Estudo epidemiológico, clínico-patológico e avaliação de sobrevida global em cadelas com neoplasias mamárias

Neoplasias mamárias caninas (NMCs) são as lesões mais frequentes em cadelas. Estudos que correlacionam os critérios patológicos com a evolução clínica em cadelas com neoplasias mamárias são escassos. Este estudo objetiva apresentar dados epidemiológicos, clínico-patológicos e de sobrevida global fornecendo informações que auxiliam a estabelecer o prognóstico e a compreender o comportamento biológico de NMCs. Foram incluídos 1539 casos, 85% malignos e 13% benignos. O tamanho tumoral foi um importante fator prognóstico, sendo associado com a sobrevida global das pacientes (P<0,0001). A maioria das cadelas diagnosticadas com neoplasias malignas (83%) apresentavam estadiamentos clínicos iniciais, enquanto 17% apresentavam metástases regionais ou à distância no momento do diagnóstico, denotando menor sobrevida global (P<0,0001). O carcinoma em tumor misto foi o tipo histológico mais frequente e de melhor prognóstico. Os carcinomas sólidos, carcinomas micropapilares e carcinossarcomas foram considerados tipos histológicos de comportamento biológico agressivo, sendo associados a pior prognóstico e menor sobrevida global (P<0,0001).

Palavras-chave:
cadelas; glândula mamária; carcinomas; prognóstico

Autoria

F.C. Nunes

Universidade Federal de Minas Gerais ˗ Instituto de Ciências Biológicas ˗ Belo Horizonte, MGUniversidade Federal de Minas GeraisBrazilBelo Horizonte, MG, BrazilUniversidade Federal de Minas Gerais ˗ Instituto de Ciências Biológicas ˗ Belo Horizonte, MG

C.B. Campos

Division of Hematology and Oncology ˗ Mayo Clinic ˗ Scottsdale ˗ AZ, USAMayo ClinicUSAScottsdale, AZ, USADivision of Hematology and Oncology ˗ Mayo Clinic ˗ Scottsdale ˗ AZ, USA

S.V. Teixeira

A.C. Bertagnolli

Instituto de Pesquisas Veterinárias Desidério Finamor ˗ Eldorado do Sul, RSInstituto de Pesquisas Veterinárias Desidério FinamorBrazilEldorado do Sul, RS, BrazilInstituto de Pesquisas Veterinárias Desidério Finamor ˗ Eldorado do Sul, RS

G.E. Lavalle

Universidade Federal de Minas Gerais ˗ Escola de Veterinária ˗ Belo Horizonte, MGUniversidade Federal de Minas GeraisBrazilBelo Horizonte, MG, BrazilUniversidade Federal de Minas Gerais ˗ Escola de Veterinária ˗ Belo Horizonte, MG

G.D. Cassali ^**Autor para correspondência (corresponding author) E-mail: cassalig@icb.ufmg.br

*Autor para correspondência (corresponding author) E-mail: cassalig@icb.ufmg.br

SCIMAGO INSTITUTIONS RANKINGS

Division of Hematology and Oncology ˗ Mayo Clinic ˗ Scottsdale ˗ AZ, USAMayo ClinicUSAScottsdale, AZ, USADivision of Hematology and Oncology ˗ Mayo Clinic ˗ Scottsdale ˗ AZ, USA

Figuras | Tabelas

Figuras (1)
Tabelas (2)

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Figure 1
Overall survival curve derived from the Kaplan-Meier analysis of female dogs with malignant mammary neoplasms. A. Malignant mammary neoplasms classified by tumor size as follows: T1:142; T2: 88 and T3: 128 cases, respectively. B. Malignant mammary neoplasms classified according to the clinical stage as follows: Stage I (n= 132); Stage II (n= 69) and Stage III (n= 65), which did not reach the median. Stage IV (n= 30) had a median survival of 331 days and Stage V (n= 5) had a median survival of 236 days. C. Malignant mammary neoplasms classified by histological type. MTC: carcinoma in mixed tumor (n= 212), IPC: invasive papillary carcinoma (n= 19) and TC: tubular carcinoma (n= 14), did not reach the median; MC: micropapillary carcinoma (n= 9), SC: solid carcinoma (n= 18), and CS: carcinosarcoma (n= 13), median 120, 268 and 113 days, respectively. D. Malignant mammary neoplasms classified according to histological grade. Grade I (n= 44) and Grade II (n= 43) did not reach the median and Grade III (n= 18) median at 504 days.

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Table 1
Epidemiological and clinical-pathological information for the benign and malignant neoplasms of the mammary gland in dogs

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Table 2
Classification and frequency of mammary tumors in female dogs seen at the UFMG veterinary hospital

Figure 1 Overall survival curve derived from the Kaplan-Meier analysis of female dogs with malignant mammary neoplasms. A. Malignant mammary neoplasms classified by tumor size as follows: T1:142; T2: 88 and T3: 128 cases, respectively. B. Malignant mammary neoplasms classified according to the clinical stage as follows: Stage I (n= 132); Stage II (n= 69) and Stage III (n= 65), which did not reach the median. Stage IV (n= 30) had a median survival of 331 days and Stage V (n= 5) had a median survival of 236 days. C. Malignant mammary neoplasms classified by histological type. MTC: carcinoma in mixed tumor (n= 212), IPC: invasive papillary carcinoma (n= 19) and TC: tubular carcinoma (n= 14), did not reach the median; MC: micropapillary carcinoma (n= 9), SC: solid carcinoma (n= 18), and CS: carcinosarcoma (n= 13), median 120, 268 and 113 days, respectively. D. Malignant mammary neoplasms classified according to histological grade. Grade I (n= 44) and Grade II (n= 43) did not reach the median and Grade III (n= 18) median at 504 days.

