Carcinoma inflamatório de mama em mulheres e cadelas: análise comparativa e perspectivas terapêuticas

Abstract

Inflammatory mammary carcinoma (IMC) is a clinic-pathological presentation of breast cancer characterized by rapid progression, aggressiveness, and poor prognosis, affecting both women and female dogs. Despite significant advances in understanding the pathogenesis and management of IMC in humans, and the recognition of female dogs as a model for comparative and translational studies in mammary oncology, research in veterinary medicine remains limited. The objective of this study was to conduct a comprehensive systematic review of IMC in women and female dogs, employing a rigorous methodology based on the PRISMA protocol, aiming to compare clinicopathological characteristics, prognostic factors, and therapeutic approaches, as well as identify critical gaps in current knowledge. The Scopus, Web of Science, Embase, and PubMed databases were used, identifying 1,299 records, of which 53 studies met the inclusion criteria. Analyses included keyword maps, concepts, and citations, using VOSviewer software to visualize the interrelationships between the searched terms. Results showed that most studies on IMC in female dogs were retrospective and observational, with little experimental evidence, likely due to the aggressive nature of the disease. Comparing human and veterinary studies, a predominance of terms related to human IMC was observed, such as "inflammatory breast cancer" and "survival". In contrast, specific terms from canine oncology, such as "canine mammary tumors", appeared isolated, highlighting the lack of interconnection between the two areas. The most common clinical manifestations in women and female dogs included edema, erythema, and the "peau d'orange" appearance. However, studies in veterinary medicine indicated a greater diversity of histological types associated with IMC, suggesting additional complexity in the pathogenesis of the disease in female dogs. Differences in molecular markers were identified, with HER-2, ER, and PR being widely used in humans but still little explored in female dogs. The review highlighted the scarcity of comparative studies of IMC in humans and dogs. This study also examined treatment options for IMC in women and dogs. In humans, multimodal therapy has been used in most studies in women. In dogs, the therapeutic options evaluated were limited, usually involving palliative care and, in some situations, chemotherapy. The relevance of canine models for translational cancer research has grown, but there is still a significant gap to be filled, especially in the 9 validation of biomarkers and specific therapies. Advances in veterinary oncology research, especially in prospective studies and controlled clinical trials, are necessary to elucidate shared molecular mechanisms and identify therapeutic targets. This comparative approach has the potential to revolutionize the management of IMC in both species, significantly improving the prognosis and quality of life of affected patients.