Carcinomas

Question 1

What are Carcinomas

Answer 1

Epithelial surfaces and glandular structures

Locally slightly more circumscribed (1 cm margin might be good enough)

Metastasis to lymph nodes more than via blood

Can be internal

Question 2

Carcinomas

Glandular

Answer 2

Apocrine gland adenocarcinomas

Question 3

Carcinomas

Skin

Answer 3

Squamous cell carcinoma

Question 4

Mammary Tumors

Spaying Stats

Answer 4

0.5% of in-tact females are at risk for development of malignant tumors if spayed prior to first estrus

8% after first estrus

26% after second estrus

Question 5

Mammary Tumors

More than 2 heats?

Answer 5

26% chance of developing malignant tumors

Can just do hysterectomy that way will still be able to respond to LH

Question 6

Canine Mammary Tumors

Presentation

Answer 6

Mammary mass; 65-70% occur in glands 4 and 5

Respiratory, neurologic signs or bone pain - secondary to metastasis

Question 7

Canine Mammary Tumors

Inflammatory tumors

Answer 7

Inflamed plaque like lesions or multiple nodules in the skin (poor prognosis)

Diffuse edema in mammary area

Question 8

Canine Mammary Tumors

Biologic behavior

Answer 8

50% rule if in-tact

41-53% of mammary masses are malignant

50%, of the 50%, of malignant tumors are low grade

Older dogs with larger tumors more likely to be malignant

Question 9

Canine Mammary Tumors

Diagnosis

Answer 9

Cytology is never diagnostic

Requires histopathology; might as well take it off

Question 10

Canine Mammary Tumors

Staging (3 things)

Answer 10

Evaluate local tumor

Lymph node evaluation (palpation, aspiration, removal and histopathology)

Thoracic radiographs (must)

Question 11

Canine Mammary Tumors
Treatment
Surgery

Answer 11

Lumpectomy still means usually one gland ahead and one behind

Complete masectomy: taking the whole chain which is usually not necessary in the dog

Question 12

Canine Mammary Tumors
Treatment
Chemotherapy

Answer 12

Usually not done unless metted

Difficult to assess efficacy

Doxorubicin single agent
Doxorubicin and Docetaxel
Gemcitabine
Tyrosine Kinase Inhibitor (Pallaida)

Question 13

Canine Mammary Tumors

Prognosis

Answer 13

Correlated with:
Tumor size
Lymph node involvement 
Presence of distant metastasis
Histologic type
Degree of invasion
Intravascular or lymphatic growth

Question 14

Feline Mammary Tumors

Background

Answer 14

More than 75% of feline mammary neoplasms are malignant

Third most frequent tumor in cat

Question 15

Feline Mammary Tumors

Signalment

Answer 15

Can be seen in spayed cats

Age: 10-12 years (but 9 months to 23 years)

DSH

Siamese breed has 2x risk

Question 16

Feline Mammary Tumors

Hormonal influences

Answer 16

Hormones most likely play role in development

Synthetic progestins or estrogen-progestin combinations increase risk 3x (contraceptives)

Question 17

Feline Mammary Tumors

Presentation

Answer 17

Mammary mass

Metastatic lesions; lymph node, lungs, bone

Question 18

Feline Mammary Tumors

Biologic Behavior

Answer 18

80% are adenocarcinomas

Highly aggressive, metastasis very common

Question 19

Feline Mammary Tumors

Diagnosis

Answer 19

Histopathology (definitive diagnosis)

Assume all mammary masses are bad

Staging must be done PRIOR to removal

Question 20

Feline Mammary Tumor

Staging

Answer 20

Assess tumor and all mammary glands
Assess draining lymph nodes (cranial glands axillary LN must be assessed)
Thoracic radiographs (less obvious)

Ultrasound of abdomen particularly if tumor is gland 3 or 4 or if cat is sick

Question 21

Feline Mammary Tumors
Treatment
Surgery

Answer 21

Get it right the first time!
Complete mastectomy (get as much as you can may have to do second surgery to get the other side at  later point)

Include the closest LN:
Gland 1&2: axillary
Gland 3&4: inguinal

Question 22

Feline Mammary Tumors

Chemotherapy

Answer 22

More likely to be helpful than in dog

Should still do surgery
Doxorubicin (15 month survival)
Doxorubicin + Cyclophosphamide

Question 23

Feline Mammary Tumors

Prognosis

Answer 23

Average survival since detection: 10-12 months

Size of tumor at diagnosis is most important indicator of survival! Smaller = better

Aggressive surgery is important