Removal of mammary glands in cats. Cat after mammary tumor removal

IN modern world New diseases are becoming more and more common and significantly reducing living standards. Unfortunately, cats, like people, can become targets for the disease. In this article we will look at such an ailment as. This is an oncological disease that is caused by the appearance of a neoplasm and has different degrees severity of manifestation. We will try to talk about its causes, types, signs, as well as possible methods of its treatment (surgery to remove a mammary tumor in a cat). Any information in the text is given for informational purposes only, self-medication is dangerous, and ignoring the disease can be a mistake, the cost of which is equal to the life of the animal.

Mammary tumor in a cat: causes

Statistics show that tumor Breast diseases rank first among cancers by the number of registered calls to veterinary centers. Among the possible reasons The appearance of this disease can be distinguished as follows:

1 age characteristics. Research has shown a direct relationship between age and the appearance of malignant neoplasms. Young individuals are much less likely to be affected by this disease, unlike more mature ones. How older cat, the higher the risk of developing the disease. The age threshold in this case is at 8-10 years. After crossing it, the risk of neoplasm is quite high; 2 genetic predisposition and natural characteristics - this factor greatly influences the appearance of mammary tumors (mammary gland tumors) in a cat. Some breeds are more prone to this than others. For example, the leaders in the number of cancer manifestations, unfortunately, are the Siamese and Oriental cat breeds; 3rd gender – females, unlike males, are much more likely to become the target of this disease. Cats are usually get sick five times more often.

Hormonal characteristics of the body - mammary tumor in a cat

This is also a reason for which a separate space should be allocated. An example is the procedure for sterilizing an animal. It must be approached with particular seriousness, since ignorance of some aspects can result in bad consequences for an animal. When carrying out sterilization in at a young age the risk of tumor development in the future is very much reduced, as if it were performed on more mature cats. This is explained by hormonal changes, the stabilization of which at a young age is more realistic than in adulthood.

Some owners, bypassing sterilization, resort to use hormonal drugs , which put your pet to sleep for a while. This is also very dangerous due to the appearance of a neoplasm. For example, progesterone, used on cats to reduce their aggressiveness during periods of exacerbation of sex hormones may cause a tumor to appear mammary gland in a cat. There are many nuances and pitfalls that must be taken into account when keeping any animal. Our assistant in this is veterinary center, where you can call at any time and get competent advice from a specialist.

These are the main reasons that can be identified in the description of this disease. They will help you navigate the health status of your pet, will be able to help you choose the breed of your pet, and will be able to prevent this disease using all possible methods.

Mammary tumor in a cat: types

Speaking about types of neoplasms, we can highlight to a greater extent the features of their manifestations. Let's look at this point in more detail.

All tumors in the mammary glands, as a rule, resemble a kind of nodules to the touch, which can vary in size, ranging from almost unnoticeable to quite impressive. They may also differ from each other in mobility. Some may be fixed, while others can move freely under the thickness of the skin. There are cases when the neoplasm can seem to bulge, resembling a cyst. Suppuration at the site of the tumor is often found.

Mammary tumor in a cat: symptoms

Like most diseases, a mammary gland tumor in a cat is accompanied by certain symptoms that indicate malfunctions in your pet’s body.

Let's take a closer look signs of this disease:

• the presence of seals in the nipple area is probably the main symptom that should make the owner worry and take the pet to the veterinarian. Healthy mammary glands do not have any lumps;
• temperature – an increase in thermometer readings may indicate the presence of an inflammatory process in the pet’s body. Such processes occur precisely in the places where compactions appear. All this indicates actively progressing oncology. But only a specialist can say for sure;
• necrosis - damage to the tissue around the nipples, also a sign of an unwanted neoplasm;
• increased attention to the chest area when washing – this is also caused inflammatory process which causes itching. As we know, cats are quite clean animals. But if your pet spends too much time on the area around the nipples, you should be wary. Since the rough surface of the tongue can aggravate the situation, because ulcers may appear;
• presence of an unpleasant odor - the odor can come directly from the mammary glands, this is caused by tissue rotting;
• loss of appetite – occurs due to a general deterioration in the pet’s condition;
• apathy and decreased physical activity.

As we can see, all the symptoms are pronounced, it is very difficult not to notice them, therefore if there is any sign of illness, the cat needs to be shown to a specialist. Under no circumstances should you self-diagnose the disease, much less self-medicate. An incorrect diagnosis can worsen the animal's condition, and lack of treatment can provoke complications in an already difficult situation.

Mammary tumor in a cat: diagnosis

Before prescribing treatment, the diagnosis must be confirmed. This requires diagnosis, which is carried out by a veterinarian. This is done through certain activities, which include examination of the patient and further examinations.

Below are examples of such diagnostic measures for a mammary tumor in a cat:
• examination of the animal by a veterinarian - if cancer is suspected, the animal must be examined by a specialist who is qualified in this field, since neoplasms can be malignant and benign. Without the necessary skills, competent diagnosis is impossible;
• Lymph node biopsy - collection of living cells from the cat will help identify the disease. This is a very important examination that must be carried out carefully, in compliance with all rules and regulations;
• ultrasound and radiography - these examinations help to identify the presence or absence of tumors in the animal’s organs (lungs and abdominal organs);
• blood tests - standard procedure, which is necessary for any diagnosis, reflects the general condition of the body.

After confirming the diagnosis, it is necessary to establish What stage is a cat's mammary tumor at? .

The following are distinguished: stage of mammary gland tumor in a cat:

• initial – at this stage, as a rule, there are no visible symptoms, but neoplasms can arise that are almost invisible. This stage is most often detected during routine examinations. veterinarian. At the initial stage, the animal has a better chance of undergoing treatment with a successful outcome and eliminating the occurrence of complications. The older the animal, the more often it needs to be shown to a veterinarian, this will help prevent the onset of the disease or detect it at the initial stage;
• second - at this stage the tumor is already progressing well, increasing in size quite significantly. Unfortunately, at this stage of the disease the chances of successful treatment are greatly reduced. Once diagnosed with stage 2 cancer, cats live an average of about 12 months;
• third, treatment of the disease itself at this stage is considered pointless. Basically, all actions are aimed at maintaining the vital functions of the body and extinguishing unpleasant symptoms in an animal that helps lead full life, but with some restrictions;
• the fourth is the most difficult stage. The animal may experience severe suffering caused by the disease. Doctors often, together with the owners, decide to euthanize the animal to avoid its suffering. It is difficult to talk about the correctness of this choice in this case. All situations are purely individual.

