Surveillance for Distant Metastasis in Breast Cancer Patients Who Underwent Contemporary Management: A Report from the Korean Breast Cancer Society Survivor Research Group.

BACKGROUND: Current guidelines recommend against the use of routine imaging tests to detect distant metastasis in asymptomatic breast cancer patients. However, recent advancements in effective therapeutics and diagnostic accuracy have raised the need to reassess the clinical efficacy of intensive metastasis surveillance. We report the results of a multicenter retrospective study to investigate the association between intensive imaging studies and survival outcomes. PATIENTS AND METHODS: We retrospectively reviewed the data of 4130 patients who underwent surgery from 11 hospitals in Korea between January 2010 and December 2011. Patients were divided into two groups on the basis of the intensity of metastasis imaging studies during their disease-free period. The types and intervals of the imaging studies were based on each physician's decisions. RESULTS: High-intensive screening showed a shorter distant metastasis-free survival [p < 0.001, hazard ratio (HR) 1.62; 95% confidence interval (CI) 1.29-2.04], especially for patients in whom bone or lung was the first site of metastasis. With a median follow-up period of 110.0 months, the 5-year breast cancer-specific survival (BCSS) rate was 96.5%. The high-intensity screening group showed significantly poorer BCSS compared with the low-intensity screening group (p < 0.001, HR 3.13; 95% CI 2.32-4.21). However, both multivariable analysis and propensity score matching analysis showed no significant association between the screening intensity and BCSS. CONCLUSIONS: Frequent imaging studies to detect distant metastasis were associated with earlier detection of distant metastasis, especially for lung and bone metastasis. However, intensive surveillance showed no apparent association with BCSS despite the use of currently available treatments.

Non-brachycephalic dogs with stertor have higher nasopharyngeal collapsibility compared with dogs without stertor and foramen lacerum level is ideal for evaluating nasopharyngeal collapse on dynamic CT.

Stertor, a clinical sign associated with obstructive airway syndrome, is often observed in non-brachycephalic dogs. This prospective, case-control study aimed to compare soft palate dimensions, nasopharyngeal cross-sectional area (CSA), and nasopharyngeal collapsibility at various locations in non-brachycephalic dogs with and without stertor. A total of 50 dogs were recruited and stratified into control (n = 34) and stertor (n = 13) groups. Static and dynamic computed tomography was conducted without tracheal intubation, and the following variables were calculated: normalized soft palate length and thickness, normalized maximum and minimum nasopharyngeal CSAs (rCSAmax and rCSAmin), and nasopharyngeal collapsibility at the level of the cranial end of the soft palate, pterygoid hamulus, foramen lacerum, bony labyrinth, and caudal end of the soft palate. The stertor group demonstrated significantly lower rCSAmax and rCSAmin, as well as higher nasopharyngeal collapsibility compared with the control group, while no significant differences were noted in the soft palate dimension. Evaluating nasopharyngeal collapse at the foramen lacerum level was recommended due to the clear presence of identifiable bony landmarks and lower overlap in the nasopharyngeal collapsibility between dogs with and without stertor. Physical dimensions of the soft palate may not be the primary contributing factor to nasopharyngeal collapse and clinical signs in non-brachycephalic dogs.

Deep learning-based reconstruction for canine brain magnetic resonance imaging could improve image quality while reducing scan time.

Optimal magnetic resonance imaging (MRI) quality and shorter scan time are challenging to achieve in veterinary practices. Recently, deep learning-based reconstruction (DLR) has been proposed for ideal image quality. We hypothesized that DLR-based MRI will improve brain imaging quality and reduce scan time. This prospective, methods comparison study compared the MR image denoising performances of DLR and conventional methods, with the aim of reducing scan time and improving canine brain image quality. Transverse T2-weighted and fluid-attenuated inversion recovery (FLAIR) sequences of the brain were performed in 12 clinically healthy beagle dogs. Different numbers of excitations (NEX) were used to obtain the image groups NEX4, NEX2, and NEX1. DLR was applied to NEX2 and NEX1 to obtain NEX2DL and NEX1DL . The scan times were recorded, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated for quantitative analysis. Five blinded veterinarians assessed the overall quality, contrast, and perceived SNR on four-point Likert scales. Quantitative and qualitative values were compared among the five groups. Compared with NEX4, NEX2 and NEX1 reduced scan time by 50% and 75%, respectively. The mean SNR and CNR of NEX2DL and NEX1DL were significantly superior to those of NEX4, NEX2, and NEX1 (P < 0.05). In all image quality indices, DLR-applied images for both T2-weighted and FLAIR images were significantly higher than NEX4 and NEX2DL had significantly better quality than NEX1DL for FLAIR (P < 0.05). Findings indicated that DLR reduced scan time and improved image quality compared with conventional MRI images in a sample of clinically healthy beagles.

