The prognostic value of serum neoplastic biomarkers CA 15-3 and CEA in canine mammary neoplasms: a review / O valor prognóstico dos biomarcadores neoplásicos séricos CA 15-3 e CEA em neoplasias mamárias caninas: uma revisão

As neoplasias mamárias caninas (NMCs) são as mais frequentes em cadelas, com isso, uma grande variedade de técnicas tem sido utilizada para identificar os seus fatores prognósticos. Dentre as possibilidades, os biomarcadores neoplásicos séricos antígeno do câncer (CA 15-3) e o antígeno carcinoembrionário (CEA) são os mais promissores. Biomarcadores neoplásicos são substâncias presentes na neoplasia, sangue ou demais produtos biológicos, produzidos pela neoplasia, ou secundariamente pelo paciente, em resposta à sua presença. Na medicina veterinária, esses marcadores são pouco estudados. Em termos gerais, eles não podem ser usados para o diagnóstico primário de neoplasias mamárias, mas estão relacionados com os fatores prognóstico já bem estabelecidos na literatura e tem como vantagem se tratar de uma análise menos invasiva e que é possível de ser feita de forma seriada. O objetivo desta revisão é descrever o CA 15-3 e o CEA como biomarcadores utilizados nas NMCs, o progresso recente feito na literatura e providenciar um sumário dos principais resultados já obtidos. O CA 15-3 e o CEA apresentam potencial prognóstico nas NMCs. Apesar de existir uma grande variação de resultados para esses biomarcadores na literatura, o seu uso deve ser considerado, visto os resultados obtidos na caracterização e prognóstico das NMC.(AU)

Female canine mammary neoplasms (CMNs) are the most frequent neoplasm in bitches, and a variety of techniques have been used to identify they prognostic factors. Among the possibilities, the serum biomarkers cancer antigen (CA 15-3) and carcinoembryonic antigen (CEA) are the most reliable. Neoplastic biomarkers are substances present in the neoplasia, blood, or other biological products, produced mainly by the neoplasia, or secondarily by the patient, in response to their presence. In veterinary medicine, these biomarkers are poorly studied. In general terms they cannot be used for primary diagnosis of mammary neoplasms but are related to the prognostic factors and have the advantage of being a less invasive analysis and that it is possible to be done in a serial way. The objective of this review is to describe CA 15-3 and CEA use as biomarkers in CMNs, the recent progress made in literature and the main overall results that had been already obtained. CA 15-3 and CEA have prognostic potential for CMNs. There is a wide variation of results for these biomarkers in literature, but despite this, its use must be considered as they provide relevant results in terms of characterization and prognostic in CMNs.(AU)

Infiltrating mammary carcinoma in a cat with a congenital disorder: prognostic interest of histological examination / Carcinoma mamario infiltrante en una gata con un trastorno congénito: interés pronóstico del examen histológico

Resumen En esta publicación se describe el manejo y la evolución clínica de un carcinoma mamario felino (CMF) maligno en una gata mestiza de ocho años de edad con un trastorno congénito. La eficacia de la extirpación de la masa tumoral y el pronóstico del caso se establecieron mediante el examen histológico de rutina postoperatorio. Tras una mastectomía completa se extirpó un bulto de 6 cm de diámetro en la glándula mamaria torácica izquierda de aspecto multinodular y exudado purulento de coloración rojiza. El análisis histopatológico mostró la presencia de numerosos émbolos tumorales linfovasculares y células con alta frecuencia de figuras mitóticas con núcleos hipercromáticos. Estos hallazgos fueron consistentes con una neoplasia agresiva de mal pronóstico, lo que explicaba el fallecimiento de la paciente a las 7 semanas de la cirugía. Los hallazgos histológicos y citológicos son de importancia crítica para los clínicos en el manejo de las neoplasias mamarias más comunes en los gatos, con el fin de aliviar de la mejor manera posible a los animales con cánceres que amenazan su vida. También podría servir como modelo de cáncer para avanzar en el conocimiento de patologías similares en otras especies.

Abstract This report describes the handling and clinical evolution of a malignant feline mammary carcinoma (FMC) in an eight-year-old female crossbred cat with a congenital disorder. Hence, the efficacy of tumor mass removal and the case prognosis was established by postoperative routine histological examination. A 6 cm diameter lump in the left thoracic mammary gland of multinodular appearance and purulent exudate with a reddish hue was excised after the entire mastectomy. The histopathological analysis showed the presence of numerous lymphovascular tumor emboli and frequently mitotic cells with hyperchromatic nuclei. These were consistent with an aggressive malignancy with a poor prognosis explaining the patient's death within 7 weeks after surgery. Histology and cytology findings are of critical importance to clinicians in the management of the most common mammary malignancies in cats, to provide the best possible relief to animals with life-threatening cancer. It could also serve as a cancer model for advancing knowledge in congenitally affected humans.