Mammary tumor in a cat: treatment and removal

If veterinarians have discovered a mammary tumor in a cat, do not despair; in many cases, surgery helps. First of all, you need to follow all the instructions of the veterinarian and carry out all therapeutic measures aimed at treating it. Even with a poor prognosis, there is a chance of recovery. The professionalism of the attending physician plays a very important role. The specialists of our veterinary center are highly qualified in this field, which is confirmed by diplomas and certificates.

When treating an animal, various measures are used. A popular method is chemotherapy. Surgical intervention is also common, which we will discuss in more detail.
Breast removal surgery is carried out if the pet’s health condition allows it. For this, a preliminary consultation with a cardiologist is necessary. The fact is that any surgical intervention creates additional stress on the heart. Therefore, the procedure is performed only on animals with healthy heart.
If the situation is not too advanced, the affected mammary gland is removed. Sometimes it is necessary to remove an entire row of glands to prevent metastases. If an operation in several stages is necessary, there should be a gap of at least two weeks between them. If there are contraindications to surgery, you have to maintain your pet’s health through the use of special medications.

Prevention of mammary tumor in cats

Better than any treatment is disease prevention. A strong assistant in this is preventive actions, they help prevent the onset of disease.

Let's look at the basic recommendations of veterinarians for keeping cats:
• sterilization and castration of animals. These events are recommended not only to be carried out, but to be carried out on time. Since castration and sterilization of individuals at a more mature age provokes the appearance of unwanted neoplasms caused by hormonal imbalances;
• You should not start other diseases that can provoke or develop into cancer. These include mastopathy.
• take into account the characteristics of the cat’s breed - when choosing an animal, it is necessary to take into account all the genetic characteristics that the breed dictates. If your pet is prone to cancer, throughout its life it is necessary to pay attention to Special attention when examining his body for lumps and other symptoms;
• eliminating stress. Stressful situations can trigger the appearance of tumors;
• nutrition – the animal’s diet must be complete and balanced. It must contain all the necessary components and microelements, as well as vitamins and minerals;
• take into account age characteristics - the older your animal is, the more careful attention its body requires.

All these recommendations are not overwhelming work when keeping cats, but if you follow them throughout the animal’s life, you can exclude the appearance of oncology, or detect it at an early stage, which increases the chances of recovery.

Mammary tumor in a cat: conclusion

In this article, we looked at one of the types of cancer - a mammary tumor in a cat. This is very terrible disease which often leads to the loss of pets. As you already understand, the danger lies in most cases at the genetic level. Some animals cannot avoid this disease. Therefore, you need to devote the proper amount of time to keeping your pet if you are interested in the length and quality of its life.

Our veterinary center "YA-VET" offers you a number of services that are aimed at helping pets. This is not just help, these are events that are carried out following European standards. We work only with the latest equipment and only with certified drugs. All our specialists have extensive experience and high qualifications.

We advise you to pay attention to the “call a veterinarian at home” service. This service can become an integral component of keeping any pet. It will significantly save your time when visiting a veterinary center, and will also save your pet from possible stress during transportation. And in the case of cancer, stress is one of the worst enemies. We are always happy to help you and your pet!

Photo magazine Clinician's Brief

Journal of Feline Medicine and Surgery May 2013 15: 391-400,

Translation from English ..:veterinarian Vasiliev AB

Summary

Practical significance: Mammary tumors are one of the most common tumors in both cats and dogs, but the prevalence of malignant histological types in cats is much higher (the ratio of malignant to benign is at least 4:1).

Clinical problems: The more aggressive nature of mammary tumors in cats poses treatment challenges. The prognosis is influenced by the size of the tumor and, therefore, early detection and treatment of breast tumors is of paramount importance. Although primary tumors can be removed surgically, there are no studies showing that chemotherapy significantly increases survival time; therefore, metastatic spread remains an important clinical problem.

Patient group: Mammary tumors usually affect older female cats, mainly unspayed females. Siamese and Oriental breeds may be predisposed. Male cats can develop neoplasia, but this is rare.

Evidence base: This review summarizes the current literature regarding the etiology, pathology, clinical presentation, diagnosis, staging, treatment, and prognosis of feline mammary tumors.

Epidemiology

Mammary tumors are the third most common type affecting female cats, after lymphoma and skin tumors, accounting for 17% of all tumors. The published incidence is 25.4 per 100,000 female cats per year(1). Although precise statistics are not available, the incidence of mammary tumors in cats may vary globally, depending on the adoption of sterilization policies. Sterilization is performed less frequently in Scandinavia and some other parts of Europe than in the UK, for example.

Gender, age, breed

Mammary tumors occur in older female cats ( average age 10-12 years) and, usually, in unsterilized ones). Mammary tumors also occur in male cats (mean age 12.8 years) (7), but they are rare, accounting for 1–5% of mammary tumors. Siamese cats and others oriental breeds may be at risk for mammary tumors occurring at a younger age, but domestic shorthaired cats, which are probably the most common cat breed, are also very often affected by these tumors.

Etiology

As in humans and dogs, hormonal fluctuations associated with repeated estrous cycles may influence the development of mammary tumors in cats. This is supported by a case-control study reporting that cats neutered before 1 year of age had a reduced risk of developing mammary tumors (9) and that non-neutered cats were 7 times more likely to have mammary tumors in the cat population compared to with a control group (10). However, cats neutered before 1 year of age also develop mammary tumors, so early neutering does not eliminate the risk of mammary tumors (8) and early studies report an increased incidence of mammary tumors , may perhaps reflect sterilization practices at the time more than a true increased risk (11).