Table 1 Epidemiological and clinical-pathological information for the benign and malignant neoplasms of the mammary gland in dogs

	Benign neoplasms	Malignant neoplasms	P value
	(n= 201)	(n= 1310)
Age (mean ± SD)	8.43±2.77	10.74±2.75	0.0001
Breed
Mixed breed	33 (18%)	296 (24%)	0.0629
Pure race	155 (82%)	951 (76%)
Reproductive status
Intact	54 (71%)	565 (72%)	0.7905
Neutered	22 (29%)	217 (28%)
Pseudocyesis
Present	33 (55%)	332 (59%)	0.68
Absent	27 (45%)	235 (41%)
Estrous Cycle
Regular	41 (73%)	421 (72%)	0.8777
Irregular	15 (27%)	165 (28%)
Administration of hormones
Present	3 (6%)	41 (7%)	10
Absent	50 (94%)	524 (93%)
Adherence
Present	1 (1%)	135 (10%)	0.0001
Absent	200 (99%)	1172 (90%)
Ulceration
Present	3 (1%)	77 (6%)	0.0064
Absent	198 (99%)	1223 (94%)
Relapse
Present	0	37 (3%)	0.0103
Absent	204 (100%)	1273 (97%)
Location of the tumor
Cranial thoracic	10 (5%)	63 (6%)	0.0536
Caudal thoracic	18 (10%)	158 (14%)
Cranial abdominal	19 (10%)	167 (15%)
Caudal abdominal	45 (25%)	278 (25%)
Inguinal	78 (42%)	346 (32%)
Multicenter	14 (8%)	92 (8%)
Tumor size
T₁ (< 3cm)	124 (76%)	539 (50%)	0.0001
T₂ (> 3 and < 5cm)	22 (14%)	237 (22%)
T₃ (> 5cm)	17 (10%)	304 (28%)

Table 2 Classification and frequency of mammary tumors in female dogs seen at the UFMG veterinary hospital

Tumors classification	Histological classification	N	%
1. Non-neoplastic lesions 2. N=28 (2%)	1.1. Adenose	1	0.06%
	1.2. Ductal ectasia	16	1%
	1.3. Ductal hyperplasia	1	0.06%
	1.4. Lobular hyperplasia	1	0.06%
	1.5. Lactational hyperplasia	5	0.32%
	1.6. Mastitis	4	0.25%
2. Benign neoplasms N=201 (13%)	2.1. Adenoma	6	0.40%
	2.2. Basal cell adenoma	2	0.13%
	2.3. Ductal adenoma	2	0.13%
	2.4. Tubular adenoma	2	0.13%
	2.5. Adenomyoepithelioma	1	0.06%
	2.6. Fibroadenoma	1	0.06%
	2.7. Papilloma	18	1.17%
	2.8. Benign phyllodes tumor	2	0.13%
	2.9. Benign mixed tumor	167	11%
3. Malignant neoplasms N=1310 (85%)	3.1. Carcinomas
	3.1.1. Carcinoma in situ	99	6.44%
	3.1.2. Ductal carcinoma in situ	7	0.45%
	3.1.3. Carcinoma in mixed tumor	680	44.18%
	3.1.4. Invasive papillary carcinoma	87	6.00%
	3.1.5. Noninvasive papillary carcinoma	55	3.60%
	3.1.6. Tubular carcinoma	84	5.50%
	3.1.7. Tubulo-papillary carcinoma	27	1.75%
	3.1.8. Solid carcinoma	124	8.06%
	3.1.9. Apocrine carcinoma	7
	3.2. Special carcinoma types
	3.2.1. Micropapillary carcinoma	37	2.40%
	3.2.2. Lobular pleomorphic carcinoma	5	0.32%
	3.2.3. Mucinous carcinoma	4	0.30%
	3.2.4. Lipid-rich carcinoma	2	0.13%
	3.2.5. Anaplastic carcinoma	1	0.06%
	3.3. Myoepithelial neoplasms
	3.3.1. Myoepithelioma	6	0.40%
	3.3.2. Adenomyoepithelioma	7	0.45%
	3.4. Sarcomas
	3.4.1. Sarcoma in mixed tumor	2	0.13%
	3.4.2. Sarcoma	3	0.20%
	3.4.3. Osteosarcoma	7	0.45%
	3.4.4. Fibrosarcoma	3	0.20%
	3.4.5. Chondrosarcoma	1	0.06%
	3.4.6. Hemangiosarcoma	2	0.13%
	3.5. Malignant epithelial and mesenchymal neoplasms
	3.5.1. Carcinosarcoma	60	4.00%

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Universidade Federal de Minas Gerais, Escola de Veterinária Caixa Postal 567, 30123-970 Belo Horizonte MG - Brazil, Tel.: (55 31) 3409-2041, Tel.: (55 31) 3409-2042 - Belo Horizonte - MG - Brazil
E-mail: abmvz.artigo@gmail.com

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Estudo epidemiológico, clínico-patológico e avaliação de sobrevida global em cadelas com neoplasias mamárias

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[1] *Autor para correspondência (corresponding author) E-mail: cassalig@icb.ufmg.br