Increased radiographic opacity in the region of the gallbladder can be identified in dogs with large amounts of gallbladder sediment, sludge balls, and gallbladder mucocele.

Increased soft-tissue opacity in the region of the canine gallbladder is incidentally detected on radiographs. We hypothesized that there is a difference in the detection of gallbladder sediment on radiographs depending on the amount or mobility of the sediment. In this retrospective and analytical study, we aimed to assess the ultrasonographic features of gallbladder sediment that were detected radiographically. We also aimed to assess the differences in the detection of increased opacity of the gallbladder between radiographic views. We included 223 dogs that underwent thoracic radiography, abdominal radiography, and gallbladder ultrasonography. Ultrasonographic images of the gallbladder were divided into five groups: group 1, gravity-dependent sediment occupying < 50% of the gallbladder; group 2, gravity-dependent sediment occupying ≥50%; group 3, sediment attached to the gallbladder wall; group 4, sludge ball; and group 5, gallbladder mucocele. Dogs showing increased opacity on subjective assessment of any radiographic view were recorded, and the sensitivity of radiographic views for detecting gallbladder sediment was analyzed. Of 168 dogs with gallbladder sediment, 37 had increased opacity on at least one radiographic projection. The frequency was compared as a percentage within each category, and Group 4 was the highest percentage with increased radiographic gallbladder opacity, followed by Groups 2 and 5. The sensitivity for detecting increased opacity was highest in the thoracic ventrodorsal view. Thus, in dogs with increased gallbladder opacity on radiographs, large amounts of gallbladder sediment, sludge balls, and gallbladder mucocele should be considered differential diagnoses. In addition, the thoracic ventrodorsal view is recommended to evaluate gallbladder opacity.

Evaluation of safety and anti-obesity effects of DWP16001 in naturally obese dogs.

BACKGROUND: The aim of this study was to investigate the anti-obesity effects of DWP16001, a sodium-glucose cotransporter-2 (SGLT2 inhibitor), in naturally obese dogs. A total of 20 dogs were divided into four equal groups: one obese control (OC group), and three treated groups; DWP0.2 group, DWP0.5 group, and DWP1 group. OC group fed with food for maintenance and treated groups were fed with food for maintenance with 0.2 mg/kg DWP16001, 0.5 mg/kg DWP16001 and 1 mg/kg DWP16001, respectively. The food for maintenance was provided to dogs as 2 RER (Resting energy requirement) in kcal and DWP16001-supplemented food was administered once a day for 8 weeks. RESULTS: Body condition score, body weight, and fat thickness were significantly reduced (P < 0.05) in the DWP0.2 group compared with the OC group, respectively without affecting the food consumption. At the 10th week the food consumption rate was 101.35 ± 2.56, 166.59 ± 4.72, 98.47 ± 1.44 and 123.15 ± 2.45% compared with initial food consumption rate. Body fat percentage, chest and waist circumference, blood glucose, and insulin were reduced compared to OC group but not significantly different from those of the OC group during experimental period. Serum alanine aminotransferase, alkaline phosphatase, creatine phosphokinase, and creatinine were significantly reduced in DWP0.2 group on 8 weeks. Serum cholesterol and triglycerides were reduced but not significantly. No specific adverse effects were observed throughout the experiment, and hematological parameters were unchanged. The results indicate that DWP16001 was not harmful to the dogs in our study and might have anti-obesity effects in naturally obese dogs. CONCLUSIONS: The above results and discussion suggest that DWP16001 is safe and might have anti-obesity effects in naturally obese dogs.