Other evidence supporting a hormonal etiology is that estrogen and progesterone receptors are found in normal breast tissue and benign tumors, but are often absent in malignant tumors and metastases (12–17). In addition, exogenous administration of progesterone to prevent pregnancy or suppress aggression has been associated with the development of tumors (benign and malignant) in both male (18) and female cats (19). A possible dose-dependent effect may occur, with an increased risk of breast carcinoma if progesterone is given regularly rather than intermittently (10). There is no definitive evidence for a viral etiology of mammary tumors in cats, although this has been suggested in early reports. Obesity doesn't matter, but dogs do.

Clinical picture

Cats have 4 pairs of mammary glands (2 mammary and 2 abdominal) and although any tumor can be involved, some studies report a predisposition of the caudal glands to mammary tumors (11,20). Mammary tumors appear as solitary subcutaneous nodules or masses in within the mammary glands (Figures 1 and 2), which may be discrete and mobile or associated with underlying tissue and appear ulcerated (Figure 3). Some may look like cysts. In cats, it is difficult to distinguish benign from malignant nodules, so all should be treated as potentially malignant. Multiple tumor masses within multiple lobes are common (usually unilateral but occasionally bilateral) (Figure 4) and, according to one study, occur in 60% of cats (8). Sometimes the true extent of this disease cannot be assessed without removing the fur. Drained lymph nodes (inguinal or axillary) may also be visible or palpable enlarged.

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Fig.1 Tumor mass in the thoracic lobe of the mammary gland in an 11-year-old unsterilized domestic shorthair cat

Figure 2 Tumor mass in the pectoral lobes and axillary lymph node of an eight-year-old unsterilized domestic shorthair cat.

Figure 3 Ulcerated tumor mass of the second abdominal lobe in a 21-year-old neutered domestic shorthair cat

Figure 4. Bilateral masses in the mammary glands before (a) and after (b) hair removal

In the presence of aggressive inflammatory carcinoma with widespread lymphatic involvement, the breasts may be swollen, hot, and tender (4). This clinical presentation may be difficult to distinguish from fibroadenoma hyperplasia (fibroepithelial hypertrophy, feline mammary hypertrophy), although the latter more commonly affects young cats (21).

Differential diagnosis

A variety of non-neoplastic hyperplasias and dysplasias can occur in the mammary glands and, although much less common in cats than in dogs, they can all be mistaken for mammary tumors. These include glandular ductal hyperplasia, ductal ectasia (dilatation), cysts, and lobular hyperplasia, all of which may demonstrate focal fibrosis. Widespread bilateral breast enlargement and swelling may also occur with fibroadenomatous hyperplasia, a type of lobular hyperplasia that may appear after prolonged metestrus, false pregnancy or pregnancy, or the use of exogenous progesterone.

Diagnosis

If the tumor mass is palpable, confirmation that it is neoplasia requires tissue biopsy or fine needle aspiration to perform cytological examination. Because most mammary tumors in cats are malignant, fine needle aspiration is more reliable than in dogs and useful in confirming the diagnosis (Figure 5).

Figure 5. Cytologic examination of feline mammary carcinoma demonstrating a mass of polygonal neoplastic epithelial cells with anisocytosis and anisokaryosis, several multinucleated cells, and visible nucleoli, often several per nucleus.

Most mammary tumors in cats arise from the glandular epithelium and all are strictly adenomas or adenocarcinomas, although the latter are often classified as carcinomas. Benign tumors are uncommon, with fibroadenoma being the most common and simple adenoma or ductal papilloma being rare. The main histological type of mammary tumors in cats is simple adenocarcinoma, arising from the epithelium of the mammary ducts and alveoli (Figure 6). Complex or mixed tumors involving both ductal and myoepithelial cells are rare in cats compared to dogs, although they may be associated with a better prognosis (22,23). In cats, carcinomas may be tubulopapillary, solid, cribriform, or mucinous, although transitional cell carcinoma and mixed carcinosarcoma also occur (24).

Figure 6. Histological examination of simple adenocarcinoma of the mammary glands of cats. Sections show invasion primary tumor into the muscle (a), metastasis to the lungs (b) with tumor cells in blood vessels and lung tissue.

Inflammatory breast carcinoma, which has a particularly poor prognosis due to an additional inflammatory component that blocks lymphatic system and impairing lymphatic drainage, causing glandular swelling and tenderness, was identified in three cats with underlying high-grade, papillary mammary carcinoma (25).

Stages of the disease

If a breast tumor is suspected or confirmed, then studies must be performed to determine the local extent and degree of invasion into body tissue before surgical removal of the tumor. Since few breast lesions are benign, and the general appearance is not a reliable basis for differentiating benign from malignant tumors, disease staging should be routine in the presence of breast masses. The WHO staging system is commonly used (Table 1) (26)

Measurement of the primary tumor is important because tumor size affects prognosis: tumors<3 см в диаметре ассоциированы с лучшим выживанием, чем опухоли >3 cm.

Table 1 TNM and system clinical definition stages for mammary tumors in cats

Staging of a confirmed tumor should include palpation and aspiration of lymph nodes draining the tumor site, since more than a quarter of cats have regional metastases at the time of diagnosis (27). Involvement of multiple axillary lymph nodes is usually detected by lymphangiography (58-75% of cases), but involvement single lymph node is more common (84-94% of cats) (28). Although axillary and inguinal lymph nodes are the most commonly involved lymph nodes in feline mammary tumors (80% of cats), obstructive lymph nodes may also be involved (30% of cats) (27). To assess the spread of the tumor in the body, radiography in three projections (mainly performed under anesthesia in the inhalation phase) and ultrasound examination of the abdominal cavity are performed, since the most common regions of metastases are the lungs, medial iliac lymph nodes and abdominal organs (Figure 7). Pulmonary metastases usually show a miliary pattern on chest x-ray, but the pleural membranes may also be involved and in some cases metastatic lung disease may cause pleural effusion (Figure 8). More rarely, metastases can be detected in the bones.

Figure 7: An enlarged left medial iliac lymph node with surrounding hyperechoic fat identified on staging ultrasound in an eleven-year-old spayed Abyssinian cat with mammary carcinomas in the left caudal abdominal and right cranial thoracic lobes.

Figure 8 Left lateral (a) and dorsoventral (b) radiographs of the cat's chest cavity from Figure 7. These radiographs showed a general increase in radiodensity within the chest cavity with a pronounced collapse of the lung fields below the dorsal wall and a smoothing of the silhouette of the heart and diaphragm, which is characteristic of pleural effusion .

