犬的乳腺肿瘤
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报道－2岁前绝育的犬（包括做乳房切除术的年龄），如患恶性肿瘤， 存活率高于2岁后绝育的和已发生乳腺肿瘤并要切除乳房的犬。
Another- spaying at the time of mastectomy did not effect survival 另有报道—乳房切除的同时再做绝育，对存活率没有影响
– In one study, the risk of development of malignant mammary cancer in spayed dogs was reduced if the dogs were of lean body composition at 9–12 months of age. 一项研究表明，如绝育犬在9-12月大时较瘦，则其患恶性乳 腺癌的危险性就小。
One report- Dogs spayed within 2 years of the development of their malignant tumor ( including at the time of their mastectomy) have a survival advantage compared to those spayed 2+ years prior to mammary tumor development and mastectomy.
Tumour Pathology 肿瘤病理学
Benign or Malignant (50:50) 良性或恶性 Carcinomas (60%) 癌 Complex (30%)
复合型 Sarcomas(10%)
肉瘤
Treatment Options 治疗方法
Surgery 手术
Radiotherapy 放疗
Risk Factors- Hormones 危险因素—激素
Estrogen and progesterone receptor concentration diminishes as the degree of malignancy of neoplastic cells and size of the tumor increases 雌激素和孕酮受体的浓度会随着恶性赘生细胞的增多和肿瘤的增大而减少
– This finding was supported by a second study indicated that dogs that were obese at 1 year of age had increased risk of development of both benign and malignant mammary tumors. 另一项研究证实了这一说法，即1岁时肥胖的犬患良性和恶 性乳腺肿瘤的危险性会增加。
Experimental exposure to combined high doses of estrogens and progestin does increase risk of malignant mammary tumors. 实验性地暴露于高剂量的雌激素和黄体激素中，确实会增加恶性乳腺瘤的 发生风险。
Preferred- histologic diagnosis 首选—组织学检查
Diagnosis 诊断
Benign 良性
– Movable 可移动 – Small 小 – Not erosive 非侵蚀性 – Not ulcerative
不溃烂
Malignant 恶性
– Firm 固定 – Attached 附着 – Erosive 侵蚀性 – Exhibit rapid growth
Stage 分期
1
Primary tumor 原发性肿瘤
T1 (<3 cm)
Regional LN status Distant metastasis 局部淋巴结的情况 远端转移
N0
M0
2 T2 (3-5cm) N0
M0
3 T3 (>5cm) N0
M0
4 Any T
N1
M0
5 Any T
Any N
M1
Early detection and small tumor size are important prognostic factors for survival. 早期检测和肿瘤的大小是其存活率的重要预后因素
Local control with surgical excision is successful in providing long term control in a majority of cases, however some patients will require adjuvant chemotherapy 在大部分病例局部的手术切除就可成功的将其长期控制，但有 些患畜仍要辅助性化疗
Inflammatory Carcinoma 炎性癌
Inflammatory
carcinoma
is
characterizedபைடு நூலகம்by a poorly
differentiated carcinoma with heavy
inflammatory cell infiltrates.
炎性癌的特征是有大量炎性细胞浸润
Risk of development if spayed prior to the first estrus is 0.05%; 8% after the first estrus, and 26% if spayed after the second estrus as compared to the risk in intact females. 第一次发情前绝育（摘除卵巢），发病率0.05%； 第一次发情后绝育，发病率后，发病率8%； 第二次发情后绝育，发病率26%，与未绝育的发病率相当。
Mammary Tumours: Risk Factors 乳腺肿瘤的危险因素
Sex 性别
Ovariohysterectomy 绝育手术
Age at Ovariohysterectomy 绝育年龄
Exogenous Progestogens 外源性性激素
Risk Factors- OVH 危险因素—
表现出生长迅速
Clinical Staging 临床检查
1. Thoracic radiographs- 3 view 三个角度的胸部X光片
2. CBC 全血细胞计数 3. Chem panel ？？？ 4. U/A 尿检 5. Abdominal Ultrasound ( if possible, for sublumbar
Steroid receptors are infrequently identified in metastatic mammary cells. 甾体激素受体在转移的乳腺细胞中很少见
Neither long-term exposure to estrogens or progestins appears to consistently increase risk of development of malignant mammary tumors. 长期接触雌激素或黄体激素并不会持续增加恶性乳腺瘤的发生风险
Signalment 特征
Typically older 年龄偏大 9-11 years old 9—11岁 Sexually intact ？？？性完整 （未绝育）
Clinical signs 临床症状
A palpable mammary mass or masses 可触及一个或多个乳房团块
Diagnosis 诊断
A palpable mammary mass should be strongly suspicious for mammary neoplasia. 乳房有可触及的团块，要强烈怀疑乳房瘤
Should be measured and well documented 要判断并证明
Association of this tumor with disseminated intravascular coagulation is reportedly common. 在这种肿瘤常有弥散性血管内凝血的 报道
12/12 dogs with inflammatory carcinoma in one study were thrombocytopenic. 一篇报道说12/12患有炎性癌的狗都 有血小板减少症。
Risk Factors- Breeds 危险因素—品种
Suggests a genetic component- not yet identified 建议遗传分组—尚不能识别
– toy and miniature poodles 玩具和迷你贵宾犬 – english springer spaniels 英国史宾格犬 – britanny spaniels – cocker spaniels 可卡犬 – english setters 英国雪达犬 – Pointers 波音达犬 – german shepherds 德国牧羊犬 – Maltese 马尔他犬 – yorkshire terriers 约克夏梗 – Dachshunds 腊肠犬
More than half of the patients have multiple nodules at the time of diagnosis 诊断时会发现大部分的患畜会长多发结节
Risk Factors 危险因素
Genetic predisposition 遗传易感性 Diet 饮食
Pain/ inflammatory skin 疼痛，皮肤发炎 Signs of metastatic disease 肿瘤转移的症状 Paraneoplastic signs- 副肿瘤性症状
– Cachexia 恶病质 – Hypercalcemia 高钙血症 – Anemia 贫血 – Inflammation 炎症
Chemotherapy 化疗
的分化性腺癌
Clinically these neoplasms are very infiltrative, often bilateral, are often associated with medial thigh involvement, and are readily invasive into dermal lymphatics.
