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)

Francesco Gemignani, Philipp Mayhew, Michelle Giuffrida, Jason Palaigos, Jeffrey J. Runge, David E. Holt, Nicholas A. Robertson, Bernard Seguin, Meaghan Walker, Ameet Singh, Julius M. Liptak, Giorgio Romanelli, Marina Martano, Sarah E. Boston, Cassie Lux, Roberto Busetto, William T Culp, Katherine A Skorupski, Jenna H Burton

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1393-1402
Number of pages10
JournalJournal of the American Veterinary Medical Association
Volume252
Issue number11
DOIs
StatePublished - Jun 1 2018

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Mastectomy
adenocarcinoma
Disease-Free Survival
breasts
Adenocarcinoma
Cats
Breast
cats
metastasis
Neoplasm Metastasis
risk factors
death
lymph nodes
Lymph Nodes
neoplasms
postoperative complications
excision
risk reduction
Human Mammary Glands
disease course

ASJC Scopus subject areas

  • veterinary(all)

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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). / Gemignani, Francesco; Mayhew, Philipp; Giuffrida, Michelle; Palaigos, Jason; Runge, Jeffrey J.; Holt, David E.; Robertson, Nicholas A.; Seguin, Bernard; Walker, Meaghan; Singh, Ameet; Liptak, Julius M.; Romanelli, Giorgio; Martano, Marina; Boston, Sarah E.; Lux, Cassie; Busetto, Roberto; Culp, William T; Skorupski, Katherine A; Burton, Jenna H.

In: Journal of the American Veterinary Medical Association, Vol. 252, No. 11, 01.06.2018, p. 1393-1402.

Research output: Contribution to journalArticle

Gemignani, Francesco ; Mayhew, Philipp ; Giuffrida, Michelle ; Palaigos, Jason ; Runge, Jeffrey J. ; Holt, David E. ; Robertson, Nicholas A. ; Seguin, Bernard ; Walker, Meaghan ; Singh, Ameet ; Liptak, Julius M. ; Romanelli, Giorgio ; Martano, Marina ; Boston, Sarah E. ; Lux, Cassie ; Busetto, Roberto ; Culp, William T ; Skorupski, Katherine A ; Burton, Jenna H. / 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). In: Journal of the American Veterinary Medical Association. 2018 ; Vol. 252, No. 11. pp. 1393-1402.
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abstract = "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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T1 - Association of surgical approach with complication rate, progression-free survival time, and disease-specific survival time in cats with mammary adenocarcinoma

T2 - 107 cases (1991–2014)

AU - Gemignani, Francesco

AU - Mayhew, Philipp

AU - Giuffrida, Michelle

AU - Palaigos, Jason

AU - Runge, Jeffrey J.

AU - Holt, David E.

AU - Robertson, Nicholas A.

AU - Seguin, Bernard

AU - Walker, Meaghan

AU - Singh, Ameet

AU - Liptak, Julius M.

AU - Romanelli, Giorgio

AU - Martano, Marina

AU - Boston, Sarah E.

AU - Lux, Cassie

AU - Busetto, Roberto

AU - Culp, William T

AU - Skorupski, Katherine A

AU - Burton, Jenna H

PY - 2018/6/1

Y1 - 2018/6/1

N2 - 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.

AB - 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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