Advanced imaging techniques (those CT scan) lungs provide a more accurate assessment of the presence of metastases and should be used if chest x-rays are questionable.

Figure 9. X-ray in the left lateral projection of a 12-year-old unsterilized domestic shorthair cat with carcinoma of the second abdominal lobe of the mammary gland. A pair of faint, ill-defined soft tissue masses superimposed on the silhouette of the heart and raised suspicion for metastases in this view (arrows) but not in the right lateral view. ST chest confirmed the presence of hyperattenuated nodules measuring 2-3 mm in the middle right lobe of the lung and (b) and a hyperattenuated nodule measuring 4.8 mm in the caudal part of the left lobe of the lungs (arrow).

Since most sick animals are aged, it is also necessary to perform general and biochemical blood tests and a urine test to identify concurrent diseases. Paraneoplastic conditions are rare in mammary tumors, and feline leukemia virus and feline immunodeficiency virus are not related to the etiology of the disease. However, if further treatment, including chemotherapy, is being considered, it is important to assess viral infection status, as immunosuppression caused by viruses may interfere with the effectiveness of treatment.

Surgery

The main method of treating mammary tumors is still surgical removal. The volume of surgery is influenced by the lymphatic drainage pathways for mammary tumors (see table), since tumor cells quickly spread beyond the primary tumor and complete removal tumors should include everything possible ways lymphatic drainage.

Recommendations based on studies of lymphatic drainage pathways include unilateral or bilateral mastectomies, due to possible contact between individual lobes and between the right and left sides. Although radiographic imaging studies suggest that this is not necessary in every case, additional prognostic analyzes support the use of unilateral or bilateral mastectomy because the apparent surgical volume corresponds to a significant difference in local recurrence/disease-free interval (DFI) (33) and survival time (34).

For bilateral mastectomy, a two-week interval between operations is recommended, although simultaneous bilateral mastectomy can also be performed (Figure 10). Fixation of the tumor to the skin or abdominal fascia is an indication for en bloc removal of these structures (35).

Figure 10. Bilateral mastectomy in a cat with mammary carcinoma.

Removal of lymph nodes The inguinal lymph node has a close connection to the caudal lobe of the mammary gland and is therefore removed along with the lobe as part of the gland block being removed. An axillary lymph node should be removed if it is enlarged or if there is tumor extension identified by biopsy or FNA, but there is no evidence that prophylactic removal prolongs survival.

Simultaneous ovariohysterectomy. There is no evidence that ovariohysterectomy at the time of mastectomy has any benefit on survival or tumor recurrence (8), or the development of new tumors or carcinoma progression (10). It may, however, reduce the need for progestin therapy, which may be beneficial.

Lymphatic drainage

Since tumor cells spread rapidly from the primary site, complete removal of all known drainage routes must be performed.

Lymphatic drainage has been studied by dye injection and postmortem examination (29,30) and radiological

using intravital methods healthy cats(28), the latter was more accurate because dynamic blood pressure influences the direction of natural lymphatic flow. The data from most studies agree that the first and second (thoracic) lobes drain cranially into the axillary lymph nodes; although postmortem studies have shown that the second lobe may drain caudally into axillary lymph node, it is not visualized using x-ray methods. The third (abdominal) lobe drains both cranially into the axillary and caudally into the inguinal lymph nodes, and the fourth lobe drains caudally into the inguinal lymph node. Direct drainage from the third and fourth abdominal lobes to the medial iliac lymph node was reported in one cat, however, direct drainage from the first, second, third lobes to the retrosternal lymph node was not confirmed in this cat.

Although connectivity between the lobes of the mammary gland and between the right and left sides has previously been suggested, intravital studies have not confirmed this in healthy cats (28). Drainage may vary between normal and tumor-bearing lobes, making it difficult to determine precise drainage routes (31) and probably making it desirable to use indirect lymphography in each patient to help determine the type of drainage and examine sentinel lymph nodes (32). Potentially, this may encourage more conservative resections.

Chemotherapy

There is some evidence showing that chemotherapy may be effective in in vitro breast cell lines (36⇓–38) and that in vivo treatment of unresectable disease with doxorubicin and cyclophosphamide can reduce tumor size in 50% of cases and possibly prolong survival (Table 2 ) (38-40). Benefits of using chemotherapy as an adjunct to surgical removal mammary tumors in cats, however, is not yet clear (Table 3).

Table 2. Effect of chemotherapy (doxorubicin) on breast carcinomas

Table 3 Effect of chemotherapy (doxorubicin) as an adjunct to surgical removal of breast tumors.

DFI - time interval without illness

Doxorubicin1 1 mg/kg IV every 3 weeks

Doxorubicin 2 dose not given

Cyclophosphamide dose not given

Doxorubicin 3 1 mg/kg IV every 3 weeks (one case was given IV vincristine 0.7 mg/m2 and 13 cases were given cyclophosphamide 250 mg/m2 IV 1 week after doxorubicin)

A large multicentric study of 67 cats supplemented with doxorubicin reported a median survival time of 448 days (41). Although this study did not have a control group, this survival time was longer than historical controls and was similar to that obtained in another study of 23 cats without a control group (460 days) when combining supplemental doxorubicin with the COX-2 inhibitor meloxicam (42).

A more recent study of 73 cats, which included a control group of 36 cats undergoing surgical excision alone, reported increased survival time and DFI for cats receiving postoperative doxorubucin and cyclophosphamide (1406 vs 848 days [survival time] and 676 vs 372 days)34 ); however, the difference was not statistically significant.

It is possible that with larger numbers and greater statistical power, the true benefit of aggressive chemotherapy may become apparent. Alternatively, various approaches to antiangiogenic metronomic (low-dose) chemotherapy may be effective, although low-dose chemotherapy using vincristine, cyclophosphamide, and methotrexate does not prevent relapse or metastasis, in one report (8).