Nasopharyngeal collapse can be identified on radiography in healthy male Beagle dogs without cardiopulmonary diseases.

Pharyngeal collapse has been described as a decrease of more than 50% in the diameter of the lumen. However, there has been no study on changes in the pharyngeal lumen in clinically normal dogs. The hypothesis of this prospective, observational, and pilot study was that change in nasopharyngeal lumen would be over 50% in Beagle dogs without cardiopulmonary diseases. Thus, we assessed the nasopharyngeal luminal change using cervical radiography in Beagle dogs without respiratory signs or cardiac abnormalities. The study sample included 42 Beagle dogs without cardiopulmonary diseases. Cervical radiographies were acquired during inspiration and expiration, and nasopharyngeal luminal change (%) was calculated. The median nasopharyngeal luminal change was 16.6%, and nasopharyngeal luminal change over 50% was identified in two dogs. The nasopharyngeal luminal change was significantly associated with body condition score and body weight. There was no correlation between nasopharyngeal luminal change and age. This study revealed that change in nasopharyngeal lumen over 50% can be identified in Beagle dogs without cardiopulmonary diseases and may be over-diagnosed as partial pharyngeal collapse. Further studies for comparing change in nasopharyngeal lumen between clinically normal dogs and dogs with respiratory signs are warranted.

Pancreatic adenocarcinoma with atypical imaging features mimicking chronic pancreatitis in a dog.

An 11-year-old intact female Pomeranian dog was referred for jaundice, anorexia, and vomiting. The blood analysis revealed increased alanine aminotransferase, alkaline phosphatase, and gamma-glutamyl transpeptidase. The serum canine pancreatic lipase immunoreactivity was within the normal reference range. The radiography revealed no significant findings. On ultrasound, the gallbladder was enlarged with a markedly distended common bile duct (CBD) measuring up to 6 mm in diameter. The pancreas had an irregular contour, a hypoechoic peripheral rim, multiple hyperechoic foci with acoustic shadowing, and showed increased echogenicity of the adjacent mesentery. Based on these results, an extrahepatic biliary obstruction secondary to the presumed chronic pancreatitis was diagnosed. The computed tomography (CT) images showed a hypoattenuating pancreatic parenchyma compared to the liver in the early phase, as well as multiple calcifications. A laparotomy was performed to reserve the patency of the CBD. The histopathological examination of the pancreas revealed exocrine pancreatic adenocarcinoma. While various appearances of exocrine pancreatic adenocarcinoma on CT have been reported in humans, CT features of pancreatic adenocarcinoma have not been well-established in dogs. The purpose of this report is to describe the atypical imaging features of pancreatic adenocarcinoma that are similar to those of chronic pancreatitis in a dog.

Changes of ultrasonographic pattern of the spleen examined with a high-frequency linear transducer during growth in puppies.

A normal spleen is a homogeneous, finely textured, and hyperechoic organ. The development of high-frequency transducers has enabled the examination of the structural features of the spleen. Thus, the spleen can appear mildly mottled, even in normal dogs, and this could be misinterpreted as an abnormality. The purpose of this prospective, longitudinal, descriptive study was to describe the ultrasonographic pattern of the splenic parenchyma using a high-frequency transducer in puppies. The study included nine, normal, client-owned puppies that were born healthy. Transabdominal ultrasonographic examination was performed from 4 to 60 weeks serially every 4 weeks. Ultrasonographic patterns of the spleen were graded as follows: granular, mild reticulonodular, moderate reticulonodular, and marked reticulonodular pattern. The examinations were performed by one veterinary clinician, and the grades of the ultrasonographic patterns were determined by two veterinary clinicians experienced in ultrasonography, based on consensus. Differences and associations between time and the grade of the splenic parenchyma were determined using the paired t-test and scatter plots. There was a strong quadratic relationship between time and the grade of the splenic parenchyma. It was found that the splenic parenchymal patterns changed with increasing age, with a granular appearance initially at 4 weeks, followed by a reticulonodular pattern with well-defined hypoechoic nodules-most marked between 28 and 36 weeks, after which this pattern decreased until there was a homogeneous granular pattern again at 60 weeks. These findings should not be misinterpreted as being indicative of a disease in normal puppies, particularly those aged between 28 and 36 weeks.

