Carcinomas Flashcards
What are Carcinomas
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
Carcinomas
Glandular
Apocrine gland adenocarcinomas
Carcinomas
Skin
Squamous cell carcinoma
Mammary Tumors
Spaying Stats
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
Mammary Tumors
More than 2 heats?
26% chance of developing malignant tumors
Can just do hysterectomy that way will still be able to respond to LH
Canine Mammary Tumors
Presentation
Mammary mass; 65-70% occur in glands 4 and 5
Respiratory, neurologic signs or bone pain - secondary to metastasis
Canine Mammary Tumors
Inflammatory tumors
Inflamed plaque like lesions or multiple nodules in the skin (poor prognosis)
Diffuse edema in mammary area
Canine Mammary Tumors
Biologic behavior
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
Canine Mammary Tumors
Diagnosis
Cytology is never diagnostic
Requires histopathology; might as well take it off
Canine Mammary Tumors
Staging (3 things)
Evaluate local tumor
Lymph node evaluation (palpation, aspiration, removal and histopathology)
Thoracic radiographs (must)
Canine Mammary Tumors
Treatment
Surgery
Lumpectomy still means usually one gland ahead and one behind
Complete masectomy: taking the whole chain which is usually not necessary in the dog
Canine Mammary Tumors
Treatment
Chemotherapy
Usually not done unless metted
Difficult to assess efficacy
Doxorubicin single agent
Doxorubicin and Docetaxel
Gemcitabine
Tyrosine Kinase Inhibitor (Pallaida)
Canine Mammary Tumors
Prognosis
Correlated with: Tumor size Lymph node involvement Presence of distant metastasis Histologic type Degree of invasion Intravascular or lymphatic growth
Feline Mammary Tumors
Background
More than 75% of feline mammary neoplasms are malignant
Third most frequent tumor in cat
Feline Mammary Tumors
Signalment
Can be seen in spayed cats
Age: 10-12 years (but 9 months to 23 years)
DSH
Siamese breed has 2x risk
Feline Mammary Tumors
Hormonal influences
Hormones most likely play role in development
Synthetic progestins or estrogen-progestin combinations increase risk 3x (contraceptives)
Feline Mammary Tumors
Presentation
Mammary mass
Metastatic lesions; lymph node, lungs, bone
Feline Mammary Tumors
Biologic Behavior
80% are adenocarcinomas
Highly aggressive, metastasis very common
Feline Mammary Tumors
Diagnosis
Histopathology (definitive diagnosis)
Assume all mammary masses are bad
Staging must be done PRIOR to removal
Feline Mammary Tumor
Staging
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
Feline Mammary Tumors
Treatment
Surgery
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
Feline Mammary Tumors
Chemotherapy
More likely to be helpful than in dog
Should still do surgery
Doxorubicin (15 month survival)
Doxorubicin + Cyclophosphamide
Feline Mammary Tumors
Prognosis
Average survival since detection: 10-12 months
Size of tumor at diagnosis is most important indicator of survival! Smaller = better
Aggressive surgery is important