Other treatments

Although immunomodulators such as Bacillus Calmette-Guerin (BCG) (43), Corynebacterium parvum (44), liposome-encapsulated muramyl tripeptid ephosphatidylethanolamine (L-MTP-PE) (45) and oral levamisole (46) have been used by injection in tumor (BCG) or in addition to surgical removal of mammary tumors in cats, has not been shown to have a beneficial effect on survival time or change the rate of recurrence. There are no reports on the use of antiestrogens in cats, probably because most feline mammary malignancies do not have estrogen receptors and the expected benefit is therefore likely to be minimal.

Small molecule inhibitors that act on receptor tyrosine kinases (receptor tyrosine kinase inhibitors or RTKIs) are effective in treating some types of veterinary tumors, especially those that have impaired TK activity (47). Imatinib and masitinib are well tolerated in cats (48–51), but there is no information available on their effectiveness against feline mammary tumors.

Forecast

The prognosis is poor for most cats with mammary tumors, with death usually caused by local recurrence or metastasis. The average time between tumor detection and death is 10–12 months (20.35); however, as already mentioned, the prognosis of breast tumors is influenced by several factors. (Table 4)

Table 4. Prognostic factors for feline mammary tumors

Factor	Details
Tumor size	Diameter ˂ 3 cm – median survival 21-24 months Diameter ˃ 3 cm – median survival 4-12 months
Clinical stage	Stage I - median survival 20 months Stage II – median survival 12.5 months Stage III—median survival 9 months Stage IV – median survival 1 month
Operative field area	Radical surgery(unilateral mastectomy) reduces recurrence rates compared to conservative mastectomy

A large percentage of patients in our oncology department are cats and dogs with mammary gland tumors (MGT). The leading oncologist of the Biocontrol clinic, Candidate of Biological Sciences Alexander Alexandrovich Shimshirt, answered the most frequently asked questions by owners about this disease.

— What is a breast tumor? Who is she dating?
— A tumor of the mammary gland is a fairly common pathology; in terms of frequency of occurrence in cats and dogs, it ranks 3-4 among all pathological diseases.

— At what age does mammary gland tumor most often occur in dogs and cats?
— For dogs, this age is about 7-8 years. Breast cancer in cats most often occurs after 10 years of age, however, there are cases of the disease at a younger age.

— How often do tumors in the mammary gland turn out to be malignant?
— It is believed that 90% of tumors in the mammary gland in cats are of a malignant nature. Most often these are carcinomas with deliberately aggressive behavior.

For dogs, the statistics are slightly better: up to 60% of them have malignant processes and 40% are benign.

Unfavorable factors that indicate aggressive behavior tumors and the need for prompt intervention are:

• rapid tumor growth;
• signs of inflammation;
• the appearance of ulcers;
• if this formation begins to bother the animal.

— Is a neoplasm on the mammary gland always a tumor or cancer?
— When examining and palpating an animal, it is impossible to say whether it is a lipoma or a tumor of the mammary gland. Any neoplasm that owners find in their animal in the mammary gland area (taking into account the age of the animal) requires contacting a doctor, preferably in a specialized clinic. Only a doctor, having examined the animal and carried out the necessary diagnostics, will be able to determine to what extent this neoplasm is malignant, its stage and how soon it is necessary to take action. It is possible that examination and differential diagnosis will show something different.

In principle, any formation in the mammary gland in an animal in adulthood and old age deserves close attention.

— Are there any predispositions or factors that contribute to the development of AML?
— If we talk about dogs, then here we can include in the risk group for those animals that often have false pregnancies. They would have O greater predisposition to changes in the mammary gland, because false pregnancy and lactation lead to the development of mastopathy, which can subsequently transform into tumor processes.

In cats, such a pattern was not observed, however, hormone receptors were found in the tissue of both cats and dogs. We can state that, of course, there is a certain connection, especially in cats, between giving the animal drugs that suppress estrus, and a subsequent increase in the risk of developing AMF.

— Owners quite often ask for surgery on their pets if there is a tumor on the mammary gland. Is this an effective solution?
— Much depends on the stage of the disease, because if these are the initial stages, then the treatment methods are predominantly surgical and the prognosis for such treatment is favorable.

— Can the tumor be operated on by any veterinary surgeon, or by someone who deals specifically with this problem?
— Surgical treatment of breast cancer is the main method of treatment. Basically, on early stages it significantly prolongs life and, in some cases, helps get rid of the tumor process. The main task is to ensure that the surgical intervention is performed correctly. To do this, you need to contact a specialist who can expertly advise you regarding the stage of the tumor process.

The extent of surgical intervention directly depends on the location, stage and type of tumor. For cats, for example, there are certain rules that involve removing the entire mammary ridge along with regional lymph nodes. For dogs, there is such a feature that if the tumor is in the third milk bag, and the animal has five mammary glands on each side, then the surgeon will remove the entire ridge. If the dog has a tumor in the fourth or fifth milk pouch, the third, fourth and fifth pouches are removed, along with the regional lymph nodes. If the first or second mammary gland is affected, the first three bags and the lymph node are removed.

— Does the tumor recur?
- Yes, this is quite real. That is why after surgery you need to see a doctor regularly, every 3 months.

— How is the stage of AML determined?
— Like most tumor processes, staging of breast cancer is based on:

• the state of the primary focus;
• the condition of the tumor itself;
• the presence of altered lymph nodes;
• presence of distant metastases.

It is believed that the criterion for the unfavorable behavior of a tumor is the size of the tumor: for cats it is 3 centimeters or more, for dogs of medium breeds it is 5-7 centimeters or more.

— What diagnostic stages does an animal go through when it is examined and the stage of AMF is established?
- This is an examination by a specialist doctor, blood tests, chest x-ray, ultrasound of the abdominal cavity. Sometimes a CT scan is required.

— If an animal is not in the early stages of AMF, then there is no hope?
— Breast cancer, both for animals and humans, is an aggressive neoplasm that is well treated with initial stages. When the stage reaches the third or fourth, the prognosis and quality of life of the animal become significantly worse. Therefore, I believe that first of all, a correct diagnosis must be made in order to know the stage of tumor development, to be able to predict some points that will improve the animal’s quality of life and, perhaps, even cure it.

— At what age is it no longer worth removing a tumor?
— This is an extremely individual question, since everything is decided by the doctor after a full examination and analysis of the specific situation.

