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An Urban Experience
S. Ettinger1
A Practical Approach to Lumps and Bumps Sue Ettinger, DVM, DACVIM (Oncology)
Dr Sue Cancer Vet PLLC and Animal Specialty & Emergency Center Wappinger Falls, NY, USA
What is “See Something, Do Something. Why wait? AspiratE. DR SUE CANCER VET? ®”
“See Something, Do Something” (SSDS) is a lumps and bumps cancer awareness program that provides guidelines for evaluating superficial masses in dogs and cats. We hope these guidelines to increase client awareness will promote early cancer detection and diagnosis, as well as early surgical intervention. In veterinary medicine, most skin and subcutaneous tumors can be cured with surgery alone if diagnosed early when tumors are small.
See Something: If a skin mass is the size of a pea (1 cm) and has been there 1 month,
Do Something: Aspirate or biopsy, and treat appropriately!
Why do we need SSDS?
It is well documented that cytologic and histologic evaluations are important diagnostic tools in veterinary oncology and that obtaining a preliminary diagnosis optimizes treatment planning. It is also recommended
to evaluate masses that are growing, changing in appearance, or irritating to the patient. At this time, no specific guidelines exist for determining when to aspirate or biopsy or when to monitor canine and feline skin and subcutaneous masses.
Without standard of care guidelines, superficial masses may be monitored for too long. This can negatively impact our patient’s prognosis as well as limit their treatment options. Larger tumors that are diagnosed later may require more advanced treatments. Surgical excision of larger masses may result in less than adequate surgical margins (narrow or incomplete), leading to recurrence and additional costly therapy (second more aggressive local surgery, radiation therapy and/or chemotherapy).
With significant time delays and prolonged monitoring, there may be no reasonable surgical treatment options to remove large advanced tumors. These are often the most frustrating and heartbreaking cases.
Why diagnose early?
Obtaining a definitive diagnosis with cytology or biopsy early and before excision will lead to improved patient outcomes for superficial masses. When smaller, superficial tumors are detected early, surgery is likely curative - especially benign lesions and tumors that are only locally invasive with a low probability of metastasis. If tumors are removed with complete surgical margins, the prognosis is often good with no additional treatments needed.
• Visual monitoring is not enough.
• Pet owners need to be aware of the “pea” size requirement to have masses evaluated
• Veterinarians must measure and document the size of the mass in order to compare growth.
• If > 1 cm (or size of large pea) and present for a month, the mass should be aspirated or biopsied.
• Knowing the tumor type prior to the FIRST surgery will increase success of a curative-intent surgery.
What are the most common tumors?
Primary skin and subcutaneous tumors are common in dogs and cats. While the overall incidence in dogs and cats is difficult to determine, approximately 25 to 43% of biopsies submitted in dogs and cats are of the skin. Of submitted samples, 20 to 40% are reported to be malignant.
The most common malignant skin tumors in dogs are mast cell tumors (MCT) (10-17%), soft tissue sarcomas (including fibrosarcomas [2-6%], malignant nerve sheath tumors [4-7%]), and squamous cell carcinomas (2-6%). The most common benign canine skin and subcutaneous benign tumors include lipomas (8%), histiocytomas (8-12%), perianal gland adenomas (8- 12%), sebaceous gland adenomas/hyperplasia (4-6%), trichoepitheliomas (4%), papillomas (3%), and basal cell tumors (4-5%).
In cats, the most common superficial tumors include basal cell tumors (BCT) (15-26%), mast cell tumors (13-21%), squamous cell carcinomas (10-15%), fibrosarcomas (15-17%). These four tumor types make up about 70% of all skin tumors in cats. Sebaceous gland adenomas are much less common (2-4%). If BCT are excluded, the percentage of malignant skin tumors in cats is higher than dogs, with studies reporting 70 to 80%.

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