Imaging contrasts provide information regarding specific tumour drainage; however, there is still little evidence for their use. The axillary and superficial inguinal lymph nodes are well-established as regional lymph nodes of the cranial and caudal mammary glands. In sequence, accessory axillary, medial iliac, popliteal, and sternal lymph nodes should receive attention if they demonstrate contrast drainage, even considering that the literature has not shown a relationship between drainage and metastasis in these cases. In conclusion, recent studies have provided us with more support in regional lymph node excision regarding the TNM staging system. Studies are highly heterogeneous and method comparisons do not fit due to the non-uniformity of samples, materials, and procedures. We suggest further studies with a larger sample size, complete follow-up of patients, contrast use, and lymph node morphological and immunohistochemical analysis.
Assuntos
Doenças do Cão , Linfonodos , Neoplasias Mamárias Animais , Cães , Animais , Neoplasias Mamárias Animais/cirurgia , Neoplasias Mamárias Animais/patologia , Doenças do Cão/cirurgia , Feminino , Linfonodos/patologia , Metástase Linfática , Excisão de Linfonodo/veterináriaRESUMO
PURPOSE: Partial breast irradiation (PBI) and intraoperative radiation (IORT) represent alternatives to whole breast irradiation (WBI) following breast conserving surgery. However, data is mixed regarding outcomes. We therefore performed a pooled analysis of Kaplan-Meier-derived patient data from randomized trials to evaluate the hypothesis that PBI and IORT have comparable long-term rates of ipsilateral breast tumor recurrence as WBI. METHODS: In February, 2023, PubMed, EMBASE and Cochrane Central were systematically searched for randomized phase 3 trials of early-stage breast cancer patients undergoing breast-conserving surgery with PBI or IORT as compared to WBI. Time-to-event outcomes of interest included ipsilateral breast tumor recurrence (IBTR), overall survival (OS) and distant disease-free survival (DDFS). Statistical analysis was performed with R Statistical Software. RESULTS: Eleven randomized trials comprising 15,460 patients were included; 7,675 (49.6%) patients were treated with standard or moderately hypofractionated WBI, 5,413 (35%) with PBI and 2,372 (15.3%) with IORT. Median follow-up was 9 years. PBI demonstrated comparable IBTR risk compared with WBI (HR 1.20; 95% CI 0.95-1.52; p = 0.12) with no differences in OS (HR 1.02; 95% CI 0.90-1.16; p = 0.70) or DDFS (HR 1.15; 95% CI 0.81-1.64; p = 0.43). In contrast, patients treated with IORT had a higher IBTR risk (HR 1.46; 95% CI 1.23-1.72; p < 0.01) compared with WBI with no difference in OS (HR 0.98; 95% CI 0.84-1.14; p = 0.81) or DDFS (HR 0.91; 95% CI 0.76-1.09; p = 0.31). CONCLUSION: For patients with early-stage breast cancer following breast-conserving surgery, PBI demonstrated no difference in IBTR as compared to WBI while IORT was inferior to WBI with respect to IBTR.
