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

Approach to Mammary Tumours Flashcards

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

A

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

20
Q

Indications in histopathological grade for a high tumor grade

A

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

21
Q

Outline Mammary tumour grading

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

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

A

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

24
Q

Are lipomas benign or malignant

A

Benign

25
Q

Are sarcomas typically benign or malignant

A

Highly aggressive – metastasise to bone, lungs etc (haematogenously)

26
Q

Difference between Solid and Anaplastic epithelial tumour types

A

Solid- Fixed, Ulcerated, Rapid growth
Anaplastic- Ulcerated, Dermal & lymphatic invasion

27
Q

Is solid or anaplastc tumour types more malignant

A

Anaplastic

28
Q

Is Inflammatory carcinoma common in cats

A

Few cases reported in cats
Undifferentiated, anaplastic, v malignant carcinomas

29
Q

Two ways to take a sample of mammary tumour

A

FNA and biopsy

30
Q

Diagnosis of mammary tumour using FNA

A

Sucks out some cells
Usually diagnostic if uniform carcinoma
May rule out non-mammary tumours eg MCT, lipoma, abscess

31
Q

Advantages of biopsy over FNA

A

Biopsy will give more information than FNA eg tissue architecture, histological type and grade

32
Q

Outline the first stage of staging primary tumour (T)

A

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
Q

Main treatment of mammary tumours

A

Surgery
Role of Chemotherapy and endocrine therapy unproven

34
Q

Name of surgery to remove mammary tumour

A

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
Q

What is the surgery of choice of feline mammary tumours

A

Radical mastectomy

36
Q

When do I remove lymph nodes for mammary tumour treatment

A

Inguinal excised with gland 4 (cat), or 5 (dog)

37
Q

Arguments why I should have a concurrent ovariohystectomy

A

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
Q

Should you use chemotherapy and what drug to give for mammary tumours

A

Needed for aggressive carcinomas BUT not very effective
Most evidence supports some efficacy for Doxorubicin

39
Q

Other therapies for mammary tumours

A

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
Q

Prognostic factor (Dog)
Histological type: Tubular, papillar, solid, anaplastic

A

tubular, papillary = good, solid, anaplastic = poor

41
Q

Prognostic factor (Dog)
Histological grade

A

Low (grade I) = good, High (grade III) = poor

42
Q

Prognostic factor (Dog)
Tumour size

A

<3cm diameter = good, > 5cm = poor

43
Q

Prognostic factor (Dog)
Spay status

A

Not spayed (more likely ER positive) = good

44
Q

ER tumour meaning

A

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
Q

Prognostic factor (Cat)
Histological grade

A

Low (grade I) is good, but less common!
High (grade III) – 90-100% dead at 1 year

46
Q

Prognostic factor (Cat)
Tumour size

A

<2cm diameter = good, > 3cm = bad

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

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