Dosagem sérica do marcador tumoral CA 15. 3 em cadelas portadoras de neoplasias mamárias pelo método de eletroquimioluminescência / Serum dosage of the tumor marker Ca 15. 3 in bitches presenting mammary neoplasia with the chemiluminescence method

The objective of the present study was to analyze the serum levels of the tumor marker Ca15.3 in healthy bitches and those with mammary neoplasms, correlating results with tumor type, clinical staging, time until presentation, and presence of ulceration and vascularization. For the study, 30 bitches with mammary tumors and 30 healthy bitches (control group) were selected. Histopathology was performed for identification of tumor type, and blood was collected for measurement of serum concentration of the marker via the chemiluminescence method using a commercial kit. A higher frequency of malignant neoplasms was observed (76.7%), with a higher quantity of carcinoma in mixed tumor (26.7%). Regarding serum concentration of the marker Ca15.3, there was no difference in serum values when comparing the means from bitches with neoplasia and healthy bitches, nor when comparing the other characteristics. The majority of results for serum concentration of Ca15.3, whether in bitches with neoplasia or in healthy bitches, was zero. It is concluded that the measurement of the marker Ca15.3 using the chemiluminescence method and commercial kits for humans did not offer significant results that would make this method or this marker a useful tool for patient monitoring and evaluation of the prognosis of bitches with mammary neoplasms.(AU)

Dosagem sérica do marcador tumoral CA 15. 3 em cadelas portadoras de neoplasias mamárias pelo método de eletroquimioluminescência / Serum dosage of the tumor marker Ca 15. 3 in bitches presenting mammary neoplasia with the chemiluminescence method

The objective of the present study was to analyze the serum levels of the tumor marker Ca15.3 in healthy bitches and those with mammary neoplasms, correlating results with tumor type, clinical staging, time until presentation, and presence of ulceration and vascularization. For the study, 30 bitches with mammary tumors and 30 healthy bitches (control group) were selected. Histopathology was performed for identification of tumor type, and blood was collected for measurement of serum concentration of the marker via the chemiluminescence method using a commercial kit. A higher frequency of malignant neoplasms was observed (76.7%), with a higher quantity of carcinoma in mixed tumor (26.7%). Regarding serum concentration of the marker Ca15.3, there was no difference in serum values when comparing the means from bitches with neoplasia and healthy bitches, nor when comparing the other characteristics. The majority of results for serum concentration of Ca15.3, whether in bitches with neoplasia or in healthy bitches, was zero. It is concluded that the measurement of the marker Ca15.3 using the chemiluminescence method and commercial kits for humans did not offer significant results that would make this method or this marker a useful tool for patient monitoring and evaluation of the prognosis of bitches with mammary neoplasms.(AU)

Tumor filodes benigno de la vulva: reporte de un caso / Benign phyllodes tumor of the vulva: Case Report

Resumen: ANTECEDENTES: El tumor filodes de la vulva es una lesión proliferativa, benigna, poco común, que comparte características similares con los tumores mamarios. Aparece en forma de masa unilateral, no dolorosa, localizada en los labios mayores o menores, y en la horquilla posterior de la vulva. Hasta la fecha se han reportado 30 casos de tumor filodes vulvar en todo el mundo. Debido a su baja incidencia no se han estimado los datos epidemiológicos y fisiopatológicos concretos de la enfermedad. CASO CLÍNICO: Paciente de 20 años, que acudió a consulta debido a la aparición de una masa vulvar de aproximadamente 11 cm en el labio mayor izquierdo, no dolorosa, de crecimiento rápido. El tratamiento consistió en resección quirúrgica. El diagnóstico presuntivo fue fibroma vulvar. El servicio de Anatomopatología reportó: tumoración de 280 g, de 12 x 7 x 6 cm, con bordes y formas irregulares, multinodular, cubierta por piel con epidermis; superficie sólida, con bordes irregulares, de aspecto frondoso y consistencia blanda. Se estableció el diagnóstico de tumor filodes de bajo grado (benigno). CONCLUSIÓN: El tumor filodes de la vulva es una alteración excepcional, por lo que es importante conocer sus manifestaciones clínicas, características macro y microscópicas para establecer el diagnóstico y tratamiento certeros.

Abstract: BACKGROUND: Phyllodes tumor of the vulva is a rare, benign, proliferative lesion that shares similar characteristics with mammary tumors. It appears as a unilateral, non-painful mass located on the labia majora or majora, and on the posterior fork of the vulva. To date, 30 cases of phyllodes tumor have been reported worldwide. Due to its low incidence, the specific epidemiological and pathophysiological data of the disease have not been estimated. CLINICAL CASE: A 20-year-old patient, who came to the clinic for a vulvar mass of approximately 11 cm in the left, non-painful, rapidly growing lip. Treatment consisted of surgical resection. The presumptive diagnosis was vulvar fibroma. The pathology service reported: a 280 g mass, 12 x 7 x 6 cm, with irregular edges and shapes, multinodular, covered by skin with epidermis; Solid cutting surface with uneven edges, leafy appearance and soft consistency. The diagnosis of low-grade phyllodes (benign) tumor was established. CONCLUSION: The phyllodes tumor of the vulva is an exceptional alteration, so it is important to know its clinical manifestations, in addition to the macro and microscopic characteristics to establish the accurate diagnosis and treatment.