CT variants of the caudal vena cava in 121 small breed dogs.

Computed tomography is increasingly used as a treatment planning method in canine patients with diseases of the retroperitoneum, however, published information on normal variations in the caudal vena cava (CVC) are currently lacking. The objectives of this retrospective descriptive study were to characterize CVC variants using CT angiography in a sample of small breed dogs and localize the CVC bifurcations for each variant. Inclusion criteria were small breed dogs (weight ≤ 15) that underwent contrast-enhanced CT scans of the CVC, abdominal aorta, and CVC tributaries. A total of 121 small breed dogs were sampled. Four right-sided and one left-sided CVC variations were identified: normal (88/121, 72.7%), caudal-partial split (17/121, 14.0%), partial duplication (8/121, 6.6%), complete duplication (7/121, 5.8%), and left-sidedness (1/121, 0.8%). The mean lumbar vertebral levels of the CVC bifurcation were L6.39 ± 0.41, L5.70 ± 0.35, L4.39 ± 0.42, L2.74 ± 0.38, and L6.4 in the normal, caudal-partial split, partial duplication, complete duplication, and left-sidedness types, respectively. The location of the CVC bifurcation, the relationship between the aortic trifurcation and the CVC bifurcation, and the location of the bilateral deep circumflex iliac veins with respect to the CVC bifurcation were significantly different among the right-sided types (P ≤ .001). Bilateral deep circumflex iliac veins joined to the ipsilateral common iliac veins and the CVC in the caudal-partial split and duplication types, respectively. The results of this study indicated that canine CVC variants may be frequent and should be considered during surgery or diagnostic imaging of the retroperitoneum.

Evaluation of interthalamic adhesion size as an indicator of brain atrophy in dogs with and without cognitive dysfunction.

Interthalamic adhesion thickness has been previously described as a parameter for quantifying canine brain atrophy and hypothesized to correlate with brain height or ventricular size. However, studies testing this hypothesis are lacking. This retrospective cross-sectional study aimed to compare interthalamic adhesion thickness, interthalamic adhesion thickness/brain height ratio, and interthalamic adhesion thickness/brain height ratio/lateral ventricle to brain height ratio values in dogs with and without cognitive dysfunction. Medical records for dogs meeting the following inclusion criteria were retrieved from two hospitals: available brain magnetic resonance imaging (MRI) or computed tomography (CT) studies, no cerebral parenchymal lesions, and no prior neurological treatment. For each included dog, values of interthalamic adhesion thickness, interthalamic adhesion thickness/brain height ratio, and interthalamic adhesion thickness/brain height ratio/lateral ventricle to brain height ratio were measured by one observer from transverse CT or MRI images and a consensus was reached. A total of 113 dogs met inclusion criteria. Dogs were divided into three groups based on the following criteria: Young group (no cognitive dysfunction, <9-year-old, n = 43), Aging group (no cognitive dysfunction, ≥9-year-old, n = 61), and Dementia group (n = 9). All three parameters were significantly lower in the dementia group than in the Young and Aging groups. In the Young and Aging groups, there was significant negative correlation of all three parameters with age and positive correlation of interthalamic adhesion thickness and interthalamic adhesion thickness/brain height ratio/lateral ventricle to brain height ratio with body weight, while there was no correlation of interthalamic adhesion thickness/brain height ratio with body weight (P < 0.05). There were no differences in all three parameters according to skull type or gender. Findings from the current study supported the use of interthalamic adhesion thickness, interthalamic adhesion thickness/brain height ratio, and interthalamic adhesion thickness/brain height ratio/lateral ventricle to brain height ratio for quantifying brain atrophy in dogs with cognitive dysfunction.

Computed tomographic evaluation of portal vein indices in cats with the extrahepatic portosystemic shunts.