Assuntos
Braquiterapia , Neoplasias da Mama , Neoplasias Mamárias Animais , Humanos , Animais , Feminino , Neoplasias da Mama/radioterapia , Neoplasias da Mama/cirurgia , Braquiterapia/métodos , Recidiva Local de Neoplasia/patologia , Mama/patologia , Intervalo Livre de Doença , Mastectomia Segmentar , Neoplasias Mamárias Animais/cirurgiaRESUMO
Gelatinases (MMP-2 and MMP-9) are related to tumor invasion and metastasis. In humans, the diagnostic value of serum levels of gelatinases has been confirmed in breast cancer, but their diagnostic value in canine mammary tumors is still unknown. This study aimed to determine the serum level of gelatinases in dogs with mammary tumors in order to determine their value in the diagnosis of malignancy or benign tumors and also in predicting the possibility of metastasis and recurrence. Frequent measurement of MMP-2 and MMP-9 by gelatin zymography in serum before and after surgical treatment has not previously been studied for monitoring mammary tumors in dogs. Thus, the serum levels of MMP-2 and MMP-9 in 26 dogs with mammary tumors before surgical treatment and then 1, 4 and 12 months after surgery were evaluated by gelatin zymography. Serum samples of 26 healthy dogs with normal conditions were used as control. Dogs with benign and malignant mammary tumors showed bands of pro-MMP-2, pro-MMP-9 and active MMP-9. However, only pro-MMP-2 and pro-MMP-9 bands appeared in the serum of control group. Our results showed that the presence of active MMP-9, regardless of its level, was prognostically important for metastasis and or recurrence (M/R). However, the presence of active MMP-2 band was more important for M/R than active MMP-9, as its presence coincides with definitive M/R. It seems that serum gelatin zymography could possibly be used at regular intervals before and after surgery to evaluate the probability of M/R in dogs with mammary tumors. More research is needed in this regard.
Assuntos
Doenças do Cão , Neoplasias Mamárias Animais , Humanos , Cães , Animais , Metaloproteinase 2 da Matriz , Metaloproteinase 9 da Matriz , Estudos Longitudinais , Gelatina , Prognóstico , Neoplasias Mamárias Animais/diagnóstico , Neoplasias Mamárias Animais/cirurgia , Doenças do Cão/diagnósticoRESUMO
PURPOSE: Multifocal or multicentric (MFMC) breast cancer is mainly focused on breast cancer patients with unknown BRCA status, the incidence and clinical relevance of MFMC disease in BRCA1/2 carriers is less explored to date. Our study was to investigate the incidence of MFMC disease in BRCA1/2 carriers and whether MFMC disease influences local recurrence and clinical outcomes. METHODS: In this retrospective study, 479 breast cancer patients with BRCA1/2 variants and 1437 age-matched noncarriers were enrolled and patients received either breast-conserving therapy (BCT) or mastectomy with or without radiotherapy. RESULTS: The rates of MFMC disease in BRCA1 and BRCA2 carriers, and noncarriers were 33.0% (61 of 185), 37.4% (110 of 294), and 31.2% (449 of 1437), respectively. MFMC disease in BRCA2 carriers was significantly higher than that in noncarriers (P = 0.039). After a median follow-up of 8.1 years, among patients treated with BCT, BRCA2 carriers with MFMC disease experienced a significantly higher rate of ipsilateral breast tumor recurrence (IBTR) than those with unifocal disease (16.7% vs 4.1%, P = 0.044). Moreover, BRCA2 carriers with MFMC disease had a significantly worse RFS (unadjusted hazard ratio [HR], 3.65 [95% CI 1.40-9.52]; P = 0.008), DRFS (unadjusted HR, 3.07 [95% CI 1.07-8.80]; P = 0.037), and OS (unadjusted HR, 4.96 [95% CI 1.18-20.02]; P = 0.029) than those with unifocal disease when treated with BCT. CONCLUSION: MFMC breast cancer is more common in BRCA2 carriers, and BRCA2 carriers with MFMC disease treated with BCT exhibit a higher rate of IBTR and may have a poor survival.