Carcinoma neuroendocrino de mama con diferenciación pulmonar. Reporte de un caso / Neuroendocrine breast carcinoma with pulmonary differentiation. A case report

Resumen ANTECEDENTES: Los carcinomas neuroendocrinos de mama son neoplasias malignas poco frecuentes, con incidencia de 2%. El diagnóstico es difícil de establecer debido a sus características clínicas y morfológicas inespecíficas. La inmunohistoquímica es un estudio útil para identificar marcadores neuroendocrinos. Es importante descartar los casos de metástasis relacionados con algún origen primario distinto, para de esta forma prescribir el tratamiento adecuado. CASO CLÍNICO: Paciente de 37 años, procedente de otra institución con diagnóstico sugerente de carcinoma de alto grado de células medianas, con diferenciación neuroendocrina, afectación de los tres niveles de Berg y adenopatías supraclaviculares patológicas. Después de los estudios de imagen y determinación de marcadores tumorales específicos de la enfermedad se estableció el diagnóstico de carcinoma neuroendocrino de mama. Se indicó tratamiento neoadyuvante con cisplastino y etoposido, con el que se observó reacción parcial de 50%. Posteriormente se efectuó la mastectomía radical, con vaciamiento de los tres niveles de Berg y extirpación de los ganglios supraclaviculares, sin complicaciones aparentes. En la actualidad, la paciente permanece estable, en tratamiento con quimioterapia coadyuvante. CONCLUSIÓN: Lo importante en estos casos es determinar los marcadores tumorales asociados con los carcinomas neuroendocrinos de mama y así poder establecer el diagnóstico certero e implementar el tratamiento adecuado, que puede variar en función de su origen. Hasta la fecha no existe un consenso de tratamiento, por lo que cada caso debe individualizarse. Se requieren estudios adicionales para ampliar el conocimiento de esta variante tumoral.

Abstract BACKDROUND: Neuroendocrine carcinomas are infrequent breast neoplasms representing less than 2% of breast neoplasms. The diagnosis is difficult, since their clinical and morphological characteristics do not help to differentiate them from other types of breast neoplasms. The immunohistochemistry that will determine the characterization of the tumor by the presence of neuroendocrine markers. It is important to rule out a cases of metastasis related to a different primary origin, in order to prescribe the appropriate treatment for the patient. CLINICAL CASE: A 37-year-old patient from another institution with a diagnosis suggestive of high-grade carcinoma of medium cells, with neuroendocrine differentiation, involvement of the 3 levels of Berg and pathological supraclavicular adenopathies. After performing the imaging studies and determining the specific tumor markers of the disease, the diagnosis of breast neuroendocrine carcinoma. Neoadjuvant treatment with cisplastin and etoposide is indicated, with the same partial reaction of 50%. Subsequently, the radical mastectomy was performed, with the emptying of the 3 levels of Berg and the removal of the supraclavicular nodes without apparent complications. Currently remains stable in the treatment with adjuvant chemotherapy. CONCLUSIONS: It is important to determine the tumor markers associated with breast neuroendocrine carcinomas, with the aim of establishing accurate diagnosis and implementing the appropriate treatment, which may vary depending on its origin. To date there is no consensus of treatment, so each case must be individualized. Additional studies are required to expand the knowledge of this tumor variant.

Eletrocardiografia em cadelas submetidas à mastectomia unilateral total / Electrocardiogram in bitches submitted to unilateral total mastectomy

