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An Urban Experience
After surgery:
- Review the histopathology report – tumor type, grade, vascular and lymphatic invasion.
- Consult with a veterinary oncologist for additional therapeutic considerations for malignant tumors.
- Assess the QUANTITY of surgical margins in consideration of tumor type and biologic behavior. (One mm margins for a malignant tumor may be called “clean” on a biopsy report, but size of margins must be considered in light of tumor histology.)
- If margins are inadequate, recommend adjunctive treatment before tumor recurrence for optimum patient outcome. Post-operative options include scar revision (second surgery), radiation to prevent regrowth, or chemotherapy which may slow recurrence in some cases.
- It is important to consult a board certified surgeon before attempting scar revision.
- Monitor for local tumor recurrence and metastasis as indicated by the histologic diagnosis and margin assessment.
Recurrence and Monitoring
Patients with reported complete surgical margins can potentially suffer tumor recurrence due to microscopic cancer extension that is not seen in the evaluated sections. Therefore, it is essential to monitor for local regrowth, and to recruit the pet owner to monitor the surgical scar as well, to identify early relapse.
For malignant tumors with wide, clean margins and
low metastatic potential, follow-up rechecks are recommended every two to three months after the surgery for as much as one year of follow up. Early detection is key to addressing recurrence and metastasis to ensure the highest possible chance of success.
Owners are encouraged to check their pets regularly at home for new masses.
- Owners should check their pet monthly for superficial masses by noting their location and size.
- Create a “body map” with size and location of superficial masses recorded, along with fine needle aspiration cytology results. This body map can serve as an objective medical record document and owner guide to follow masses longitudinally, and to allow for identification of new masses over time.
- All masses should be aspirated and submitted for cytology. Masses that do not need cytologic assessment include lipomas, cysts, and those containing acellular debris.
- If cytology is non-diagnostic, discuss repeating the aspirate, or proceeding to biopsy.
- Know the tumor type prior to surgery. The first surgery is your patient’s best chance for cure.
Surgery may be all that is needed
We all must be proactive to advocate for early cancer detection. Visual monitoring of superficial masses is
not enough. Obtaining a definitive diagnosis via either cytology or biopsy early and before excision will lead
to improved patient outcomes for superficial masses. Surgery is likely curative for the majority of these cases, especially for benign masses and those locally invasive malignancies that are non-metastatic. If tumors are detected and removed earlier – when they are small and with clean margins, the prognosis is often good and the patient may not require additional therapy.
See Something: When a skin mass is the size of a pea (1 cm) and has been present for 1 month, Do Something: Aspirate or biopsy, and treat appropriately!
Early detection saves lives. Why wait? Aspirate.®
See Something Do Something, Copyright 2012 © Dr. Sue Ettinger, All Rights Reserved
@2015 Dr. Sue Ettinger and VCA Animal Hospitals, Inc. The See Something Do Something Program was jointly developed by Dr. Sue Ettinger and VCA Animal Hospitals, Inc.
References/Suggested Reading
1. Hauck ML. Tumors of the Skin and Subcutaneous Tissues. In: Small Animal Clinical Oncology. 5th ed. St. Louis Missouri: Elsevier Saunders; 2013:305-320.
2. Canine and Feline Cytology. 3rd ed. St. Louis, MO: Elsevier; 2016:34-90.

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