Current Approaches In Canine and Feline Mammary Tumors

.: PREFACE
ÖN SÖZ
PREFACE
Prof. Dr. İsmail KIRŞAN
İstanbul Üniversitesi-Cerrahpaşa Veteriner Fakültesi, Doğum ve Jinekoloji ABD, İstanbul, Türkiye
Article Language: TR
Ülkemiz de dâhil olmak üzere dünya genelinde evlerde bakılan hayvan sayısı giderek artmaktadır. Bu popülasyon içerisinde köpek ve kediler çoğunluğu teşkil etmektedir. Köpek ve kedi nüfusu içerisinde en çok görülen, en çok ölüme neden olan hastalıklar o hayvan nüfusu içerisinde en önemli sağlık sorunu olarak kabul edilir. Bu bağlamda meme tümörleri de dünyada olduğu gibi Türkiye'de de köpek ve kedilerde sıkça karşılaşılan hastalıklardan bir tanesi olmuştur. Bunun nedenlerinin başında çevre kirliliği, beslenme bozuklukları, ev içerisinde geçirilen zamanın fazla olması, hormonların etkisi, yeni ırklar oluşturulurken meme tümörleri dâhil olmak üzere bazı hastalıklara genetik yatkınlıkta artışın gelişmesi, üreme faaliyetlerinin ömür boyu devam etmesi gibi dezavantajlar biraraya getirildiğinde meme tümörü oluşma sıklığında artışa yol açmıştır. Bu durum giderek daha da artmaktadır. Jinekoloji kliniklerine getirilen vakalar içerisinde ilk sırayı meme tümörleri oluşturmaktadır. Her ne kadar yaş ortalamasında henüz belirgin bir düşme olmasa da, vaka sayısındaki artışın diğer bir sebebi olarak; veteriner hekimlik hizmetlerinde sağlanan önemli gelişmeler ve uygulamalar sayesinde hastalıkların tanı ve tedavisine yönelik uygulamaların artması ve dolayısıyla köpek ve kedilerin yaşam sürelerindeki uzama gösterilebilir.

Bazı ülkelerde erken yaşta ve yoğun bir şekilde gerçekleştirilen ovariohisterektomi girişimi sayesinde meme tümörü oluşma sıklığı az olsa bile, bu durum hastalığın dünya genelindeki küresel artış hızını çok fazla etkilememiştir. Yaklaşık çeyrek asır geriye gidip, yapılan araştırmaları incelediğimizde; dünyada köpek ve kedilerde en sık görülen tümörler arasında deri tümörlerinden sonra ikinci sırayı meme tümörlerinin aldığı yazılmış olsa da, artık günümüzde bu sıralama birçok ülkede değişmiş ve meme tümörlerini birinci sıraya taşımıştır.

Meme tümöründen korunmada birincil ve ikincil koruyucu önlemler vardır. Birincil koruyucu önlemler, yani meme tümörlerine neden olan etkenlerden korunma; genetik, hormonal ve çevresel etkenlerin tanımlanarak bunlara karşı önlem alınmasını gerektirir. İkincil önlem ise köpek ve kedi yakınlarının evde hayvanlarını severken memelerini kontrol etmeleri sırasında elde edecekleri anormal bulgularla olur. Aslında bu ikinci uygulama meme tümörlerinin oluşmasını engellemez, sadece erken dönemde teşhis edilmelerine yardımcı olur. Günümüzde köpek ve kedilerde meme tümörlerinin gelişmesine yönelik birincil ve ikincil korunma önlemleri henüz rutin uygulamalar arasında yer almaması, tanı ve tedavi olanaklarını artırmaya yönelik olan üçüncül bir yaklaşımın önemini ön plana çıkarmıştır. Üçüncül yaklaşım (erken tanı ve tedavi), köpek ve kedilerin memelerindeki normal olmayan değişimlerin düzenli aralıklarla yapılan veteriner hekim muayeneleri sırasında erken dönemde belirlenmesini, hasta yakınını bilgilendirmeyi, doğru müdahalenin zamanında yapılmasını ve hasta takibini hedefler. Dolayısıyla bu yöntem günümüzde meme tümörlerine bağlı mortalite oranlarını düşüren, evdeki dostların yaşam süresi ve konforunu olumlu yönde etkileyen bir yaklaşım olmuştur.

