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Publication
Rare And Uncommon Mammary Gland Tumors In Female Dogs
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Advisor(s)
Abstract(s)
Os tumores da glândula mamária constituem as neoplasias mais comuns em cadelas não castradas, sendo o seu desenvolvimento associado principalmente à exposição crónica à progesterona e aos estrogénios endógenos ou exógenos. Diferentes estudos mostraram que o subtipo histológico dos tumores de mama da cadela influencia o prognóstico. Alguns tipos histológicos tais como os carcinomas tubulopapilares e os carcinomas sólidos são frequentes, enquanto outros são considerados raros ou incomuns (RUMT), incluindo carcinomas simples – micropapilar e anaplásico, e de tipo especial – carcinoma adenoescamoso, carcinoma mucinoso, carcinoma rico em lípidos, carcinoma secretor, carcinoma de células fusiformes, carcinoma inflamatório, mioepitelioma maligno e carcinossarcoma. Em medicina humana, diferentes estudos demonstraram que alguns destes tumores apresentam alterações genéticas, moleculares e fenotípicas específicas, e estão associados a um pior prognóstico. Apesar de alguns estudos reportarem também um pior prognóstico de alguns destes RUMT em animais de companhia, o conhecimento relativo a estes tumores é escasso devido à sua baixa frequência. Por este motivo, este estudo teve como objetivos principais fazer uma caracterização e avaliar a evolução clínica, nomeadamente o tempo livre de doença (DFI) e o tempo de sobrevivência global (OS), de cadelas com RUMT através de um estudo retrospetivo multicêntrico.
Com esse propósito, foram analisados os registos clínicos de cadelas com tumores da glândula mamária apresentadas em diferentes centros de atendimento médico veterinários de Portugal entre 2012 e 2023. Cadelas com RUMT, mas sem informação clínica disponível, com comorbilidades, com história de neoplasia maligna prévia (mamária ou outros tipos), com apenas lesões mamárias não neoplásicas, tumores mamários benignos ou tumores mamários malignos de tipos histológicos frequentes foram excluídas. Cadelas com RUMT e com lesões mamárias não neoplásicas, tumores mamários benignos ou tumores mamários malignos de tipos histológicos frequentes concomitantes foram admitidas.
Foram incluídos neste estudo 42 cadelas com tumores mamários com idades compreendidas entre os 5 e os 18 anos (média de 11 anos) no momento do diagnóstico, das quais 14 apresentavam carcinossarcomas, sete carcinomas adenoescamosos, seis carcinomas inflamatórios, quatro carcinomas anaplásicos, quatro mioepiteliomas malignos, três carcinomas micropapilares, dois carcinomas de células fusiformes, um carcinoma mucinoso e um carcinoma e mioepitelioma maligno. De acordo com os resultados obtidos, os carcinomas anaplásicos e os carcinossarcomas apresentaram um comportamento biológico menos agressivo e uma evolução clínica mais favorável do que anteriormente descrito. Em contraste, as fêmeas com carcinomas de células fusiformes e carcinomas mucinosos apresentaram um pior prognóstico do que o anteriormente reportado, embora apenas dois e um animal de cada subtipo tumoral (respetivamente) tenham sido avaliados. Os carcinomas adenoescamosos, os carcinomas inflamatórios e os carcinomas micropapilares apresentaram um comportamento agressivo e as cadelas afetadas tiveram uma evolução clínica desfavorável, de acordo com o descrito em pesquisas anteriores. Em contrapartida, as cadelas com mioepiteliomas malignos tiveram melhor prognóstico, também de acordo com os resultados obtidos em estudos anteriores.
Diferentes estudos demonstraram que os tumores mamários caninos são um modelo natural adequado para o estudo do cancro da mama humano, pelo que, do ponto de vista da medicina comparativa, o conhecimento sobre os RUMT em cadelas pode também ser potencialmente útil para a compreensão dos RUMT em humanos.