IMPORTANCE: The portal vein to aorta (PV/Ao) ratio is used to assess the clinical significance of extrahepatic portosystemic shunt (EHPSS). Previous studies using computed tomography (CT) were conducted in dogs but not in cats. OBJECTIVE: This study aimed to establish normal reference values for PV indices (PV/Ao ratio and PV diameter) in cats and determine the usefulness of these for predicting symptomatic EHPSS. METHODS: This study included 95 dogs and 114 cats that underwent abdominal CT. The canine normal (CN) group included dogs without EHPSS. The cats were classified into feline normal (FN, 88/114), feline asymptomatic (FA, 16/114), and feline symptomatic (FS, 10/114) groups. The PV and Ao diameters were measured in axial cross-sections. RESULTS: The group FN had a higher PV/Ao ratio than the group CN (p < 0.001). Within the feline groups, the PV indices were in the order FN > FA > FS (both p < 0.001). The mean PV diameter and PV/Ao ratio for group FN were 5.23 ± 0.77 mm and 1.46 ± 0.19, respectively. The cutoff values between groups FN and FS were 4.115 mm for PV diameter (sensitivity, 100%; specificity, 97.7%) and 1.170 for PV/Ao ratio (90%, 92.1%). The cutoff values between group FA and FS were 3.835 mm (90%, 93.8%) and 1.010 (70%, 100%), respectively. CONCLUSIONS AND RELEVANCE: The results demonstrated significant differences in PV indices between dogs and cats. In cats, the PV/Ao ratio demonstrated high diagnostic performance for symptomatic EHPSS. The PV diameter also performed well, in contrast to dogs.

Long-term prognostic value of the GenesWell BCT score in Asian women with hormone receptor-positive/HER2-negative early breast cancer.

BACKGROUND: Accurate prediction of the risk of recurrence is crucial for optimal treatment decisions in hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative early breast cancer. The GenesWell BCT is a molecular assay to predict the 10-year risk of distant metastasis. In this study, we evaluated the long-term prognostic value of the GenesWell BCT assay. METHODS: The BCT score was assessed in patients with HR-positive/HER2-negative early breast cancer who did not receive chemotherapy. We compared the 15-year distant metastasis-free survival (DMFS) between risk groups classified based on the BCT score. The risk of early (0-5 years) and late (5-15 years) recurrence was evaluated based on the BCT score classification. RESULTS: According to the BCT score, 366 patients from Japan and Korea were categorized as BCT low risk (83.6%) and high risk (16.4%) for distant metastasis. Median follow-up time was 17.4 years. The 15-year DMFS rate was significantly lower in the BCT high-risk group (63.3%) than in the BCT low-risk group (93.6%) (P < 0.001). The BCT risk group was an independent prognostic factor for 15-year DMFS (hazard ratio, 4.59; 95% confidence interval 2.13-9.88; P < 0.001). Furthermore, the BCT score was a significant predictor of late recurrence (5-15 years) in patients aged ≤ 50 years and those aged > 50 years, and added prognostic information to traditional clinical prognostic factors. CONCLUSION: The BCT score can identify patients at low risk for recurrence who may not require adjuvant chemotherapy or extended endocrine therapy, regardless of age.

Diagnostic yield of contrast-enhanced abdominal staging CT in patients with initially diagnosed breast cancer.

PURPOSE: To estimate the diagnostic yield (DY) of abdominal staging CT for detecting breast cancer liver metastasis (BCLM) in patients with initially diagnosed breast cancer and to determine the indications for abdominal staging CT. METHODS: Patients with newly diagnosed breast cancer who underwent abdominal CT as an initial staging work-up between January 2019 and December 2020 were retrospectively analyzed. DY was calculated and analyzed according to patient age, type of treatments, histologic type, histologic grade, lymphovascular invasion, Ki-67 status, hormone receptor status, subtype, and the American Joint Committee on Cancer anatomical staging. RESULTS: A total of 2056 patients (mean age, 51 ± 11 years) were included. The DY of abdominal staging CT for detecting BCLM was 1.1 % (22 of 2056). DY was significantly higher in stage III than in stage I or II cancers (3.9 % [18 of 467] vs. 0 % [0 of 412] or 0.4 % [4 of 1158], respectively, p < .001), and in human epidermal growth factor receptor-2 (HER2)-enriched cancers than in luminal or triple negative cancers (2.9 % [16 of 560] vs. 0.4 % [4 of 1090] or 0.5 % [2 of 406], respectively, p < .001). CONCLUSIONS: The DY of abdominal staging CT for detecting BCLM was low among all patients with initially diagnosed breast cancer. However, although abdominal staging CT for detecting BCLM is probably unnecessary in all patients, it can be clinically useful in patients with stage III or human epidermal growth factor receptor-2-enriched breast cancers.