— Maybe if a breast tumor appears, it would be more correct to remove all the mammary glands and then the cancer will not return?
— The question is very controversial. Bilateral mastectomy is an extremely traumatic, dangerous and unjustified operation.

— How often are animals diagnosed with AMF sent for chemotherapy or radiation therapy?
— It all depends on the stage of the disease. If the third and fourth stages, then the question arises about additional treatment methods that can slow down the metastatic spread of the process. Unfortunately, at these stages of the disease the prognosis is cautious: in cats average duration Life expectancy at this stage can be up to 1.5 years; in dogs this figure is slightly longer.

— Is specific care indicated for animals diagnosed with AMF and undergoing chemotherapy?
— Chemotherapy is carried out under the supervision of a specialist. It is necessary to regularly monitor the animal's dynamics and take blood tests. Maintenance treatment for such a patient is necessarily prescribed, and no specific diet or special care is required.

– Is it true that mammary gland tumors occur not only in females, but also in males?
- Yes it is. However, they are much less common in males than in females. From total number Only 2% of breast cancer patients are male. In terms of treatment tactics, division into stages and prognosis, the approach to treatment is the same as in cases with females: surgical intervention in the initial stages of the disease, and not in the early stages - a combination of surgical treatment with chemotherapy.

– What are the causes of the formation of mammary gland tumors in males?
– In females, the main predisposing factor to the development of mammary gland tumors is hormonal influence. This mainly happens in the first two years of the animal’s life, during the first two to four heats. Excess body weight is also a predisposing factor, since adipose tissue at a young age is a source of proestrogens (precursors of sex hormones), which can also affect the functioning of the mammary gland.

It's more complicated with males. There are no clear statistics, the number of such clinical cases extremely few, so it is very difficult to say that they definitely have some kind of hormonal basis. Opinions on this matter vary. Some doctors recommend castrating the animal, some, on the contrary, are against it, because if we are talking about cats, then they are most often already castrated by the time mammary tumors develop. It is impossible to unequivocally answer the question why males also have mammary gland tumors.

– Is it possible to prevent breast cancer?
– Regarding females, it has already been unequivocally proven that in both cats and dogs, the main predisposing factor to the formation of mammary gland tumors is hormonal effects. It follows from this that mammary gland tumors in females are a preventable disease. Prevention - sterilization of the animal during the first two years of life, preferably within the first two heats. In countries where there is medical insurance for animals, long-term studies have been carried out statistical research according to insurance companies, which showed the incidence of mammary tumors in sterilized females during the first two years of life and the incidence in non-sterilized animals. So far, a clear relationship has been identified between sterilization in the first two years of life and tumor incidence. It is believed that sterilization in the first years of life prevents the development of breast cancer by 80%.

A breast tumor (MBT) is a neoplasm associated with pathological tissue growth that increases in size over time. This is one of the most common neoplasms found in cats. Modern medicine has a number of effective methods for their treatment, but the successful outcome and future life of the pet depends primarily on the timeliness of seeking medical help.

The tumor is a lump, the size of which varies from a small nodule to a tennis ball. It can be of two types:

• Benign (cyst, adenoma) - does not pose a threat to life, but can cause significant inconvenience to the pet if it reaches a large size. She usually has correct form, is separated from nearby tissues by a capsule, is located only on one of the glands and grows slowly, without penetrating into nearby tissues, but only moving them. But such compactions require constant monitoring, as they can develop into malignant formations.
• Malignant (carcinoma, sarcoma) is a deadly neoplasm that provokes the development of metastases and grows into neighboring tissues and organs. It usually has an irregular shape and a lumpy, nodular surface.

Fibroadenomatous hyperplasia in the Sphynx

Most often, AMF occurs in unsterilized elderly individuals (over 7 years old), as well as in those who have suffered trauma to the mammary glands or suffer from hormonal imbalances. And for a share benign formations accounting for 10-15% of cases, while the rest are classified as malignant. The pathology does not occur in animals that were sterilized before the first heat, and all other individuals are already at risk. Moreover, the disease can be detected even in young pets (up to 2 years of age).

A neoplasm can be diagnosed using palpation, x-rays or ultrasound. But its type and nature can only be determined through cytological or histological examination of material taken from the tumor using a syringe. Additionally taken general analysis blood and other studies are carried out that allow us to assess the health of the animal and determine further actions that will be appropriate in a particular case.

Treatment

The main method of treating breast tumors is surgery, during which the overgrown tissue is completely removed. After surgery, the removed material is sent for histological examination, and based on its results, further treatment is prescribed and its outcome is predicted.

In the postoperative period, in some cases, a course of chemotherapy is prescribed, which is necessary to destroy possible residues in the body tumor cells. It is a procedure of drip administration of drugs (cytoxan, mitoxantrone, etc.) with an interval of 21 days and is usually well tolerated by cats without causing hair loss.

As additional means for treatment, you can give the animal decoctions of milkweed, calendula, arnica, wild rosemary, and knotweed. They contain substances that block the development of tumor cells. But this can only be done after the veterinarian's approval.

How is the operation performed?

Progress of the operation to remove the tumor:

• Preparation surgical field(hair shaving, treatment with antiseptics);
• providing access to the tumor (cutting the skin);
• ligation and cutting off of the vessels feeding the compaction;
• removal of the tumor, including 2-3 cm of healthy tissue, as well as nearby lymph nodes;
• suturing the wound.

Depending on the severity of the lesion, the lump, one mammary gland, or an entire line is removed. In particularly severe situations, treatment involves a bilateral mastectomy - removal of two lines of mammary glands, which is carried out in two steps.

The operation to remove a breast tumor belongs to the category of complex surgical interventions. Due to the fairly high percentage of relapses, doctors do not promise fast recovery And favorable outcome operations. One of the factors on which recovery depends is the degree of damage:

• in the initial stages, removal of the tumor can save the cat’s life;
• on late stages most likely the doctor will not perform the operation, since it will not be justified. In such cases it is prescribed palliative care, which is aimed at improving the pet’s quality of life. It includes antibiotics, painkillers and anti-inflammatory drugs.

The operation is not always possible due to the age of the animal: the older it is, the more difficult it is to tolerate general anesthesia and postoperative period.