Background: The frequency of oncological diseases in companion animals has increased in recent years, mainly due tothe longer longevity of dogs. The neoplasms are not only open by the presence of the tumor and its location, but also byparaneoplastic syndromes, which are disorders that occur due to the production of substances by the tumor that cause.In addition to causing local changes and damages, oncological diseases may also result in injuries at distant sites, suchas paraneoplastic syndromes, which, if untreated, may result in death of animals. The present study aimed to investigatewhether female dogs with mammary tumors demonstrate electrocardiographic changes, and if so, to investigate whetherthese cease after removal of the tumor, and to relate the type of tumor with the occurrence of arrhythmias.Materials, Methods & Results: Eighteen female dogs, aged between 4 and 14 years, underwent electrocardiogram 24 hprior to undergoing a total unilateral mastectomy. After removal of the tumor, electrocardiograms were again performed 24(M24), 48 (M48), and 72 (M72), as well as 14 days (M14d) after surgery. Histological analysis of the neoplasms showedthat 55% of the tumors were benign, with predominance of adenoma (38%), and 45% were malignant, with predominanceof adenocarcinoma (22%). The following rhythms and arrhythmias were observed: normal sinus rhythm (37.2%), sinusarrhythmia (62.8%), wandering pacemaker (26%), 1st degree atrioventricular block (AVB; 5%), premature ventricularcomplex (PVC; 10%), and T-wave > 25% of R-wave (25%); more than one change could occur simultaneously. Out of theevaluated electrocardiographic parameters, a significant difference was observed in the QT interval between the followingtimepoints: M24 (204 ± 18), M48 (204 ± 22), and M72 (203 ± 23), as well as Mbasal (192 ± 15) and M14d (178 ± 43).Discussion: Regarding the observed rhythms, arrhythmias, and changes, respiratory sinus arrhythmia was the normal predominant...

Eletrocardiografia em cadelas submetidas à mastectomia unilateral total / Electrocardiogram in bitches submitted to unilateral total mastectomy

Background: The frequency of oncological diseases in companion animals has increased in recent years, mainly due tothe longer longevity of dogs. The neoplasms are not only open by the presence of the tumor and its location, but also byparaneoplastic syndromes, which are disorders that occur due to the production of substances by the tumor that cause.In addition to causing local changes and damages, oncological diseases may also result in injuries at distant sites, suchas paraneoplastic syndromes, which, if untreated, may result in death of animals. The present study aimed to investigatewhether female dogs with mammary tumors demonstrate electrocardiographic changes, and if so, to investigate whetherthese cease after removal of the tumor, and to relate the type of tumor with the occurrence of arrhythmias.Materials, Methods & Results: Eighteen female dogs, aged between 4 and 14 years, underwent electrocardiogram 24 hprior to undergoing a total unilateral mastectomy. After removal of the tumor, electrocardiograms were again performed 24(M24), 48 (M48), and 72 (M72), as well as 14 days (M14d) after surgery. Histological analysis of the neoplasms showedthat 55% of the tumors were benign, with predominance of adenoma (38%), and 45% were malignant, with predominanceof adenocarcinoma (22%). The following rhythms and arrhythmias were observed: normal sinus rhythm (37.2%), sinusarrhythmia (62.8%), wandering pacemaker (26%), 1st degree atrioventricular block (AVB; 5%), premature ventricularcomplex (PVC; 10%), and T-wave > 25% of R-wave (25%); more than one change could occur simultaneously. Out of theevaluated electrocardiographic parameters, a significant difference was observed in the QT interval between the followingtimepoints: M24 (204 ± 18), M48 (204 ± 22), and M72 (203 ± 23), as well as Mbasal (192 ± 15) and M14d (178 ± 43).Discussion: Regarding the observed rhythms, arrhythmias, and changes, respiratory sinus arrhythmia was the normal predominant... (AU)

Metástasis mamaria de linfoma de células del manto / Mammary metastasis of mantle cell lymphoma

Resumen ANTECEDENTES: Los linfomas mamarios primarios constituyen menos de 1% de todos los linfomas no-Hodgkin, 1.7-2.2% de todos los linfomas no-Hodgkin nodales adicionales y 0.04-0.5% de todas las neoplasias malignas de la mama. El linfoma de células del manto representa 4% de los linfomas en Estados Unidos, y entre 7-9% en Europa y se diagnostica en pacientes con una mediana de edad de 60 años. Aparece en mujeres posmenopáusicas en forma de masa mamaria indolora, unilateral. El linfoma de mama secundario es sistémico, con afectación simultánea o posterior en otro sitio. CASO CLÍNICO: Paciente con una tumoración mamaria, inicialmente postraumática, que en el contexto de plaquetopenia se catalogó clínica y radiológicamente como hematoma y que, más tarde, el diagnóstico fue: linfoma de células del manto secundario a linfoma previo nodal inguinal en segunda línea de tratamiento con quimioterapia. CONCLUSIONES: La persistencia o el rápido crecimiento de un hematoma mamario o de una lesión con apariencia radiológica benigna, sobre todo con antecedente de linfoma previo, puede resultar maligna. La biopsia mediante aguja gruesa es decisiva en el diagnóstico porque permite el estudio histológico e inmunohistoquímico para la confirmación molecular. El tratamiento se basa, sobre todo, en quimio y radioterapia, opciones que mejoran la supervivencia y disminuyen la recurrencia.