Türkiye Klinikleri'nin bu kitabında, köpek ve kedilerde önemli bir sağlık sorunu olan meme tümörlerinin biyolojisi, genetiği, epidemiyolojisi, risk faktörleri, tarama ve görüntüleme yöntemleri, metastaz mekanizmaları, biyobelirteçler, meme tümörlerinin yaşam kalitesi ve süresi üzerine etkileri, beslenme ve bakıma yönelik yaklaşımlar, cerrahi işlemler ve teknikler, palyatif yaklaşımlar, komplikasyonları kapsayan güncel bilgileri içeren bölümler yer almaktadır.

Bu kitap ile köpek ve kedilerde meme tümörlerine yönelik bilimsel araştırma yapacak akademisyenlere, klinisyen veteriner hekimlere teşhis ve tedavi alternatiflerini geliştirmelerine yardımcı olacak en yüksek düzeydeki güncel bilimsel bilgileri içeren bölümleri yayınlamak suretiyle kapsamlı multidisipliner bir kaynak olmayı ve literatüre katkıda bulunmayı amaçladık.

Sağlık ve başarı dileklerimle.

Prof. Dr. İsmail KIRŞAN
Editör
Including our country, the number of pets kept at homes is increasing gradually. Dogs and cats constitute the majority in this population. The most common diseases that cause the most mortality in the dog and cat population are considered as the most important health problem in that animal population. In this regard, mammary tumours in Turkey as well as in the world has been one of the frequently encountered disease in dogs and cats. One of the main reason for this is environmental pollution, nutritional disorders, excessive time spent at home, the effects of hormones, whil new breeds forming an increased genetic susceptibility to certain diseases including mammary tumours, when the disadvantages such as life-long continuation of reproductive activities together leads to an increase in the mammary tumour incidence. This situation is increasing more and more. Mammary tumours constitute the first line among the cases brought to our clinic. Although there is not a significant decrease in the average age yet, another reason for the increase in the number of cases can be shown as the applications for the diagnosis and treament of diseases and therefore the prolongation of the life span of dogs and cats, connected to the important developments and applications in gynecology clinics.

Even though the incidence of mammary tumour formation was low due to the early and intensive ovariohysterectomy in some countries, this situation did not affect the global increase rate of the disease worldwide. Although it was written that mammary tumours take the second place after skin tumours among the most common tumours in dogs and cats in the world, when we go back about a quarter of a century, this order has now changed in many countries and brought mammary tumours to the first place.

There are primary and secondary preventive measures in preventing mammary tumours. Primary preventive measures, that is, protection from factors that cause mammary tumours, requires identifying and taking measures against genetic, hormonal and environmental factors. Secondary precaution occurs with abnormal findings that pet owners will obtain while checking their dogs and cats' mammary glands while petting them at home. In fact, this second application does not prevent the formation of mammary tumours, it only helps them to be diagnosed in the early period. Nowadays, primary and secondary prevention measures for the development of mammary tumours in dogs and cats are not among the routine practices yet, highlighting the importance of a tertiary approach to increase diagnosis and treatment possibilities. The tertiary approach (early diagnosis and treatment) aims to detect abnormal changes in the mammary glands of dogs and cats during regular veterinary examinations, to inform the patient's owners, to perform the correct intervention on time and to follow-up the patient. Therefore, this method has become an approach that reduces the mortality rates due to mammary tumours and positively affects the life expectancy and comfort of friends at home.

In this book of Türkiye Klinikleri, is containing chapters up-to-date information on approaches to nutrition and care, surgical procedures and techniques, palliative approaches, and complications, mammary tumours biology, genetics, epidemiology, risk factors, screening and imaging, metastasis mechanisms, biomarkers, the effects of mammary tumours on quality and longevity of life which is an important health problem of dogs and cats.

With this book, we aimed to be a comprehensive multidisciplinary resource and to contribute to the literature by publishing chapters containing the highest level of up-to-date scientific information that will help academics, clinicians and veterinarians to develop diagnostic and treatment alternatives for mammary tumours in dogs and cats.

I wish you health and success.

Prof. Dr. İsmail KIRŞAN
Editor

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