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Module 17-Urinary, Endocrinology, Oncology > Approach to Mammary Tumours > Flashcards

Approach to Mammary Tumours Flashcards

(46 cards)

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1
Q

What is the most common type of neoplasm in intact bitches?

A

Mammary tumours

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2
Q

Prognosis of mammary tumor in the bitch

A

Variable ~50%Malignant

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3
Q

Prognosis of mammary tumour in the queen

A

Poor-90% Malignant

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4
Q

Dog breeds predisposed to mammary tumours

A

Miniature and toy breeds- Yorkshire terriers, Poodles, dachshunds, spaniels

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5
Q

Cat breeds predisposed to mammary tumours

A

Oriental breeds (Siamese), DSH

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6
Q

Mean age of dog to develop mammary tumours

A

7-13 yrs (malignant 9-11y vs benign 7-9y)

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7
Q

Mean age of cat to develop mammary tumours

A

10-12 yrs
9yrs (Siamese)

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8
Q

3 main causes of development of mammary tumours

A

Genes and Hormones and Obesity

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9
Q

Two genetic reasons for development of mammary tumours

A

Sporadic – Combination of upregulated or downregulated (mutated) genes acquired through life
Familial- Inherited from generation to generation

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10
Q

Ovariohysterectomy in Dog reduces risk of malignant mammary tumours if done______ years

A

<2.5 years

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11
Q

T/F Previous mammary tumour increases the risk of second tumour

A

True!
22% of dogs with benign tumour developed another later
49% of dogs with malignant tumour developed another later

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12
Q

Signalment of Fibroadenomatous hyperplasia

A

Follows metoestrus, pregnancy, exogenous progestins
Young animals- Check if pregnant with US
One or multiple glands are swollen, painful, oedematous but no milk production
Anorexia, lethargy, tachycardia

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13
Q

Adenocarcinoma is neoplasm of what cells (Mammary tumour)

A

Ductal epithelium
Luminal epithelium
Myoepithelium

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14
Q

A Circumscribed, non-fixed, hard, knobbly, Cartilage/bone presented histologically suggest what kind of tumour?

A

Mixed mammary tumour
Ep +/- myoep but cartilage or bone always present

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15
Q

Are mixed mammary tumours benign or malignant

A

Benign

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16
Q

What is the most common malignant mammary tumour in the dog

A

SIMPLE carcinoma
single epithelium

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17
Q

What is inflammatory carcinoma

A

Invasion of dermal lymphatics by tumour emboli causes local oedema

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18
Q

Anaplastic definition

A

A term used to describe cancer cells that divide rapidly and have little or no resemblance to normal cells

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19
Q

Sort by increasing malignancy
Complex carcinomas
Simple carcinomas( Tubulopapillary, Solid, Anaplastic)
Sarcomas

Study These Flashcards
A

Complex carcinomas
Simple carcinomas( Tubulopapillary, Solid, Anaplastic)
Sarcomas

20
Q

Indications in histopathological grade for a high tumor grade

Study These Flashcards
A

Invasive
Poor tubule formation
Nuclear pleomorphism
Hi mitotic count (>20/10HPF)

21
Q

Outline Mammary tumour grading

Study These Flashcards
A

Tubule formation
Nuclear pleomorphism (variation in size and shape)
Mitoses / 10 HPF

Graded on a scale 1-3 and added together

22
Q

Outline how many grades there is in mammary tumour grading

Study These Flashcards
A

I (Low) Well differentiated (3-5)
II (Intermediate) Moderately differentiated (6-7)
III (High) Poorly differentiated (8-9)

23
Q

Name 3 types of histological types of mammary tumours

Study These Flashcards
A

SARCOMA-Stroma/ connective tissue
ADENOCARCINOM- Various epitheliums
LIPOMA- Fat

24
Q

Are lipomas benign or malignant

25
Are sarcomas typically benign or malignant
Highly aggressive – metastasise to bone, lungs etc (haematogenously)
26
Difference between Solid and Anaplastic epithelial tumour types
Solid- Fixed, Ulcerated, Rapid growth Anaplastic- Ulcerated, Dermal & lymphatic invasion
27
Is solid or anaplastc tumour types more malignant
Anaplastic
28
Is Inflammatory carcinoma common in cats
Few cases reported in cats Undifferentiated, anaplastic, v malignant carcinomas
29
Two ways to take a sample of mammary tumour
FNA and biopsy
30
Diagnosis of mammary tumour using FNA
Sucks out some cells Usually diagnostic if uniform carcinoma May rule out non-mammary tumours eg MCT, lipoma, abscess
31
Advantages of biopsy over FNA
Biopsy will give more information than FNA eg tissue architecture, histological type and grade
32
Outline the first stage of staging primary tumour (T)
Palpate both chains and all glands (66% dogs have more than one tumour, 33% of cats) Palpate and measure Primary tumour in cms (T) Size relates to prognosis Solid/cystic? Ulcerated? Fixed to skin/underlying tissues?
33
Main treatment of mammary tumours
Surgery Role of Chemotherapy and endocrine therapy unproven
34
Name of surgery to remove mammary tumour
Nodulectomy/lumpectomy Unfixed lesions < 0.5 cm Mammectomy (whole gland removal) Fixed or unfixed 0.5-1.0 cm Partial /regional mastectomy (gland plus other adjacent glands which drain from it) Radical mastectomy (mammary strip,used for multiple lesions)
35
What is the surgery of choice of feline mammary tumours
Radical mastectomy
36
When do I remove lymph nodes for mammary tumour treatment
Inguinal excised with gland 4 (cat), or 5 (dog)
37
Arguments why I should have a concurrent ovariohystectomy
Benign tumours: reduces risk of growth of further benign tumours by 50% (Kristiansen et al 2013) Will prevent pyometra Prevents the need for progestins
38
Should you use chemotherapy and what drug to give for mammary tumours
Needed for aggressive carcinomas BUT not very effective Most evidence supports some efficacy for Doxorubicin
39
Other therapies for mammary tumours
Herceptin (blocks EGFR2/HER2 antagonist) Anti-oestrogens – tamoxifen/aromatase inhibitor Cox2 inhibitors (NSAIDs) – increased COX2 expression in aggressive carcinomas and associated with poor prognosis Anti-angiogenic therapy - Thalidomide
40
Prognostic factor (Dog) Histological type: Tubular, papillar, solid, anaplastic
tubular, papillary = good, solid, anaplastic = poor
41
Prognostic factor (Dog) Histological grade
Low (grade I) = good, High (grade III) = poor
42
Prognostic factor (Dog) Tumour size
<3cm diameter = good, > 5cm = poor
43
Prognostic factor (Dog) Spay status
Not spayed (more likely ER positive) = good
44
ER tumour meaning
Estrogen receptor (ER) positive. The cells of this type of breast cancer have receptors that allow them to use the hormone estrogen to grow.
45
Prognostic factor (Cat) Histological grade
Low (grade I) is good, but less common! High (grade III) – 90-100% dead at 1 year
46
Prognostic factor (Cat) Tumour size
<2cm diameter = good, > 3cm = bad

Module 17-Urinary, Endocrinology, Oncology (28 decks)

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