Assuntos
Neoplasias da Mama , Neoplasias Mamárias Animais , Humanos , Animais , Feminino , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/genética , Neoplasias da Mama/tratamento farmacológico , Proteína BRCA1/genética , Mastectomia , Estudos Retrospectivos , Proteína BRCA2/genética , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/genética , Recidiva Local de Neoplasia/cirurgia , Neoplasias Mamárias Animais/cirurgia , MutaçãoRESUMO
A 16-year-old intact female Miniature Dachshund (dog 1) and a 13-year-old intact female American Cocker Spaniel (dog 2) presented with a chief complaint of bleeding from a mammary gland tumour ulceration. Dog 1 was transferred to hospital from a local hospital in a haemorrhagic shock state with uncontrolled continuous bleeding. Thoracic radiographs revealed multiple nodular shadows suspected to be pulmonary metastasis. Dog 2 presented with intermittent bleeding from a mass lesion in the right fifth mammary gland. Due to high anaesthetic risk secondary to severe mitral valve insufficiency (ASA status III), the owner declined surgical excision of the tumour. Therefore, microwave ablation (MWA) under local anaesthesia was chosen in order to achieve adequate haemostasis. Both dogs received local anaesthesia around the bleeding mass lesion, and the disintegrated site was microwave-ablated; dog 1 underwent MWA after blood transfusion to improve the haemorrhagic shock. The ablation site was protected using a non-adhesive dressing. Scarring of the ulcerated site led to complete haemostasis in both cases. Dog 1 underwent tumorectomy on the 31st hospital day to prevent rebleeding; histopathology results were consistent with mammary adenocarcinoma with the ablation site covered by a capsule structure. To the authors' knowledge, this is the first case report describing the use of MWA to stop bleeding from mammary tumours in veterinary medicine. MWA is a feasible and potentially effective palliative treatment modality to stop bleeding from disintegrated mammary tumours in dogs under local anaesthesia.
Assuntos
Doenças do Cão , Neoplasias Pulmonares , Neoplasias Mamárias Animais , Ablação por Radiofrequência , Choque Hemorrágico , Cães , Feminino , Animais , Choque Hemorrágico/veterinária , Micro-Ondas/uso terapêutico , Ablação por Radiofrequência/veterinária , Resultado do Tratamento , Neoplasias Pulmonares/veterinária , Neoplasias Mamárias Animais/cirurgia , Doenças do Cão/cirurgia , Doenças do Cão/patologiaRESUMO
We studied the relationship between the level of cytokines in the lymph of the thoracic duct and the morphometric parameters of the mesenteric lymph nodes after surgical treatment of breast cancer, chemotherapy, and administration of fragmented (double-stranded, dsDNA) human DNA. In comparison with surgical treatment and with chemotherapy alone, administration of a human dsDNA has a stimulating effect on the T-cell link of the immune response. In the paracortical zone, the relationship between the chemokine MCP-1 and increased content of small lymphocytes in this zone was revealed. Interrelations of IL-2 cytokines with small lymphocytes and of IL-4 with medium lymphocytes were revealed in germinal centers. We also observed interrelations of IL-7 with small lymphocytes and IL-4 with macrophages in the medullary cords, chemokine MIP-1α with immature and mature plasma cells (the number of these cells is reduced), and of MCP-1 with immunoblasts (the number of which is also reduced) in the medullary sinuses.
Assuntos
Adjuvantes Imunológicos , Neoplasias da Mama , Citocinas , DNA , Linfonodos , Neoplasias Mamárias Animais , Feminino , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/cirurgia , Neoplasias da Mama/terapia , Quimiocinas/metabolismo , Citocinas/metabolismo , DNA/administração & dosagem , Interleucina-4/metabolismo , Linfa/metabolismo , Linfonodos/metabolismo , Animais , Ratos , Ratos Wistar , Neoplasias Mamárias Animais/tratamento farmacológico , Neoplasias Mamárias Animais/cirurgia , Neoplasias Mamárias Animais/terapia , Adjuvantes Imunológicos/administração & dosagem , Linfócitos T/imunologiaRESUMO
