Tumores de mama em cadelas
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2018-06-18
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Os tumores de mama constituem a doença neoplásica mais comum nas cadelas e tem-se constatado que talvez devido ao melhoramento dos cuidados médicos prestados e ao consequente aumento da longevidade, a incidência tem vindo a aumentar em países em que a prática da OVH de conveniência não é rotineiramente executada. Por esta razão e também pelo facto de se ter vindo a demonstrar que a cadela representa um bom modelo de estudo para o cancro da mama na mulher, tem-se observado um crescente interesse no estudo nesta matéria. Os mecanismos de ordem etiológica que promovem o desenvolvimento tumoral espontâneo são de diferentes naturezas, porém, na cadela pode-se afirmar indubitavelmente que os fatores hormonais têm a maior predominância na promoção e condução desta doença. O estadio clínico é estabelecido com base no sistema TNM, através do qual se avalia as dimensões do tumor, a presença de células neoplásicas nos gânglios regionais e a evidências de metástases à distância. O diagnóstico definitivo só se poderá assumir através de uma avaliação histopatológica. É também através da análise histopatológica que se estabelece a natureza do tumor, isto é, se é benigno ou maligno e após a atribuição desta classificação impõe-se a caracterização mais detalhada do mesmo: os benignos podem ser classificados em adenomas, fibroadenomas, tumor benigno misto e papilomas ductais, ao passo que os malignos se subdividem em carcinomas não infiltrativos, carcinomas complexos e simples, tipos especiais de carcinomas, sarcomas e carcinoma inflamatório. Um diagnóstico bem fundamentado com base nos meios anteriormente mencionados contribui para a segura determinação de um prognóstico e especialmente na medicina veterinária este facto adquire uma relevância inquestionável porque na quotidianidade clínica é rara a utilização de referências de prognóstico com um maior grau de especificidade, como a quantificação da expressão hormonal (E2 e P4) ou o nível de expressão proteica de alguns genes, como o gene p53. O tratamento de eleição é a excisão cirúrgica e é esta a modalidade terapêutica mais praticada em cadelas, porém, como havia referido, tem-se observado um notável e crescente interesse nesta matéria e como resultado tem-se descoberto outras vias terapêuticas, direcionadas para alvos mais específicos. O presente trabalho focar-se-á na abordagem de seis casos de cadelas acometidas por tumores de mama, expondo-se descritivamente todos os procedimentos integrados no acompanhamento clínico de cada caso em particular. Assume-se como finalidade deste trabalho, a revisão e apreciação da rotineira metodologia clínica na abordagem e resolução terapêutica dos tumores de mama em cadelas na Clínica Veterinária Douro Sul e na Policlínica Veterinária Antuã.
Mammary tumours constitute the most common neoplastic disease in the bitches and it has been verified that the incidence has become higher, maybe due to the improvement of medical care and the consequent increased longevity in countries where the practice of convenience OVH is not routinely performed. For this reason and because of the fact that it has been solidly proven that the bitch represents the best study model for the women breast cancer, it has been observed a growing interest on this matter. The mechanisms of etiological order that promote the spontaneous tumoral development are from different natures, although we can undoubtedly claim that in the bitch it is the hormonal ones that have the greatest predominance on the promotion and conduction of this disease. On a first phase, the diagnose is approximately established based on the TNM system through which the dimensions of the tumor, the presence of neoplastic cells in the regional lymph nodes and the evidence of distant metastases are evaluated, however, we can only assume the final diagnose through a histopathological evaluation. It is also through the histopathological analysis that we establish the nature of the tumor, if it is benign or malign and after the attribution of this classification It is imposed a more detailed characterization of the tumor: the benign ones are classified as adenomas, fibroadenomas, benign mixed tumours and ductal papilloma, while the malign ones are subdivided into non infiltrative carcinoma, simple and complex carcinoma, sarcoma and inflammatory carcinoma. A well reasoned diagnose based on the previously mentioned means contributes for the secure determination of a prognosis and specially in veterinary medicine this fact acquires an unquestionable relevance because it is very rare on clinical everyday life the use of more specific prognosis references, as the quantification of hormonal expression (E2 and P4) or the protein expression level of some genes such as p53 gene expression. The treatment of election is surgery and this is the most used therapeutic modality on bitches, however, as I had referred, it has been observed a remarkable and a growing interest on this matter and as a result it has been discovered other therapeutic ways, directed to more specific targets. The present work will focus on the approach of six cases of bitches affected by breast tumors, describing all the procedures integrated in the clinical follow-up of each particular case. The purpose of this study is to review and evaluate the routine clinical methodology in the approach and therapeutic resolution of breast tumors in bitches in the Douro Sul Veterinary Clinic and in the Antuã Veterinary Policlinic.
Mammary tumours constitute the most common neoplastic disease in the bitches and it has been verified that the incidence has become higher, maybe due to the improvement of medical care and the consequent increased longevity in countries where the practice of convenience OVH is not routinely performed. For this reason and because of the fact that it has been solidly proven that the bitch represents the best study model for the women breast cancer, it has been observed a growing interest on this matter. The mechanisms of etiological order that promote the spontaneous tumoral development are from different natures, although we can undoubtedly claim that in the bitch it is the hormonal ones that have the greatest predominance on the promotion and conduction of this disease. On a first phase, the diagnose is approximately established based on the TNM system through which the dimensions of the tumor, the presence of neoplastic cells in the regional lymph nodes and the evidence of distant metastases are evaluated, however, we can only assume the final diagnose through a histopathological evaluation. It is also through the histopathological analysis that we establish the nature of the tumor, if it is benign or malign and after the attribution of this classification It is imposed a more detailed characterization of the tumor: the benign ones are classified as adenomas, fibroadenomas, benign mixed tumours and ductal papilloma, while the malign ones are subdivided into non infiltrative carcinoma, simple and complex carcinoma, sarcoma and inflammatory carcinoma. A well reasoned diagnose based on the previously mentioned means contributes for the secure determination of a prognosis and specially in veterinary medicine this fact acquires an unquestionable relevance because it is very rare on clinical everyday life the use of more specific prognosis references, as the quantification of hormonal expression (E2 and P4) or the protein expression level of some genes such as p53 gene expression. The treatment of election is surgery and this is the most used therapeutic modality on bitches, however, as I had referred, it has been observed a remarkable and a growing interest on this matter and as a result it has been discovered other therapeutic ways, directed to more specific targets. The present work will focus on the approach of six cases of bitches affected by breast tumors, describing all the procedures integrated in the clinical follow-up of each particular case. The purpose of this study is to review and evaluate the routine clinical methodology in the approach and therapeutic resolution of breast tumors in bitches in the Douro Sul Veterinary Clinic and in the Antuã Veterinary Policlinic.