Computed tomographic characteristics of normal salivary glands in dogs.

Background: Various salivary gland diseases diagnosed on computed tomography (CT) in dogs have been reported. However, no study described the size and CT attenuation value of normal salivary glands in dogs. Aim: This retrospective analytical study aimed to evaluate the size and attenuation value of the mandibular and zygomatic salivary glands on CT in dogs without cervical or head lesions. Methods: The maximum cross-sectional area (MCSA) was measured in 96 dogs and attenuation value on non-contrast and postcontrast images were measured in 90 dogs. Dogs were divided into three groups based on body weight: group 1, ≤ 5.0 kg; group 2, 5.1-10.0 kg; and group 3, 10.1-15.0 kg. Results: There were significant differences in MCSA for both glands among the three groups. There was no difference in MCSA between the left and right sides in both salivary glands. The MCSA for both salivary glands positively correlated with body weight (p < 0.001). There was a significant difference in the MCSA of the zygomatic gland between males and females (p = 0.02), but there was no significant difference in the mandibular gland. There was a significant difference in the attenuation value between the mandibular and zygomatic glands in non-contrast studies (p < 0.001), but there was no significant difference in postcontrast studies. Conclusion: This study established the reference for the size and attenuation value of the mandibular and zygomatic glands in dogs and provided background data for future CT evaluation of dogs with salivary gland diseases.

Echocardiographic diagnosis of aorto-left ventricular tunnel with supravalvular pulmonic stenosis in a Shih-tzu dog.

Background: The aorto-left ventricular tunnel (ALVT) is a congenital extracardiac channel that connects the ascending aorta to the left ventricle. Case Description: A 2-year-old Shih-tzu dog presented with mild exercise intolerance. Echocardiography revealed an abnormal slit-like tunnel structure connecting the ascending aorta to the left ventricle, with diastolic blood flow from the aorta to the left ventricle. Echogenic membranous stenosis was observed in the main pulmonary artery. Based on these findings, the dog was diagnosed with ALVT and type I supravalvular pulmonic stenosis. Conclusion: This is the first case report of ALVT in veterinary medicine that describes diagnostic imaging findings. ALVT should be considered in dogs with an aortic regurgitation murmur and can be detected by echocardiography.

Establishment of an image evaluation grading criteria for experimental stifle joint osteoarthritis in dogs: an X-ray and CT imaging study.

BACKGROUND: This study aimed to establish an image evaluation grading criteria for experimental stifle joint osteoarthritis (OA) in anterior cruciate ligament transection induced OA beagle dog models. The severity of OA was assessed using X-ray and computed tomography (CT) imaging. RESULTS: A total of 32 dogs (8 controls and 24 OA-induced dogs) were included in the study. The OA-induced group showed significantly higher manual joint palpation, gait analysis, and OA severity scores than the control group. Based on these two results, we calculated correlation coefficients. There was a strong positive correlation between manual joint palpation scores and OA severity on diagnostic imaging and between gait analysis scores and OA severity. CONCLUSIONS: The developed grading criteria based on radiographic evaluation correlated with clinical assessments. The study also employed CT imaging to enhance the accuracy and sensitivity of early-stage OA change detection in the stifle joint. However, further studies with larger sample sizes and multiple evaluators are recommended for the validation and generalizability of this grading system. These established image evaluation grading criteria can help evaluate and monitor the efficacy of interventions and changes in OA lesions in canine models.

Survey of clinicians on the use of adjuvant therapy for premenopausal women with breast cancer.