Abstract BACKGROUND: Primary mammary lymphomas represent less than 1% of all Non Hodgking Lymphomas (NHL). Mantle cell lymphoma (MCL) represents 4% of lymphomas in the United States, and 7-9% in Europe and is diagnosed in patients with a median age of 60 years. Unilateral painless mammary mass in postmenopausal women use to be the clinical presentation. Secondary breast lymphoma is defined as the presence of systemic lymphoma with breast involvement, as the patient below. CLINICAL CASE: 57-year-old female patient with post-traumatic mammary tumor, with history of thrombocytopenia, first-time diagnosed of hematoma, with breast enlargement and later diagnosed as lymphoma of mantle cells with pathology test and classified as secondary to previous inguinal nodal lymphoma. CONCLUSIONS: It is important to keep in mind this diagnosis in view of the persistence or rapid growth of a mammary hematoma or other lesion with benign radiological appearance. The biopsy is the gold standard for diagnosis, since it allows the histological and immunohistochemical study, for molecular confirmation. The treatment is mainly based on chemo / radiotherapy, which improves survival and decreases recurrence.

Envolvimento da matriz extracelular no tumor mamário canino / Extracellular matrix involviment in canine mammary tumor

A glândula mamária (GM) é um tecido dinâmico, derivado da epiderme e o seu desenvolvimento depende da interação entre as células mamárias e o estroma. A matriz extracelular (MEC) representa o principal conteúdo extracelular, responsável pela sustentação do tecido conjuntivo, da membrana basal e serve como reservatório para muitos fatores de crescimento. MEC é constituída por fibras proteicas insolúveis, como colágenos, lamininas, fibronectinas, e polímeros solúveis, como proteoglicanos e glicosaminoglicanos. Essas moléculas que compõem a MEC são importantes, tanto durante a morfogênese da GM, como para a sua manutenção conferindo-lhe a sustentação e o armazenamento de substratos necessários para seu crescimento. A desorganização da MEC na GM pode ser um indício necessário para o início e a progressão dotumor de mama. O Tumor mamário canino (TMC) é referido como um complexo de neoplasias que tem a participação de diversos fatores para seu desenvolvimento, incluindo os componentes da MEC. Desta forma, a investigação da MEC no diagnóstico dos TMC torna-se importante, para estabelecer a correlação entre os seus componentes e as células neoplásicas, além de fornecer informações sobre o comportamento biológico e o estadiamento clínico dos TMC. O entendimento da participação dessas moléculas da MEC para o desenvolvimento do TMC pode favorecer abordagens terapêuticas mais específicas, tendo como alvo elementos da MEC. Portanto, esta revisão tem como foco a participação dos componentes da MEC nos processos que contribuem para o estabelecimento do TMC, o que pode favorecer abordagens terapêuticas que visem elementos da MEC.

Mammary gland (MG) is a dynamic tissue derived from the epidermis and your development depends on the interaction between mammary cells and stroma. Extracellular matrix (ECM) is the major extracellular content of tissues responsible for supporting connective tissue and basement membrane, and serves as a reservoir for many growth factors. ECM is comprised of insoluble protein fibers as collagens, laminins, fibronectins and soluble polymers as proteoglycans, and glycosaminoglycans. The ECM components are important both during morphogenesis of MG as to maintain this fabric giving support and storage of substrates needed for the growth. ECM disorder in GM may be the progression trigger of the breast tumor. Canine mammary tumor (CMT) is a complex of malignancies that have the participation of several factors for its development, including ECM components. Therefore an investigation of ECM in the diagnosis of CMT becomes important to establish a relationship between componentes of matrix and neoplastic cells, including information on the biological behavior and clinical staging of CMT. The knowledge of ECM molecules participation in the development of CMT may further therapeutic approaches targeting elements of ECM. Thus, this review has a focus on the ECM components participation in the processes that contribute to CMT establishment, which may favor therapeutic approaches targeting elements of ECM.

Envolvimento da matriz extracelular no tumor mamário canino / Extracellular matrix involviment in canine mammary tumor

A glândula mamária (GM) é um tecido dinâmico, derivado da epiderme e o seu desenvolvimento depende da interação entre as células mamárias e o estroma. A matriz extracelular (MEC) representa o principal conteúdo extracelular, responsável pela sustentação do tecido conjuntivo, da membrana basal e serve como reservatório para muitos fatores de crescimento. MEC é constituída por fibras proteicas insolúveis, como colágenos, lamininas, fibronectinas, e polímeros solúveis, como proteoglicanos e glicosaminoglicanos. Essas moléculas que compõem a MEC são importantes, tanto durante a morfogênese da GM, como para a sua manutenção conferindo-lhe a sustentação e o armazenamento de substratos necessários para seu crescimento. A desorganização da MEC na GM pode ser um indício necessário para o início e a progressão dotumor de mama. O Tumor mamário canino (TMC) é referido como um complexo de neoplasias que tem a participação de diversos fatores para seu desenvolvimento, incluindo os componentes da MEC. Desta forma, a investigação da MEC no diagnóstico dos TMC torna-se importante, para estabelecer a correlação entre os seus componentes e as células neoplásicas, além de fornecer informações sobre o comportamento biológico e o estadiamento clínico dos TMC. O entendimento da participação dessas moléculas da MEC para o desenvolvimento do TMC pode favorecer abordagens terapêuticas mais específicas, tendo como alvo elementos da MEC. Portanto, esta revisão tem como foco a participação dos componentes da MEC nos processos que contribuem para o estabelecimento do TMC, o que pode favorecer abordagens terapêuticas que visem elementos da MEC.(AU)

