Retrospective Evaluation of Adjunctive Doxorubicin for the Treatment of Feline Mammary Gland Adenocarcinoma: 67 Cases

Novosad, C. Andrew; Bergman, Philip J.; O’Brien, Maura G.; McKnight, J. A.; Charney, Sarah C.; Selting, Kim A.; Graham, Joanne C.; Correa, Stephanie Shank; Rosenberg, Mona P.; Gieger, Tracy L.

doi:10.5326/0420110

Cited by 60 publications

(79 citation statements)

References 9 publications

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“…Bilateral mastectomy can be performed as a single-session procedure or in a staged fashion; for the latter, the 2 procedures are typically performed several weeks apart. In 1 study, 4 37 cats undergoing staged bilateral mastectomy had a longer disease-free interval than those undergoing unilateral mastectomy (917 days vs 348 days); however, this result was only statistically significant in the univariable model. Limited information exists in the published literature on cats treated with bilateral mastectomy for management of mammary adenocarcinoma, and the complication rate associated with this procedure is largely unknown.…”

Section: Small Animals and Exoticmentioning

confidence: 88%

“…prognostic factors for mammary adenocarcinoma in cats, and factors found to be significant in individual studies include tumor size, 11,12 TNM stage, 8 histologic subtype, 10,13 histologic grade, 8,14 and lymphatic invasion 3,8 as well as a variety of proliferative markers including mitotic index, 8,15 Ki67 positivity, 8 and mean AgNOR count per neoplastic cell. 16 Administration of adjuvant chemotherapy has been suggested to have a beneficial prognostic effect in some studies 4 ; however, in 1 study 6 that included a control population that did not receive adjuvant chemotherapy, no obvious beneficial effect of chemotherapy was seen.…”

Section: Small Animals and Exoticmentioning

confidence: 99%

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Association of surgical approach with complication rate, progression-free survival time, and disease-specific survival time in cats with mammary adenocarcinoma: 107 cases (1991–2014)

Gemignani¹,

Mayhew²,

Giuffrida³

et al. 2018

javma

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OBJECTIVE To evaluate potential associations between surgical approach and complication rate, progression-free survival time, and disease-specific survival time in cats with mammary adenocarcinoma. DESIGN Retrospective case series. ANIMALS 107 client-owned cats. PROCEDURES Medical records of cats that underwent surgical excision of mammary adenocarcinoma by means of a unilateral or bilateral (staged or single-session) mastectomy at 9 hospitals between 1991 and 2014 were reviewed. Relevant clinicopathologic data and details of surgical and adjuvant treatments were recorded. Outcome data were obtained, including postoperative complications, progression-free survival time, and disease-specific survival time. RESULTS Complications occurred in 12 of 61 (19.7%) cats treated with unilateral mastectomy, 5 of 14 (35.7%) cats treated with staged bilateral mastectomy, and 13 of 32 (40.6%) cats treated with single-session bilateral mastectomy. Complications were significantly more likely to occur in cats undergoing bilateral versus unilateral mastectomy. Median progression-free survival time was longer for cats treated with bilateral mastectomy (542 days) than for cats treated with unilateral mastectomy (289 days). Significant risk factors for disease progression included unilateral mastectomy, tumor ulceration, lymph node metastasis, and tumors arising in the fourth mammary gland. Significant risk factors for disease-specific death included lymph node metastasis and development of regional or distant metastasis. Among cats that did not develop metastasis, unilateral mastectomy was a significant risk factor for disease-specific death. Treatment with chemotherapy was associated with a significantly decreased risk of disease-specific death. CONCLUSIONS AND CLINICAL RELEVANCE Results supported bilateral mastectomy for the treatment of mammary adenocarcinoma in cats to improve progression-free and disease-specific survival time. Performing bilateral mastectomy in a staged fashion may help to decrease the complication rate.

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Section: Small Animals and Exoticmentioning

confidence: 88%

Section: Small Animals and Exoticmentioning

confidence: 99%

Association of surgical approach with complication rate, progression-free survival time, and disease-specific survival time in cats with mammary adenocarcinoma: 107 cases (1991–2014)

Gemignani¹,

Mayhew²,

Giuffrida³

et al. 2018

javma

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“…Additional shortcomings and possible sources of error encountered when using tumor size (or volume) as a prognostic factor are described by Matos et al 18 Recent reports support findings here, indicating that while larger tumors (>3 cm diameter) are associated with reduced survival times, tumor size alone appears to have little or no independent prognostic value when smaller than 3 cm in diameter. 25,36 The modified WHO clinical stage provides a useful prognostic indicator in cats with advanced clinical disease. 15 Stage 3 cats had significantly reduced OS compared with stage 1 cats in this study; a statistical association between WHO stage and OS has also been noted elsewhere.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Histologic Grading for Feline Mammary Carcinoma

et al. 2014

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Feline mammary carcinoma is highly malignant and generally associated with a poor prognosis, although studies suggest the range of survival times in affected cats is broad. Histologic grading of these tumors is achieved using the Elston and Ellis system, originally developed for human breast cancer. In cats, however, classification using this method has variable prognostic value. Therefore, objectives of this study were (1) to evaluate the Elston and Ellis grading system for feline mammary carcinoma in a predominantly spayed population and (2) to determine whether modification of this system or development of a novel system improved the prognostic value of histologic grading. Survey data and histologic features for 108 carcinomas from 97 cats were analyzed with respect to overall survival. Elston and Ellis grading failed to correlate significantly with overall survival. Using multivariable analysis, lymphovascular invasion, nuclear form, and mitotic count each demonstrated independent prognostic significance (P ¼ .008, <.001, and .004, respectively). Modifications of the Elston and Ellis system and a novel grading system were proposed based on these results; all showed significant correlation with overall survival (P < .001). Median survival times were 27, 29, or 31 months for grade I; 14, 12, or 14 months for grade II; and 13, 5, or 8 months for grade III carcinomas using the mitotic-modified Elston and Ellis, the revised Elston and Ellis, or the novel grading system, respectively. Based on this retrospective study, adoption of the species-specific systems as proposed here may improve the prognostic value of histologic grading for feline mammary carcinoma.

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“…Given the high rate of mammary malignancy in cats, cytologic findings of a benign-appearing population of epithelial cells, particularly in an older cat with no history of progesterone administration, should be treated with some caution. However, the combination of surgery and adjunctive doxorubicin chemotherapy resulted in improved long-term survival in cats with mammary gland adenocarcinoma, but controls were not studied (Novosad, 2003;Novosad et al, 2006). Treatment considerations will follow clinical and cytologic and/or histologic identification of a mammary neoplasm in a dog or a cat.…”

Section: Neoplasiamentioning

confidence: 99%