临床上这些肿瘤的浸润性强，常发生
于两侧，并常涉及股内侧，很容易侵 入真皮淋巴系统
Inflammatory Carcinoma 炎性癌
Metastatic rates to distant sites vary from 0/121 to 10/10 based on two separate reports. 两篇报道称，转移率从0/121—10/10 不等
lymph nodes) 腹部超声检查（如可能，检查腰下淋巴结） If regional lymphadenopathy- FNA or biopsy of the lymph node 如局部淋巴结肿大—用细针抽吸或进行活组织检查
Modified WHO Staging System 修改的WHO分期体系
Canine Mammary Tumors 犬的乳腺肿瘤
Gillian Dank
Introduction 绪论
The most common tumor of female dogs (52%) 是母犬最常见的肿瘤
Frequency of malignancy- 50% 恶性肿瘤的比率占50%
Regional lymph nodes should be palpated 触诊周围的淋巴结
FNA- problematic. Important to R/O other etiologies- mast cell tumor, primary inflammatory lesion. 有疑问的用细针抽吸。看出其他病原性肥大 细胞瘤，主要是炎性损伤很重要。
Another- spaying at the time of mastectomy did not effect survival 另有报道—乳房切除的同时再做绝育，对存活率没有影响
– In one study, the risk of development of malignant mammary cancer in spayed dogs was reduced if the dogs were of lean body composition at 9–12 months of age. 一项研究表明，如绝育犬在9-12月大时较瘦，则其患恶性乳 腺癌的危险性就小。
One report- Dogs spayed within 2 years of the development of their malignant tumor ( including at the time of their mastectomy) have a survival advantage compared to those spayed 2+ years prior to mammary tumor development and mastectomy.
Tumour Pathology 肿瘤病理学
Benign or Malignant (50:50) 良性或恶性 Carcinomas (60%) 癌 Complex (30%)
复合型 Sarcomas(10%)
肉瘤
Treatment Options 治疗方法
Surgery 手术
Radiotherapy 放疗
Risk Factors- Hormones 危险因素—激素
Estrogen and progesterone receptor concentration diminishes as the degree of malignancy of neoplastic cells and size of the tumor increases 雌激素和孕酮受体的浓度会随着恶性赘生细胞的增多和肿瘤的增大而减少
– This finding was supported by a second study indicated that dogs that were obese at 1 year of age had increased risk of development of both benign and malignant mammary tumors. 另一项研究证实了这一说法，即1岁时肥胖的犬患良性和恶 性乳腺肿瘤的危险性会增加。
Experimental exposure to combined high doses of estrogens and progestin does increase risk of malignant mammary tumors. 实验性地暴露于高剂量的雌激素和黄体激素中，确实会增加恶性乳腺瘤的 发生风险。
Preferred- histologic diagnosis 首选—组织学检查
Diagnosis 诊断
Benign 良性
– Movable 可移动 – Small 小 – Not erosive 非侵蚀性 – Not ulcerative
不溃烂
Malignant 恶性
– Firm 固定 – Attached 附着 – Erosive 侵蚀性 – Exhibit rapid growth
Stage 分期
1
Primary tumor 原发性肿瘤
T1 (<3 cm)
Regional LN status Distant metastasis 局部淋巴结的情况 远端转移
N0
M0
2 T2 (3-5cm) N0
M0
3 T3 (>5cm) N0
M0
4 Any T
N1
M0
5 Any T
Any N
M1
Early detection and small tumor size are important prognostic factors for survival. 早期检测和肿瘤的大小是其存活率的重要预后因素
Local control with surgical excision is successful in providing long term control in a majority of cases, however some patients will require adjuvant chemotherapy 在大部分病例局部的手术切除就可成功的将其长期控制，但有 些患畜仍要辅助性化疗
Inflammatory Carcinoma 炎性癌
Inflammatory
carcinoma
is
characterizedபைடு நூலகம்by a poorly
differentiated carcinoma with heavy
inflammatory cell infiltrates.