Mammary gland (MG) is a dynamic tissue derived from the epidermis and your development depends on the interaction between mammary cells and stroma. Extracellular matrix (ECM) is the major extracellular content of tissues responsible for supporting connective tissue and basement membrane, and serves as a reservoir for many growth factors. ECM is comprised of insoluble protein fibers as collagens, laminins, fibronectins and soluble polymers as proteoglycans, and glycosaminoglycans. The ECM components are important both during morphogenesis of MG as to maintain this fabric giving support and storage of substrates needed for the growth. ECM disorder in GM may be the progression trigger of the breast tumor. Canine mammary tumor (CMT) is a complex of malignancies that have the participation of several factors for its development, including ECM components. Therefore an investigation of ECM in the diagnosis of CMT becomes important to establish a relationship between componentes of matrix and neoplastic cells, including information on the biological behavior and clinical staging of CMT. The knowledge of ECM molecules participation in the development of CMT may further therapeutic approaches targeting elements of ECM. Thus, this review has a focus on the ECM components participation in the processes that contribute to CMT establishment, which may favor therapeutic approaches targeting elements of ECM.(AU)

Infecciones virales, posible factor de riesgo en cáncer de mama / Viral infection as a potential risk factor for breast cancer

Introducción: los factores de riesgo convencionales solo pueden explicar una parte del cáncer de mama esporádico. Se ha propuesto que las infecciones causadas por el virus del tumor mamario en ratón, el virus de Epstein Barr y el virus del papiloma humano constituyen un factor de riesgo potencial para el desarrollo de esta enfermedad.Objetivo: realizar una actualización acerca del papel de algunas infecciones virales en el desarrollo del cáncer de mama.Métodos: se realizó una revisión de los artículos publicados sobre este tema en algunas bases de datos (PubMed, Medline, BioMed Central y SciELO).Conclusiones: aunque existen criterios controversiales sobre el tema, algunos resultados sugieren que la acción de estos virus puede contribuir al desarrollo de las enfermedades malignas de la mama(AU)

Introduction: conventional risk factors cannot explain all cases of sporadic breast cancer. Infections caused by the mouse mammary tumor virus, Epstein-Barr virus and human papillomavirus have been suggested to be potential risk factors for this condition.Objective: to update the information on the role of some viral infections in the development of breast cancer.Methods: a review was conducted of papers about the subject published in several databases (PubMed, Medline, BioMed Central and SciELO).Conclusions: despite the fact that criteria on the subject are controversial, some results suggest that the action of these viruses may contribute to the development of malignant breast disease(AU)

Infecciones virales, posible factor de riesgo en cáncer de mama / Viral infection as a potential risk factor for breast cancer

Introducción: los factores de riesgo convencionales solo pueden explicar una parte del cáncer de mama esporádico. Se ha propuesto que las infecciones causadas por el virus del tumor mamario en ratón, el virus de Epstein Barr y el virus del papiloma humano constituyen un factor de riesgo potencial para el desarrollo de esta enfermedad. Objetivo: realizar una actualización acerca del papel de algunas infecciones virales en el desarrollo del cáncer de mama. Métodos: se realizó una revisión de los artículos publicados sobre este tema en algunas bases de datos (PubMed, Medline, BioMed Central y SciELO). Conclusiones: aunque existen criterios controversiales sobre el tema, algunos resultados sugieren que la acción de estos virus puede contribuir al desarrollo de las enfermedades malignas de la mama(AU)

Introduction: conventional risk factors cannot explain all cases of sporadic breast cancer. Infections caused by the mouse mammary tumor virus, Epstein-Barr virus and human papillomavirus have been suggested to be potential risk factors for this condition. Objective: to update the information on the role of some viral infections in the development of breast cancer. Methods: a review was conducted of papers about the subject published in several databases (PubMed, Medline, BioMed Central and SciELO). Conclusions: despite the fact that criteria on the subject are controversial, some results suggest that the action of these viruses may contribute to the development of malignant breast disease(AU)

Estadiamento do câncer de mama em mulheres atendidas em um centro de referência em oncologia / Staging of breast cancer in women admitted for care in an oncology reference center