OBJECTIVE: To investigate if anaesthesia for canine cancer mastectomy further influences host cell-mediated immunity (CMI) promoting cancer progression. STUDY DESIGN: A randomized, controlled, blinded clinical study. ANIMALS: A total of 20 bitches with malignant mammary tumours of clinical stage II or III undergoing the same type of mastectomy (regional mastectomy). METHODS: Dogs were randomly allocated to one of two anaesthetic groups (10 per group). The anaesthetic protocol of group A used minimally immunosuppressive drugs (tramadol, robenacoxib, propofol), whereas that of group B (control) used more immunosuppressive drugs (morphine, fentanyl, thiopental, isoflurane). For each animal, measurements of white blood cells (WBCs), neutrophils and lymphocytes, and flow cytometric assessment of T cells (CD3+), helper T cells (CD4+), cytotoxic T cells (CD8+) and CD5low+ T cells were performed prior to anaesthesia (day 0) and on days 3 and 10 postsurgery. Data were analysed using a General Linear Model for repeated measures and presented as mean ± standard deviation, p ≤ 0.05. RESULTS: In all animals, on day 3, WBCs and neutrophils were significantly increased (p < 0.0005), while flow cytometry revealed significantly decreased relative percentages of T cells (CD3+) (p = 0.003) and their subpopulations CD4+ (p = 0.006), CD8+ (p = 0.029) and CD5low+ (p = 0.031). Specifically, on day 3, the cytotoxic T cells (CD8+) were significantly decreased (p = 0.05) only in group B, whereas the CD4+ (p = 0.006) and CD5low+ (p = 0.008) T cells in group A. The only significant difference between groups was found preoperatively in the CD4+/CD8+ ratio, which was higher in group A (p = 0.006). CONCLUSIONS AND CLINICAL RELEVANCE: In dogs with mammary cancer undergoing regional mastectomy, a significant decrease in components of CMI was observed on day 3 postsurgery in both anaesthetic groups. Some indication, however, for better preserved cellular immunity by less immunosuppressive anaesthetic/analgesic drugs was detected, rendering their use advisable.
Assuntos
Anestesia , Doenças do Cão , Neoplasias Mamárias Animais , Tramadol , Anestesia/veterinária , Animais , Doenças do Cão/cirurgia , Cães , Imunidade Celular , Neoplasias Mamárias Animais/cirurgia , Mastectomia/veterináriaRESUMO
The aim of the study: We compare the effectiveness of multimodal optical coherence tomography (MM OCT) in the traditional structural OCT mode and the OCT elastography (OCE) mode in addressing two clinically important tasks: (1) detecting groups of tumor cells at surgical margins during breast-Ñonserving surgery (BСS) in breast cancer (BC) and (2) identifying breast tumor margins. The obtained results were correlated with corresponding histological sections. Materials and Methods: The study was performed on 100 surgical margin samples (top, bottom, medial, and lateral - four samples from each patient in total) obtained from 25 patients with BC who underwent BCS (lumpectomy), and on 25 postoperative tumor samples (to determine tumor margins). With MM OCT method, we visually and numerically assessed the scattering (level and depth of OCT signal penetration) and elastic (stiffness values, or Young's modulus (kPa)) properties of the tumor and non-tumor breast tissue and the obtained values were compared with the results of postoperative histological examination. Results: In 4 surgical margin samples (out of 100), with the OCE method we identified groups of histologically confirmed tumor cells ("positive" resection margins) at the distance of about 5 mm from the visible tumor margin. The identified zones were larger than 0.5 mm with stiffness of more than 400 kPa in all these cases. However, the structural OCT could not identify these groups of tumors and they were not distinguishable from the surrounding fibrous tissue.In the areas of tumor into non-tumor tissue transition, structural OCT images detected tumor margins only if they were adjacent to adipose tissue and did not detect them if there were adjacent to non-tumor fibrous tissue. OCE images with high stiffness values (more than 400 kPa) and high contrast showed a clear tumor margin with both adipose and fibrous tissue. Conclusion: The study demonstarets the potential of MM OCT, particularly its OCE mode, as a real-time method for intraoperative tumor margin and surgical margin assessment in BCS. OCE images compared to structural OCT images visualize higher contrast between different types of breast tissue (adipose tissue, fibrous stroma, hyalinized stroma, tumor cell clusters), as well as more accurate identification of the tumor border and detection of small groups of tumor cells at surgical margins. An algorithm for intraoperative MM OCT examination of the state of the resection margin is proposed in accordance with standard clinical guidelines for achieving clean surgical margins in breast cancer patients.
