cancer screening

Can Cats Get Breast Cancer? Learn About Mammary Tumors in Cats

What is a mammary tumor (breast cancer)?

A mammary tumor develops as a result of abnormal replication of the cells that make up the breast tissue. Mammary tumors can be benign (non-cancerous) or malignant (cancerous). These two forms of the disease have different diagnostics, treatments, management, and prognosis. In cats, the vast majority of mammary tumors are malignant.

There are several different types of mammary tumors, with carcinomas being the most common. Carcinomas often arise from the tubules of the mammary glands, or other cells found in the mammary chain.

There are several other kinds of cancers that can affect the mammary glands, including osteosarcomas.

What causes this cancer?

The exact causes for the development of mammary tumors in cats are not fully understood. However, exposure to the female reproductive hormones, estrogen and progesterone, increases the risk for mammary cancers in cats. It is hypothesized that under the influence of hormones, the cells of the mammary gland enlarge, progress to a pre-cancerous state, and continue to grow until they transform into a carcinoma.

The incidence of these tumors is related to hormone status, specifically whether a cat is intact or has had an ovariohysterectomy (i.e., has been spayed). Sexually intact cats have a 7-fold increased risk for mammary tumors compared to spayed cats. Early spaying helps to prevent the development of these tumors. Cats that are spayed before 6 months of age have only a 9% percent risk of developing mammary tumors, whereas the risk increases to 14% in cats spayed between 7 and 12 months. Male cats rarely develop mammary tumors.

Age and breed also play a role in tumor development. Mammary cancers are seen mainly in middle-aged to older cats (around 10 years of age). Siamese cats appear to be predisposed and are typically younger when diagnosed. Obesity may play a role in tumor development as well.

What are the signs that my cat has this type of tumor?

The most common clinical sign of a mammary tumor is one (or more) palpable masses (nodules) underneath the skin of the abdomen. They may be next to or within the nipple and follow along the mammary chain. The size of the mass(es) and their appearance may vary, but they are usually firm and nodular. Occasionally the skin over the mass may ulcerate (open) and bleed, and the affected area may feel warm to the touch and become painful. Your cat may tend to lick and groom the area excessively, and a strong odor can result as the exposed tissue becomes infected.

If the tumor has metastasized (spread to other areas of the body), other signs may become evident. Your cat may generally feel unwell, eat less, become lethargic, and lose weight. If the lungs are involved, your cat may have problems breathing or develop a cough.

Multiple tumors are common at the time of diagnosis.

How is this type of tumor diagnosed?

These tumors are typically found as either singular or multiple nodules along your cat’s abdomen during a physical exam. Other procedures are then performed to determine the type of tumor and whether it is benign or malignant.

A common procedure to diagnose this tumor is a fine needle aspiration (FNA). FNA involves taking a small needle with a syringe and suctioning a sample of cells directly from the tumor and placing them on a microscope slide. A veterinary pathologist then examines the slide under a microscope.

In some cases, results from FNA may not be entirely clear and removal of the entire tumor may be necessary. Pieces of the tumor are then examined by a veterinary pathologist under a microscope. This is called histopathology. Histopathology is not only helpful to make a diagnosis but can indicate whether it is benign or malignant, and therefore how the tumor is likely to behave.

Given the risk of metastasis (spread to other areas of the body) with malignant mammary tumors, your veterinarian may also recommend staging (searching for potential spread to other locations in the body). This may include bloodwork, urinalysis, X-rays of the lungs, and possibly an abdominal ultrasound. Lymph nodes associated with the mammary glands may be sampled by FNA even if they seem normal.

How does this cancer typically progress?

The way this cancer progresses is entirely dependent on the type and size of the tumor(s), and whether metastasis has occurred. Larger tumors (greater than 2 cm) and those with evidence of spread have a poor prognosis. If the histopathology report shows tumor cells invading the local blood vessels, this also carries a poor prognosis. Detecting and treating these tumors when they are small and prior to metastasis provides your cat with the best chance of long-term control. Tumors smaller than 2 cm carry the best prognosis.

What are the treatments for this type of tumor?

Surgery is by far the best treatment for cats with mammary tumors. Depending on whether there is a single mass present, or several masses a single chain mastectomy (removal of one side of the breast tissue) or double chain mastectomy (removal of both sides, with each mastectomy performed at a different time) will be performed. Depending on the tumor size and other factors, chemotherapy is typically pursued afterward, especially given the high metastatic rate in these tumors.


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Tests for Screening Cancer in Pets

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Routine lab work is a fundamental part of staging a pet’s cancer. When your veterinarian orders routine tests, they are ensuring that your pet is systemically health and that there are no surprises and any warning signs are flagged in regards to trouble such as organ function or electrolyte status.

However, such tests rarely provide insight into a pet’s cancer status. With a few exceptions (skyrocketing white blood cell count pointing to leukemia, for example) lab work will not accurately inform your veterinarian whether or not your pet has cancer.

A veterinarian may run what are considered “screening tests”. This is when your vet will perform a test in a healthy patient to rule in/out a predisposition to cancer or hidden cancer that has not yet manifested with any clinically notable signs. These tests are designed to quantitate the presence of biomarkers. Biomarkers are measurable indicators of particular biological states or conditions and can be used to detect, screen, diagnose, treat, and monitor disease.

When a veterinarian considers screening tests for cancers, most frequently, assays measure serum levels of thymidine kinase (TK) and c-reactive protein (CRP). The utility of these markers is not well established but emphasis is often placed on their ability to detect what we refer to in the medical profession as minimal residual disease (MRD).

Thymidine Kinase (TK)

TK is a protein involved in DNA synthesis and is expressed in dividing cells. TK levels increase with increased rate of cellular proliferation. TK levels correlate to the proliferative activity of lymphoid cells (and less likely with proliferation of other kinds of tumor cells). Elevated TK levels are also associated with viral infections and inflammatory conditions.

Serum TK levels tend to be higher in dogs with cancer than in healthy dogs. However, there is a large overlap in levels measured from healthy dogs, dogs with cancer, and dogs with other diseases. This means that even dogs previously diagnosed with cancer can have normal serum TK levels.

TK levels are also measured in cats, with an established interval from clinically healthy cats, cats diagnosed with lymphoma, and cats with inflammatory gastrointestinal disease. Cats with lymphoma in these studies had significantly higher serum thymidine kinase activity than healthy cats or cats with inflammatory disease and cat’s with non-hematopoietic neoplasia.

C-Reactive Protein (CRP)

CRP is the major acute phase protein produced in response to inflammation and cytokine release. Serum CRP levels correlate to the duration and severity of inflammatory response. Causes of inflammation are varied, and include infection, autoimmune disease, and cancer. Therefore, CRP is considered a sensitive marker for inflammation, but unfortunately, it is relatively non-specific as to the nature of the inflammation it represents.

Dogs present more elevated CPR in some variants of cancer, and serum levels are generally elevated in dogs with cancer than those that are clinically healthy. Dogs with lymphoma who are in remission (with microscopically detectable cancer cells in their bodies) generally have lower CRP than dogs with measurable lymphoma. This places potential value on serum CRP levels as a marker for cancer remission status and relapse of disease.

Additional research is necessary to determine the value of measuring parameters such as CRP or TK before veterinarians can routinely recommend these screening tests for every patient.

It is advisable by veterinarians that owners should begin testing their pets at the earliest possible age and test consistently throughout their pet’s lives, in order to establish the most adequate control values with which to compare to as the pet ages.

It is understandable for pet owners to wish this process would be simplified by a single lab test to assure their pets were healthy. However, it is important that diseases such as cancer is detected as early as possible.


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