O objetivo do estudo foi avaliar a possível associação entre as características sociodemográficas e o estádio clínico do câncer de mama em mulheres, admitidas para atendimento em um centro de referência em oncologia. Os prontuários de 257 pacientes com diagnóstico de câncer de mama e atendidas entre novembro de 2009 a novembro de 2010 foram revisados. Os dados de interesse foram extraídos para um banco de dados e analisados por meio de regressão logística para identificação das variáveis associadas com o estádio clínico. As pacientes tinham em média 54,5 anos de idade e a maioria eram pardas (62,8%), sem história familiar de câncer de mama (78,2%) e com índice de massa corporal acima do ideal (57,2%). O diagnóstico do câncer foi tardio (estádio III e IV) em 32,7% das pacientes. Não houve associação significativa entre o estádio clínico e a idade, cor da pele, estado civil, índice de massa corpórea ou história familiar de câncer de mama. O percentual de casos diagnosticados em estádio tardio ainda é elevado, quando comparado com o encontrado em países desenvolvidos, o que aponta para necessidade de políticas que facilitem a detecção precoce da doença na região.

The aim of the study was to evaluate the possible association between sociodemographic characteristics and the clinical stage of breast cancer in women admitted for care at an oncology reference center. The medical records of 257 patients treated between November 2009 and November 2010 were reviewed. The data of interest were extracted onto a database and analyzed using logistic regression to identify the variables associated with the clinical stage. The patients were on average 54.5 years of age, primarily Caucasian (62.8%), with no family history of breast cancer (78.2%) and above the ideal body mass index (57.7%). Cancer diagnosis was late (stage II and IV) in 32.7% of patients. There was no significant relationship between the initial or early stages and age, skin color, marital status, body mass index and family history of breast cancer. The percentage of cases diagnosed in a late stage is still high when compared to what is found in developed countries, which points to the need for policies that facilitate the early detection of the disease in the region.

Idade precoce do câncer de mama e suas implicações / Early age of breast cancer and implications

Este estudo teve como objetivo comparar os resultados de um grupo de mulheres com câncer de mama em idade inferior a 40 anos a outro grupo fora desta faixa etária.É um estudo analítico prospectivo com arquivo de dados desde Fevereiro de 2001, tendo limite final em Junho de 2014, tendo 629 casos de Neoplasia Maligna de Mama.O fator de exposição foi a idade ao diagnóstico, dividindo a amostra em 2 grupos: idade inferior a 40 anos e idade igual a superior a 40 anos.Os dados coletados foram: nome, idade, procedência, ferramenta principal de diagnóstico, tipo tumoral, grau tumoral, tamanho tumoral, estadiamento patológico, tipo de tratamento, linfonodo sentinela, sobrevida em 5 e 10 anos.Inclusão no estudo foi presença de dados e informação até 2013 de controle no serviço, tendo 40 casos em Grupo 1 e 408 , Grupo 2.Não existiu diferença significativa na taxa de ocorrência de diagnóstico precoce, ferramenta principal de diagnóstico em cada estadiamento, tamanho tumoral médio, presença de Receptor Hormonal de Estrogênio positivo, presença de superexpressão da Mutação C-erb 2, modalidade de tratamento e sobrevida entre os Grupos.A História familiar negativa foi predominante em todos os Grupos.O estudo demonstra um papel importante da Mamografia em mulheres com idade inferior a 40 anos. O resultado pode ser decorrente de nosso protocolo de Mamografia de base após 35 anos.

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...

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...

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)

Hiperplasia pseudoangiomatosa nodular gigante de la mama / Pseudoangiomatous stromal hyperplasia (pash) of the breast

La hiperplasia pseudoangiomatosa (PASH) es una lesión proliferativa benigna de la mama, poco frecuente, caracterizada por la existencia de lagos pseudovasculares embebidos en una gran proliferación del estroma mamario. Probablemente, el desarrollo de la PASH tenga una influencia hormonal, por lo que típicamente se diagnostica en mujeres en edad fértil. La PASH es un hallazgo histopatológico casual en las piezas quirúrgicas y biopsias mamarias realizadas por otra patología. La presentación clínica en forma de masa palpable es poco frecuente. El principal diagnóstico diferencial debe realizarse con el angiosarcoma de bajo grado. El tratamiento de la PASH nodular es una correcta exéresis quirúrgica asegurando borde sano amplio. El pronóstico es excelente, con un mínimo riesgo de recidiva si se realiza una adecuada cirugía. Se presenta el caso de una mujer de 37 años que acude a consulta por un nódulo mamario de crecimiento rápido.

Pseudoangiomatous stromal hyperplasia (PASH) of the breast is a rare benign proliferative mesenchymal lesion characterized by the presence of open slit like spaces embedded in a hyalinized fibrous stroma. The development of PASH is probably subject to hormonal influence so it typically affects women in the reproductive age group. Pseudoangiomatous stromal hyperplasia is frequently an incidental histologic finding in breast surgeries or biopsies performed for other injuries. In rare cases, it presents as a localized breast mass. The most important differential diagnosis is low-grade angiosarcoma. Tumorous PASH is treated by local surgical excision with clear margins. The prognosis is excellent, with minimal risk of recurrence after adequate surgery. The presented case was a 37-years-old woman who was admitted with a rapidly growing breast tumor.