Assuntos
Neoplasias da Mama , Neoplasias Mamárias Animais , Animais , Humanos , Feminino , Mastectomia Segmentar/métodos , Margens de Excisão , Tomografia de Coerência Óptica/métodos , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/cirurgia , Neoplasias da Mama/patologia , Mama/patologia , Neoplasias Mamárias Animais/cirurgiaRESUMO
The aim of the present study was to retrospectively assess whether spaying at the same time of mastectomy increased disease-free survival (DFS) in bitches with mammary tumours and to investigate the utility of clinical data when designing a surgical plan that includes gonadectomy. Characteristics of 225 bitches carrying 489 tumours were retrieved. Of the116 bitches that underwent surgery, 52 bitches underwent mastectomy and ovariectomy, 46 bitches underwent mastectomy alone, whereas 18 bitches were already spayed. Analysis by Kaplan-Meier and in-between groups comparisons using Student's T, Chi-square, and one-way ANOVA tests were performed. DFS was longer for bitches that underwent ovariectomy and mastectomy compared to those that were left intact (p = .00064) or were already spayed (p = .0098). Spaying status affected tumour size (spayed: 2.75 cm ± 2.72; intact: 1.76 cm ± 2.04; p = .039), but not malignancy (p > .05). Differences in age were detected between animals with benign and malignant tumours (years: 9.1 ± 2.8 and 10 ± 2.3; p = .004), with multiple and single tumours (years: 10.18 ± 2.6 and 9.3 ± 2.8; p = .007), and between purebred and mixed breed bitches (years: 10.46 ±1.78 and 9.27 ±2.68; p = .005). Malignant tumours were larger than benign ones (2.17 cm±2.31 and 1.34 cm ±1.82; p = .005) and size increased according to the degree of malignancy. DFS was shorter for animals presenting tumours >2 cm in size (p < .006) and with tumours in the first pair of thoracic mammary glands (p = .00009). Gonadectomy should be suggested to owners of intact bitches carrying mammary tumours and age, size of the tumour, and location should be carefully considered when performing surgery.
Assuntos
Doenças do Cão , Neoplasias Mamárias Animais , Animais , Doenças do Cão/cirurgia , Cães , Feminino , Neoplasias Mamárias Animais/patologia , Neoplasias Mamárias Animais/cirurgia , Mastectomia/veterinária , Estudos Retrospectivos , Análise de SobrevidaRESUMO
The aim of this study was to evaluate renal hemodynamics, routine clinical and laboratory parameters used to estimate renal function, and clinical evolution during six months in bitches with mammary carcinomas that underwent mastectomy and were treated (TG) or not (CG) with carprofen for three months after surgery. Twenty-six bitches with mammary carcinoma were equally distributed into TG that received carprofen 4.4 mg/kg/day for 90 days and CG that did not receive anti-inflammatory medication. Renal artery Doppler flowmetry, contrast-enhanced ultrasound (CEUS) of renal parenchyma, haematological, biochemical and clinical analyses were obtained once a month. These data were compared between groups and time via analysis of variance (ANOVA) in a completely randomized design with repeated measures (P < 0.05). On B-mode ultrasound, the area of the renal artery was greater (P = 0.0003) in the TG. Regarding laboratory findings, haematocrit and haemoglobin were similar in both groups, showing a significant and gradual increase after three months of treatment; MCV, MHC, and MCHC were increased (P < 0.05) and lymphocyte and band counts decreased (P < 0.05) in the TG. Regarding biochemical tests, ALT was the only parameter with a significant difference, being higher (P = 0.0272) in the treated group. It can be concluded that the use of carprofen for 90 days causes minimal changes in renal perfusion, erythrocyte parameters and ALT activity, and reduces the proportion of blood inflammatory cells. Therefore, use of this medication can be carried out safely in patients who require auxiliary cancer treatment.