What to do when opening a tumor

If the tumor was not detected in a timely manner and no treatment was carried out, it may open. This phenomenon also indicates the progression of the pathological process and an advanced stage of the disease. In this case, a wound appears from which the contents are released with a sharp unpleasant smell, sometimes pus and blood. In this case, the pet should be immediately taken to the veterinarian to receive recommendations about further actions. The optimal method in this situation is the same surgical removal AMF, excision of painful tissue. All other methods do not solve the underlying problem and metastases can spread to other organs, which deprives the pet of a chance for recovery. But if a cat’s mammary tumor bursts, and surgery is impossible for health reasons or other reasons, then the following is prescribed:

• Treatment of the wound with antiseptics (chlorexidine, miramistin, levomekol, etc.).
• Taking antibiotics (Tsiprovet, Fosprenil).
• Wearing a blanket or bandage that covers the wound but allows air to flow freely to prevent infection.

How long will a cat live?

If any kind of lump is detected in the area of ​​the cat's mammary glands, it should be immediately shown to a veterinarian for a diagnosis. How long a cat diagnosed with a mammary gland tumor will live depends on the timeliness of seeing a doctor, as well as the age general condition health and type of education. One of the main factors that affects life expectancy is the size of the tumor at the time of treatment (measured along the largest side):

• up to 2 cm – approximately 3 years;
• more than 3 cm – about 6 months.

If the diagnosis is made in the early stages, removal of the AMF significantly increases the chances of prolonging the pet's life. Late diagnosis large sizes neoplasms and the development of metastatic processes gives a prognosis for life within 6-12 months.

That is why it is important for the cat owner to regularly monitor the condition of her mammary glands, and if suspicious lumps appear, not to postpone a visit to the veterinarian.

You can also ask questions to our site's in-house veterinarian, who will answer them as quickly as possible in the comment box below.

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Tatyana 21:56 | 08 Mar. 2020

Good afternoon I really need your advice... The cat is now 10 months old, she was sterilized at 9 months - the spaying happened during her first heat. Now she has bumps on all her boobs, the biggest ones on the bottom ones, and smaller ones closer to the head. Tell me, can this be something other than a malignant tumor? I haven’t taken any tests yet.

Hello, we noticed that the cat had a small lump on her stomach, we went to the veterinarian, they said there was a mammary gland tumor, but he said it was not worth operating, since the tumor consists of small parts, what if it opens then just cut it. Tell me what to do? Should I cut it out now? or not? It’s written on the Internet that it’s better to cut it out in the early stages

Hello! Our cat (male) is 1 year 4 months old. The other day we discovered a lump in the mammary gland. The doctor said to take biochemistry tests, and if the results are good, it will be possible to have surgery. The removed tissue will be sent to determine the type of tumor (benign or not). Everything somehow happened within 5 days. We agreed with the prescribed treatment. Did we do the right thing? Or was there something else that needed to be done that the vet didn’t mention?

Good afternoon. Although the last few days have not been good for us at all ((The cat is 10 years old. A lump has appeared on the mammary gland. Near the nipple, a little to the side. Now it is the size of a large grape. The shape is smooth, the smooth edges can be easily felt. It’s as if it has not grown there. At the veterinary clinic they told me, to operate or not to touch it is at my discretion. I asked if it was possible to take a biopsy of the tumor without operating, they said no, only histology after removal. Now you can only see if there are metastases or not. And then, if the metastases are very small, then there are none it will be visible. The tumors are a month old. What should I do? What is the right thing to do. I’m afraid I’ll operate only to speed up the process, if I don’t operate it will be bad too. Please tell me what’s best? We can’t do it without her. What to do to make the most of it? extend her life?

Hello! You were told correctly. Histology is done after tumor removal. And the decision is only yours. No one will take responsibility for your choice, because for any outcome you will blame the one who advises. Sometimes, yes, you touch an AMF, and tumors begin to grow at the speed of light, metastases occur, and literally within a couple of months the animal burns out. And sometimes, on the contrary, you remove it, a course of chemotherapy and the animal lives for a long time. Everything is individual. Take an x-ray, look at the presence/absence of metastases and the outlines of the tumor. Blood for general analysis, look at the level of leukocytes and platelets. As an option, try chemotherapy, but this is after a face-to-face consultation with an oncologist.

Hello. All tests passed. There is no metastasis. They said the cat is strong. You can operate. Operated on 03/05. She went through the operation well. Yesterday we went and the surgeon examined the stitch. He said that everything was fine too. Mom, I see that everything looks very decent. But the cat always seems to be freezing. She gets chills very often. Sleeping under a blanket. I wrap it in a blanket. When I hold it in my arms, it feels like it’s warming up and stops shaking. So my daughter and I take turns carrying her in our arms. If you leave it wrapped in a blanket, it will crawl out and leave. At the same time, she eats like an elephant, constantly hungry. I have never seen such an appetite before. But still very skinny. I talked about this to the doctor. They measured her temperature when she was really shaking, her temperature was normal. They told me that this is normal. She’s nervous... but at home, why should she be nervous? We have very good doctors, can't complain. But they are very busy. Can I do something for her? Maybe submit something?

Hello again! Well, such an appetite is very good. Understand that the animal is recovering. He needs strength and energy. Where can she get all this from? That's right, from food. Therefore, look carefully at what you feed your pet. The diet must be balanced (give a lot of energy, have enough vitamins). Trembling, as an option, is also the body’s reaction to recovery. It may be scary (after all, there was an operation, then severe pain, because Such operations affect many nerve endings). Don’t forget about such a thing as phantom pain ( psychological condition when something that no longer exists hurts). Have you been prescribed NSAIDs/painkillers? If not, then you can try serving meloxicam for 3 days. Add another sedative (catBayun, stop-stress, fospasim and other analogues).