Mammary gland tumors are the most common neoplasias in intact female dogs, and their development is mainly associated with chronic exposure to endogenous or exogenous progesterone and estrogens. Different studies have shown that the histological subtype influences the prognosis of malignant mammary tumors in dogs. Some histological subtypes, such as tubulopapillary and solid carcinomas are common, while others are considered rare or uncommon (RUMT), including simple carcinomas – micropapillary and anaplastic, and special types of mammary tumors – adenosquamous carcinoma, mucinous carcinoma, lipid-rich carcinoma, secretory carcinoma, spindle cell carcinoma, inflammatory carcinoma, malignant myoepithelioma and carcinosarcoma. In human medicine, different studies have shown that some of these tumors present specific genetic, molecular and phenotypic alterations, and are associated with a worse prognosis. Although some studies also reported a worse prognosis for some of these RUMT in companion animals, the knowledge related with these tumors is scarce due to their low frequency. For this reason, this study aimed to characterize and evaluate the clinical evolution, namely the disease-free interval (DFI) and the overall survival time (OS), of female dogs with RUMT, through a multicentre retrospective study. For these purposes, the clinical records of female dogs with mammary gland tumors presented at different veterinary medical care centres from Portugal between 2012 and 2023 were analysed. Female dogs with RUMT but without available clinical information, with comorbidities, with a history of previous malignant neoplasia (mammary or other types), with only non-neoplastic mammary lesions, benign mammary tumors or malignant mammary tumors of frequent histological types were excluded. Female dogs with RUMT which also presented non-neoplastic mammary lesions, benign mammary tumors or malignant mammary tumors of common histotypes were included in the research. Forty-two animals aged between 5 and 18 years old (mean 11 years) at the time of diagnosis, were included in this study, of which 14 had carcinosarcomas, seven adenosquamous carcinomas, six inflammatory carcinomas, four anaplastic carcinomas, four malignant myoepitheliomas, three micropapillary carcinomas, two spindle cell carcinomas, one mucinous carcinoma and one carcinoma and malignant myoepithelioma. According with the results obtained, anaplastic carcinomas and carcinossarcomas presented a less aggressive behavior and a better clinical outcome than previously described. In contrast, females with spindle cell carcinomas and mucinous carcinomas showed a worse prognosis than previously reported, although only two and one animals of each tumor subtype (respectively) were evaluated. Adenosquamous carcinomas, inflammatory carcinomas and micropapillary carcinomas showed an aggressive behavior and affected females had a poor outcome, in accordance with previous research. In contrast, female dogs with malignant myoepitheliomas had a better prognosis, also in accordance with previous investigations. Different studies have demonstrated that canine mammary tumors are a suitable natural model for the study of human breast cancer, therefore, from a comparative medicine perspective, knowledge about RUMT in dogs could also be potentially useful for understanding RUMT in humans.
Mammary gland tumors are the most common neoplasias in intact female dogs, and their development is mainly associated with chronic exposure to endogenous or exogenous progesterone and estrogens. Different studies have shown that the histological subtype influences the prognosis of malignant mammary tumors in dogs. Some histological subtypes, such as tubulopapillary and solid carcinomas are common, while others are considered rare or uncommon (RUMT), including simple carcinomas – micropapillary and anaplastic, and special types of mammary tumors – adenosquamous carcinoma, mucinous carcinoma, lipid-rich carcinoma, secretory carcinoma, spindle cell carcinoma, inflammatory carcinoma, malignant myoepithelioma and carcinosarcoma. In human medicine, different studies have shown that some of these tumors present specific genetic, molecular and phenotypic alterations, and are associated with a worse prognosis. Although some studies also reported a worse prognosis for some of these RUMT in companion animals, the knowledge related with these tumors is scarce due to their low frequency. For this reason, this study aimed to characterize and evaluate the clinical evolution, namely the disease-free interval (DFI) and the overall survival time (OS), of female dogs with RUMT, through a multicentre retrospective study. For these purposes, the clinical records of female dogs with mammary gland tumors presented at different veterinary medical care centres from Portugal between 2012 and 2023 were analysed. Female dogs with RUMT but without available clinical information, with comorbidities, with a history of previous malignant neoplasia (mammary or other types), with only non-neoplastic mammary lesions, benign mammary tumors or malignant mammary tumors of frequent histological types were excluded. Female dogs with RUMT which also presented non-neoplastic mammary lesions, benign mammary tumors or malignant mammary tumors of common histotypes were included in the research. Forty-two animals aged between 5 and 18 years old (mean 11 years) at the time of diagnosis, were included in this study, of which 14 had carcinosarcomas, seven adenosquamous carcinomas, six inflammatory carcinomas, four anaplastic carcinomas, four malignant myoepitheliomas, three micropapillary carcinomas, two spindle cell carcinomas, one mucinous carcinoma and one carcinoma and malignant myoepithelioma. According with the results obtained, anaplastic carcinomas and carcinossarcomas presented a less aggressive behavior and a better clinical outcome than previously described. In contrast, females with spindle cell carcinomas and mucinous carcinomas showed a worse prognosis than previously reported, although only two and one animals of each tumor subtype (respectively) were evaluated. Adenosquamous carcinomas, inflammatory carcinomas and micropapillary carcinomas showed an aggressive behavior and affected females had a poor outcome, in accordance with previous research. In contrast, female dogs with malignant myoepitheliomas had a better prognosis, also in accordance with previous investigations. Different studies have demonstrated that canine mammary tumors are a suitable natural model for the study of human breast cancer, therefore, from a comparative medicine perspective, knowledge about RUMT in dogs could also be potentially useful for understanding RUMT in humans.
Description
Keywords
Cadela Tumor De Mama Tipo Histológico Raro/Incomum Intervalo Livre De Doença Tempo De Sobrevivência Global Prognóstico Dog Mammary Gland Tumor Rare/Uncommon Histological Type Disease-Free Interval Overall Survival Prognosis