炎性癌的特征是有大量炎性细胞浸润
Risk of development if spayed prior to the first estrus is 0.05%; 8% after the first estrus, and 26% if spayed after the second estrus as compared to the risk in intact females. 第一次发情前绝育（摘除卵巢），发病率0.05%； 第一次发情后绝育，发病率后，发病率8%； 第二次发情后绝育，发病率26%，与未绝育的发病率相当。
Mammary Tumours: Risk Factors 乳腺肿瘤的危险因素
Sex 性别
Ovariohysterectomy 绝育手术
Age at Ovariohysterectomy 绝育年龄
Exogenous Progestogens 外源性性激素
Risk Factors- OVH 危险因素—
表现出生长迅速
Clinical Staging 临床检查
1. Thoracic radiographs- 3 view 三个角度的胸部X光片
2. CBC 全血细胞计数 3. Chem panel ？？？ 4. U/A 尿检 5. Abdominal Ultrasound ( if possible, for sublumbar
Steroid receptors are infrequently identified in metastatic mammary cells. 甾体激素受体在转移的乳腺细胞中很少见
Neither long-term exposure to estrogens or progestins appears to consistently increase risk of development of malignant mammary tumors. 长期接触雌激素或黄体激素并不会持续增加恶性乳腺瘤的发生风险
Signalment 特征
Typically older 年龄偏大 9-11 years old 9—11岁 Sexually intact ？？？性完整 （未绝育）
Clinical signs 临床症状
A palpable mammary mass or masses 可触及一个或多个乳房团块
Diagnosis 诊断
A palpable mammary mass should be strongly suspicious for mammary neoplasia. 乳房有可触及的团块，要强烈怀疑乳房瘤
Should be measured and well documented 要判断并证明
Association of this tumor with disseminated intravascular coagulation is reportedly common. 在这种肿瘤常有弥散性血管内凝血的 报道
12/12 dogs with inflammatory carcinoma in one study were thrombocytopenic. 一篇报道说12/12患有炎性癌的狗都 有血小板减少症。
Risk Factors- Breeds 危险因素—品种
Suggests a genetic component- not yet identified 建议遗传分组—尚不能识别
– toy and miniature poodles 玩具和迷你贵宾犬 – english springer spaniels 英国史宾格犬 – britanny spaniels – cocker spaniels 可卡犬 – english setters 英国雪达犬 – Pointers 波音达犬 – german shepherds 德国牧羊犬 – Maltese 马尔他犬 – yorkshire terriers 约克夏梗 – Dachshunds 腊肠犬
More than half of the patients have multiple nodules at the time of diagnosis 诊断时会发现大部分的患畜会长多发结节
Risk Factors 危险因素
Genetic predisposition 遗传易感性 Diet 饮食
Pain/ inflammatory skin 疼痛，皮肤发炎 Signs of metastatic disease 肿瘤转移的症状 Paraneoplastic signs- 副肿瘤性症状
– Cachexia 恶病质 – Hypercalcemia 高钙血症 – Anemia 贫血 – Inflammation 炎症
Chemotherapy 化疗
的分化性腺癌
Clinically these neoplasms are very infiltrative, often bilateral, are often associated with medial thigh involvement, and are readily invasive into dermal lymphatics.
临床上这些肿瘤的浸润性强，常发生
于两侧，并常涉及股内侧，很容易侵 入真皮淋巴系统
Inflammatory Carcinoma 炎性癌
Metastatic rates to distant sites vary from 0/121 to 10/10 based on two separate reports. 两篇报道称，转移率从0/121—10/10 不等
lymph nodes) 腹部超声检查（如可能，检查腰下淋巴结） If regional lymphadenopathy- FNA or biopsy of the lymph node 如局部淋巴结肿大—用细针抽吸或进行活组织检查
Modified WHO Staging System 修改的WHO分期体系
Canine Mammary Tumors 犬的乳腺肿瘤
Gillian Dank
Introduction 绪论
The most common tumor of female dogs (52%) 是母犬最常见的肿瘤
Frequency of malignancy- 50% 恶性肿瘤的比率占50%
Regional lymph nodes should be palpated 触诊周围的淋巴结
FNA- problematic. Important to R/O other etiologies- mast cell tumor, primary inflammatory lesion. 有疑问的用细针抽吸。看出其他病原性肥大 细胞瘤，主要是炎性损伤很重要。