Assuntos
Carbazóis/administração & dosagem , Carbazóis/efeitos adversos , Carcinoma/tratamento farmacológico , Doenças do Cão/tratamento farmacológico , Rim/irrigação sanguínea , Rim/diagnóstico por imagem , Neoplasias Mamárias Animais/tratamento farmacológico , Circulação Renal/efeitos dos fármacos , Ultrassonografia Doppler , Animais , Carcinoma/fisiopatologia , Carcinoma/cirurgia , Doenças do Cão/fisiopatologia , Doenças do Cão/cirurgia , Cães , Feminino , Glândulas Mamárias Animais/cirurgia , Neoplasias Mamárias Animais/fisiopatologia , Neoplasias Mamárias Animais/cirurgia , Fatores de TempoRESUMO
OBJECTIVE: To evaluate complication rates for various types of mastectomy procedures, identify factors associated with an increased risk of complications, and determine the consequences of such complications. ANIMALS: 140 female dogs that underwent 154 separate mastectomy procedures to treat mammary gland tumors. PROCEDURES: Medical records of dogs in the Penn Vet Shelter Canine Mammary Tumor Program from July 2009 to March 2015 were reviewed. Data regarding signalment, tumor characteristics (ie, number and size, benign or malignant, and bilateral or unilateral), mastectomy type, anesthesia time, concurrent ovariohysterectomy or ovariectomy, surgeons' qualifications, antimicrobial administration after surgery, postoperative placement of surgical drains, and complications (seroma, abscess, dehiscence, or infection) were collected. Complications that required hospitalization were recorded. Fisher exact tests were used to evaluate associations between variables of interest and complications. Multivariable analysis was used to identify factors independently associated with an increased risk of complications. RESULTS: Complication rate following all mastectomy procedures was 16.9% (26/154); of these, 9 (34.6%) required hospitalization. High body weight, undergoing bilateral mastectomy, and postoperative antimicrobial administration were associated with significantly increased odds of complications. The odds of complications associated with postoperative antimicrobial administration, however, varied according to mastectomy type; dogs undergoing chain mastectomy that did not receive antimicrobials postoperatively had the highest odds of developing complications. Dogs undergoing concurrent ovariohysterectomy or ovariectomy had significantly decreased odds of complications. CONCLUSIONS AND CLINICAL RELEVANCE: Previously spayed dogs with a large body size that underwent the most extensive mastectomy procedures had increased odds of having postoperative complications.
Assuntos
Doenças do Cão , Neoplasias Mamárias Animais , Animais , Doenças do Cão/etiologia , Doenças do Cão/cirurgia , Cães , Feminino , Histerectomia/veterinária , Neoplasias Mamárias Animais/cirurgia , Mastectomia/veterinária , Ovariectomia/efeitos adversos , Ovariectomia/veterinária , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/veterinária , Estudos RetrospectivosRESUMO
This study aims to evaluate the efficacy and side effects of low dose cyclophosphamide chemotherapy plus meloxicam as an adjuvant treatment, compared with high dose doxorubicin or surgery alone in cats with mammary carcinoma. Medical records of 228 female cats treated for mammary carcinoma between 2008 and 2018, were reviewed in eight veterinary institutions. Only cats with complete tumour staging and radical mastectomy were included in the study. One hundred and thirty-seven cats were divided into three treatment groups: group 1 (n = 80) cats treated with surgery, group 2 (n = 34) cats that had surgery and adjuvant treatment with doxorubicin, and group 3 (n = 23) cats with surgery and adjuvant treatment with low dose metronomic cyclophosphamide and meloxicam. The study endpoints were disease free interval (DFI) and overall survival (OS). Toxicity was evaluated according to the VCOG-CTCAE criteria. The median DFI was 270, 226 and 372 days in groups 1, 2 and 3, respectively. The median OS was 338 (group 1), 421 (group 2) and 430 (group 3) days. The differences between groups were not significant (DFI P = .280 and OS P = .186). Toxicity was observed in 52.9% (n = 18) of cats in group 2 and 39.1% (n = 9) of cats in group 3, with mild to moderate intensity. Differences were not significant (P = .306). In conclusion, adjuvant chemotherapy treatment did not improve survival and the overall benefit remains unproven. Randomized prospective trials are necessary to clarify the effectiveness of adjuvant chemotherapy treatment for feline mammary carcinomas.