Sergey 00:43 | 09 Feb. 2019

Hello again, doctor! I want to add to my question. Sergey The cat had a small mammary gland about a centimeter soft bump, as it later turned out with purulent discharge. They took her to the veterinary clinic where she immediately had an X-ray, ultrasound, and blood test. They said the tests were good, everything was clear on X-ray and ultrasound. Blood tests said they were good. Then they had an operation to remove one row of mammary glands, ovaries and uterus. We were already hopeful, and then we sent histology tests:
Type: Cat Breed: mixed breed
Gender: Female Number:
Age: 12 years

Histological picture
The breast tissue contains a highly cellular, invasive formation composed of papillary structures, solid nests, and sheets of variable epithelial cells with a sparse fibrous stroma infiltrated by a moderate number of mixed inflammatory cells. The shape of the cells is from round to columnar or irregular, the cytoplasm is of variable volume, with unclear boundaries, the central nucleus is round, with 1-2 clearly defined nucleoli. Cells are characterized by moderate anisocytosis and anisokaryosis, mitoses occur with 2-3 in 10 fields of view.B lymph node metastasis is present
Diagnosis
Breast adenocarcinoma, moderately differentiated (papillary to solid)
And they said that she has stage 4! But I don’t understand how it’s possible, the X-ray didn’t show, the ultrasound didn’t show blood either? And she always eats vigorously within 20 minutes. And here is stage 4!!!??? What is this? And can it be cured??

Daria - veterinarian 01:22 | 10 Feb. 2019

Hello! I won't lie, I'm not an oncologist. Therefore, with such questions, I usually refer them to a specialist - a veterinary oncologist. But stage 4 is an extremely cautious prognosis. But how did they diagnose stage 4, if according to the x-ray, you say everything is clear. At stage 4, metastases are usually already registered, and not just single ones in regional lymph nodes, but with more extensive damage. And the blood should have made it clear that there is oncology. I would like to donate blood again (maybe in another clinic). If it is possible to find an oncologist (another one), maybe neighboring city to get a second opinion. Of course, I want to believe that chemotherapy will help. But I, being a client of the clinic, in such a situation would decide to visit another doctor, so that there would be no doubt about what to do and not torment myself with doubts.

Hello! I am very glad that your pet was helped and is now alive. You shouldn’t be offended, because a forecast is just an assumption about your future fate. We are not fortune tellers, and we cannot say EXACTLY how long the animal will live. One does not live even for a week, although the prognosis is favorable. Others live fully for a year or two, although the situation was terrible. As they say: if the patient wants to live, then medicine is powerless =) It’s the same with animals. If a mustache wants to live, then it will cling to life with its claws and teeth.
May you have many more years of life together. Health to the pet

Sergey 18:56 | 08 Feb. 2019

Hello! A neoplasm with purulent discharge from the nipple was found on a cat’s mammary gland. They immediately contacted the veterinarian, after which the mammary glands and uterus with ovaries were removed. Arrived 2 weeks later histological analysis tumors. Diagnosis: adenocarcinoma of the mammary glands, moderately differentiated from papillary to solid. There is metastasis in the lymph node. They agreed to chemotherapy and removal of another ridge of mammary glands. Is there any chance of full recovery??? The cat is 12 years old.

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Cats have almost all the same diseases as people. Unfortunately, oncology is no exception. The operation is quite a difficult test for small animal. After surgery to remove a mammary tumor, your beloved cat needs special care and attention. In many ways, it is from creation the right conditions The success and duration of the rehabilitation period will depend.

Creating favorable conditions for the cat

Unfortunately, almost no one is immune from the occurrence of tumors - neither people nor cats. One of the most common types of malignant neoplasms in cats is mammary tumor. Almost all animals suffer from this disease, and pets, dogs and cats, are no exception. The only one possible way Treatment in this case is surgical removal of the breast tumor.

As a rule, during surgery, not only the tumor itself is removed, but also the affected mammary gland, a neighboring gland (sometimes the entire ridge of glands), surrounding tissues and blood vessels. The operation to remove them is quite traumatic for the animal. Therefore, it is important to create the most comfortable conditions for your pet so that recovery occurs successfully.

How to create the most comfortable and favorable conditions for a cat during the postoperative period:

• When transporting an animal from the clinic to home, it must be lying on its side. It is advisable that the head be located slightly below the level of the rest of the body.
• The head should not tilt to the side or fall on the chest.
• The chest should be free from any compression.
• The animal is unable to blink independently after surgery. Therefore, every 4-5 minutes you need to gently rotate your eyelids, opening and closing your eyes. You can also use eye drops, but this should only be done after consulting your doctor.
• The cat's heat exchange is disrupted after surgery. Therefore, on the first day it is necessary to provide her with external heating - place a heating pad or a bottle of water next to her. hot water(not boiling water). You can also place the animal near the radiator. Make sure the temperature is not too high.
• Do not place your cat in high places. He cannot walk, but will try to crawl in a semi-conscious state. It is better to make a soft and warm place for the animal on the floor, also providing a fence.

It should also be remembered that during the first day (and probably several days) the animal will not be able to relieve itself in its usual place. Therefore, you need to provide a set of removable diapers, under the bottom of which you need to lay a special hospital oilcloth.

During the first day, it is advisable to spend maximum time next to the cat. This is necessary both to monitor changes in her condition and to ensure her safety and proper care. Coming out of anesthesia, the cat cannot control its body and will try to crawl, walk, run and jump. During this, the animal can receive quite serious injuries, which will only aggravate the health condition and will not contribute to rapid rehabilitation after surgery.

Pet monitoring

After removal of a tumor in cats, the animal must be monitored very carefully for several days in order to be able to notice deterioration and seek medical help in time.

Possible signs of deterioration:

• fainting;
• difficulty and heavy breathing;
• a significant decrease in temperature on the pads of the paws;
• paleness of gums and lips;
• lack of physical activity during the day after surgery;
• lack of control over the limbs 2 days after surgery;
• vomiting and belching that occur regularly;
• the presence of blood in the stool;
• convulsions;
• bleeding;
• swelling of the tissues of the mouth, pharynx, muzzle;
• allergic manifestations.

In order for the treatment to be as successful as possible, it is important to undergo a detailed examination, diagnosis and choose the most appropriate treatment regimen. But this is not enough for the cat to be healthy. After you have fought a breast tumor and overcome the disease, it is important to successfully undergo recovery period after surgery, and this depends on many factors. One of them, and perhaps the most important, is the creation of favorable conditions that will contribute to the recovery of the pet.

Even after a successful recovery of a pet, owners must remember the need regular examinations several times a year. Cases of relapse in breast cancer account for about 60% of all clinical cases.

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