PURPOSE: Considering prognostic and anatomic stages in early-stage premenopausal patients with breast cancer, clinicians decide on performing the multigene assay, adjuvant chemotherapy, or ovarian function suppression (OFS). This decision is also based on genetic information related to hormone receptor-positive and human epidermal growth factor receptor 2 negative results. We aimed to determine the tendency to use adjuvant therapy in clinical practice. METHODS: From April to May 2022, clinicians of the Korean Breast Cancer Society responded to a web-based survey. The survey included 62 multiple-choice questions mainly on decision-making under different pathologic conditions. RESULTS: Among 92 responding clinicians, 91.3% were breast surgeons. For 35-year-old patients (pT2N0 and Ki-67 50% profile), 96.8% of clinicians selected chemotherapy, whereas 50.7% selected chemotherapy for patients with pT1N0, Ki-67 10%, and without Oncotype Dx (ODX). Only 35.6% selected chemotherapy for 47-year-old patients with the same profiles, while 84.3% and 49.1% chose chemotherapy with ODX recurrence score 21 and 16, respectively. More clinicians selected tamoxifen (TMX) plus OFS than aromatase inhibitor (AI) plus OFS for 5 years of endocrine therapy in patients with adjuvant chemotherapy regardless of genomic and clinical risks. However, for the same patients without adjuvant chemotherapy, more clinicians selected AI plus OFS. A longer duration of additional OFS and TMX was selected in patients with high clinical and genomic risks, and the duration of OFS was relatively shorter in older patients. CONCLUSION: The decision regarding adjuvant therapy should be made considering clinical and genomic risks and age, and clinicians should consult with patients about adverse effects and compliance.

Undifferentiated pleomorphic sarcoma (malignant fibrous histiocytoma) of the head in a dog.

A six year-old intact female miniature poodle was presented with a soft mass of the forehead region. Computed tomography identified generalized frontal bone loss and a large extracranial mass, which had a low attenuation area of hemorrhagic necrosis with septation and enhancement of solid components. In magnetic resonance imaging, the mass was isointense in T1-weighted images except its fluid parts and hyperintense in T2-weighted images with lobulated by low-signal septa. Surgery was performed to remove the mass, and histopathologic examination revealed that the mass was consistent with undifferentiated pleomorphic sarcoma (malignant fibrous histiocytoma). The dog died from the rapidly recurrent mass and severe pulmonary metastasis.

Evaluation of the effects of thiopental, propofol, and etomidate on glomerular filtration rate measured by the use of dynamic computed tomography in dogs.

OBJECTIVE: To evaluate the effects of thiopental, propofol, and etomidate on glomerular filtration rate (GFR) measured by the use of dynamic computed tomography in dogs. ANIMALS: 17 healthy Beagles. PROCEDURES: Dogs were randomly assigned to receive 2 mg of etomidate/kg (n = 5), 6 mg of propofol/kg (7), or 15 mg of thiopental/kg (5) during induction of anesthesia; anesthesia was subsequently maintained by isoflurane evaporated in 100% oxygen. A 1 mL/kg dosage of a 300 mg/mL solution of iohexol was administered at a rate of 3 mL/s during GFR measurement. Regions of interest of the right kidney were manually drawn to exclude vessels and fatty tissues and highlight the abdominal portion of the aorta. Iohexol clearance per unit volume of the kidney was calculated by use of Patlak plot analysis. RESULTS: Mean ± SD weight-adjusted GFR of the right kidney after induction of anesthesia with thiopental, propofol, and etomidate was 2.04 ± 0.36 mL/min/kg, 2.06 ± 0.29 mL/min/kg, and 2.14 ± 0.43 mL/min/kg, respectively. However, no significant differences in weight-adjusted GFR were detected among the treatment groups. CONCLUSIONS AND CLINICAL RELEVANCE: Results obtained for the measurement of GFR in anesthetized dogs after anesthetic induction with etomidate, propofol, or thiopental and maintenance with isoflurane did not differ significantly. Therefore, etomidate, propofol, or thiopental can be used in anesthesia-induction protocols that involve the use of isoflurane for maintenance of anesthesia without adversely affecting GFR measurements obtained by the use of dynamic computed tomography in dogs.

Multicystic dysplastic kidney disease in a dog.

A 1-year-old female mongrel dog was evaluated for anorexia and vomiting of 4 days duration. Abdominal ultrasonographic findings revealed small kidneys with multiple anechoic cysts. The dog was euthanized due to poor prognosis. A full necropsy was performed, and the histopathologic findings were consistent with multicystic dysplastic kidney disease.