Assuntos
Carcinoma , Doenças do Gato , Ciclofosfamida/administração & dosagem , Doxorrubicina/administração & dosagem , Neoplasias Mamárias Animais , Meloxicam/administração & dosagem , Adjuvantes Imunológicos , Animais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma/tratamento farmacológico , Carcinoma/cirurgia , Carcinoma/veterinária , Doenças do Gato/tratamento farmacológico , Doenças do Gato/cirurgia , Gatos , Quimioterapia Adjuvante/veterinária , Feminino , Neoplasias Mamárias Animais/tratamento farmacológico , Neoplasias Mamárias Animais/cirurgia , Mastectomia/veterinária , Estudos Retrospectivos , Taxa de SobrevidaRESUMO
OBJECTIVES: The aim of this study was to evaluate the effectiveness of ovariohysterectomy (OVH) on feline mammary fibroepithelial hyperplasia (FMFH) treatment, as well as the influence of previous injectable progestin on clinical signs and treatment of FMFH. METHODS: Seventy-nine female cats diagnosed with FMFH between 2014 and 2018 were included. The animals were distributed as follows: (1) treated only with OVH (TA) or OVH plus antiprogestin (TB); and (2) no administration (G1) or previous administration (G2) of injectable progestin before FMFH diagnosis. Data regarding clinical signs of FMFH, occurrence of persistent mammary growth after OVH, and time until complete remission of FMFH post-surgery were recorded and evaluated. RESULTS: Mastectomy was not performed in any cat during the study. TA was adopted in 71/79 (89.9%) cases, with 42/71 (59.2%) from G2 and 29/71 (40.8%) from G1. TB was adopted in 8/79 (10.1%) cats, all from G2. Total remission of FMFH was observed in 73/79 (92.4%) cats, with six animals from G2 having died (n = 6/79 [7.6%]). The time until complete remission of FMFH was higher (P <0.0001) in cats from G2 than from G1. Moreover, animals from G2 had a higher percentage of persistent mammary growth after OVH (P <0.001) and a tendency to higher mortality (P = 0.052) compared with G1. CONCLUSIONS AND RELEVANCE: Previous treatment with injectable progestin may result in a more complex clinical presentation of FMFH. Ovariohysterectomy is a good treatment option for FMFH when there is no interest in breeding the queen. Treatment with antiprogestin is recommended, especially if persistent mammary growth is detected after OVH.
Assuntos
Doenças do Gato , Neoplasias Mamárias Animais , Animais , Doenças do Gato/tratamento farmacológico , Doenças do Gato/cirurgia , Gatos , Feminino , Hiperplasia/veterinária , Histerectomia/veterinária , Neoplasias Mamárias Animais/tratamento farmacológico , Neoplasias Mamárias Animais/cirurgia , Ovariectomia/veterinária , ProgestinasRESUMO
Perioperative administration of desmopressin has shown to significantly decrease rates of local recurrence and metastasis, and increase survival times in dogs with grade II and III mammary carcinomas. The objective of this study was to compare the oncologic outcome of cats with mammary carcinoma treated with bilateral mastectomy with or without perioperative administration of desmopressin. Medical records from nine veterinary institutions were searched to identify cats diagnosed with mammary carcinoma treated with bilateral mastectomy. Sixty cats treated with single-session or staged bilateral mastectomy were included. There were no significant differences in oncologic outcomes found between cats treated and not treated with desmopressin. No adverse effects were seen in any of the cats treated with perioperative desmopressin. Postoperative complications occurred in 18 cats (38.3%) treated with single-session bilateral mastectomy and in three cats (23.1%) treated with staged bilateral mastectomy (P = .48). Histologic grade and a modification of a proposed five-stage histologic staging system were both prognostic for disease-free interval. Incomplete histologic excision was associated with significantly increased rates of metastasis and tumour progression, and a shorter median survival time (MST). Cats that developed local recurrence also had a significantly shorter MST. The results of this study do not support the use of perioperative desmopressin to improve outcome when performing bilateral mastectomy for the treatment of mammary carcinoma in cats.