Evolución inusual de fibroadenomas mamarios múltiples en adolescente con metrorragia disfuncional / Unusual evolution of multiple breast fibroadenomas in adolescent with dysfunctional uterine bleeding

Se describe la inusual evolución de fibroadenomas (FA) mamarios múltiples en una adolescente de 11 años en tratamiento con progestinas cíclicas por metrorragia disfuncional. Inicialmente la ecografía mamaria mostró más de 10 lesiones sólidas en cada mama de hasta 2,6 cm, compatibles con fibroadenomas. Al cabo de 13 meses las lesiones se redujeron en número y tamaño. Se discute la historia natural de los FA, la influencia hormonal en la etiología de los FA y finalmente el diagnóstico ecográfico y manejo de este cuadro en la adolescencia. Se plantea, a modo de hipótesis, que existe un desbalance estrógeno-progesterona (E-P) dado por ciclos anovulatorios en el periodo posmenárquico, que se manifestó con metrorragia disfuncional y la presencia de FA. Al administrar progesterona cíclica se reequilibra la relación E-P explicando el control del ciclo y la involución de las lesiones mamarias.

We describe the unusual evolution of multiple fibroadenomas (FA) in a 11-years old adolescent during treatment of an abnormal uterine bleeding with cyclic progestins. Inicially ultrasound demonstrated more than 10 masses in each breast, up to 2,6 cm diameter, compatible with fibroadenomas. After 13 month follow up lesions decreased in number and size. We discuss the natural history of FA, the hormonal influence in FA etiology, the ultrasound diagnosis and the managment of this pathology in adolescents. We hypothesized that there is an estrogen/progestin imbalance, due to the anovulatory cycles of the post menarche period that caused the AUB and FA. Cyclic progesterone balanced the E/P relation, thus managing both AUB and causing regression of the breast masses.

Fator prognóstico da idade no câncer de mama / Prognosis of age factor in breast cancer

Este estudo teve como objetivo comparar os resultados de um grupo de mulheres com câncer de mama em idade inferior a 40 anos a outro grupo fora dessa faixa etária. É um estudo observacional retrospectivo de cohorte com coleta de dados em sistema de prontuário eletrônico de 575 casos no período de fevereiro de 2001 até julho de 2013. O fator de exposição foi a idade ao diagnóstico, dividindo a amostra em 2 grupos: idade inferior a 40 anos e idade igual a superior a 40 anos. Os dados coletados foram: nome, idade, procedência, tipo tumoral, grau tumoral, tamanho tumoral, estadiamento patológico, tipo de tratamento, linfonodo sentinela, sobrevida em 5 e 10 anos. Inclusão no estudo foi permitida ao caso com todos os dados acima citados. Foram excluídas as pacientes com carcinoma ductal in situ ? Estádio 0 e Estadiamento 4 no momento do diagnóstico. Adotando os critérios de inclusão e exclusão, a amostra de estudo foi constituída por 331 mulheres, disposta em 2 grupos: Grupo 1 com 30 casos (idade inferior a 40 anos) e Grupo 2 com 301 casos (idade de 40 anos ou mais). O estudo concluiu existir um perfil diferente da enfermidade em mulheres com menos de 40 anos com significância para p<0,05 em Estadiamento avançado e tendo menor sobrevida global em 5 anos após pareamento por estadiamento. Não atingiu significância em tamanho tumoral, grau, tipo histológico, tipo de tratamento, resultado do linfonodo sentinela e sobrevida de 10 anos possivelmente pelo número de casos.

This study was like objective compare the results of a group of women with breast cancer at the age under 40 years to another group outside this age range. It is an observational retrospective cohort with data collection in electronic medical record system of 575 cases in the period from February 2001 to July 2013. The exposure factor was age at diagnosis, dividing the sample into two groups: those aged up to 40 years and the age above 40 years. The data were collected: name, age, origin, tumor type, tumor grade, tumor size, pathological stage, type of treatment, sentinel node, survival at 5 and 10 years. Inclusion in the study was allowed to the case with all the data mentioned above. We excluded patients with ductal carcinoma in situ ? Stage 0 and Stage 4, being treated randomly staging upon survival analysis. Adopting the criteria of inclusion and exclusion, the study sample consisted of 331 women, arranged in two groups: Group 1 with 30 cases (aged under 40 years) and Group 2 included 301 patients (age 40 or older). The study shows a different profile of the disease in women under 40 with significance set at p <0.05 in Staging and having shorter survival after pairing Staging in 5 years. Did not reach significance in tumor size, grade, histology, type of treatment, results of sentinel lymph node and possibly survival of 10 years the number of cases.