Assuntos
Carcinoma , Doenças do Gato , Desamino Arginina Vasopressina , Neoplasias Mamárias Animais , Animais , Carcinoma/tratamento farmacológico , Carcinoma/cirurgia , Carcinoma/veterinária , Doenças do Gato/tratamento farmacológico , Doenças do Gato/cirurgia , Gatos , Desamino Arginina Vasopressina/administração & dosagem , Desamino Arginina Vasopressina/uso terapêutico , Feminino , Neoplasias Mamárias Animais/tratamento farmacológico , Neoplasias Mamárias Animais/cirurgia , Mastectomia/veterinária , Assistência PerioperatóriaRESUMO
Optical coherence tomography (OCT) uses near-infrared light waves to generate real-time, high-resolution images on the microscopic scale similar to low power histopathology. Previous studies have demonstrated the use of OCT for real-time surgical margin assessment for human breast cancer. The use of OCT for canine mammary tumours (CMT) could allow intra-operative visualisation of residual tumour at the surgical margins. The purpose of this study was to assess OCT imaging for the detection of incomplete tumour resection following CMT surgery. We hypothesized that the OCT images would have comparable features to histopathological images of tissues at the surgical margins of CMT resections along with a high sensitivity of OCT detection of incomplete surgical excision of CMT. Thirty surgical specimens were obtained from nineteen client-owned dogs undergoing surgical resection of CMT. OCT image appearance and characteristics of adipose tissue, skin, mammary tissue and mammary tumour at the surgical margins were distinct and different. The OCT images of normal and abnormal tissues at the surgical margins were utilized to develop a dataset of OCT images for observer evaluation. The sensitivity and specificity for ex vivo images were 83.3% and 82.0% (observer 1) and 70.0% and 67.9% (observer 2). The sensitivity and specificity for in vivo images were 70.0% and 89.3% (observer 1) and 76.7% and 67.9% (observer 2). These results indicate a potential use of OCT for surgical margin assessment for CMT to optimize surgical intervention and clinical outcomes. Improved training and experience of observers may improve sensitivity and specificity.
Assuntos
Doenças do Cão , Neoplasias Mamárias Animais , Margens de Excisão , Tomografia de Coerência Óptica , Animais , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/cirurgia , Cães , Feminino , Neoplasias Mamárias Animais/diagnóstico por imagem , Neoplasias Mamárias Animais/cirurgia , Sensibilidade e Especificidade , Tomografia de Coerência Óptica/veterináriaRESUMO
Surgical resection of tumours requires precisely locating and defining the margins between lesions and normal tissue. However, this is made difficult by irregular margin borders. Although molecularly targeted optical contrast agents can be used to define tumour margins during surgery in real time, the selectivity of the contrast agents is often limited by the target being expressed in both healthy and tumour tissues. Here, we show that AND-gate optical imaging probes that require the processing of two substrates by multiple tumour-specific enzymes produce a fluorescent signal with significantly improved specificity and sensitivity to tumour tissue. We evaluated the performance of the probes in mouse models of mammary tumours and of metastatic lung cancer, as well as during fluorescence-guided robotic surgery. Imaging probes that rely on multivariate activation to selectively target complex patterns of enzymatic activity should be useful in disease detection, treatment and monitoring.