先说明一下， 不一定有隆起块状物就一定是肿瘤， 不一定年轻，就可以排除肿瘤的可能性， 不一定在那个部位就是那个部位的肿瘤，有可能是循环系，或是移行的肿瘤。 这必须靠外科手术完全或部分摘取病灶做生检来决定。通常病灶必须送交具有专业训练而 有能力利用肉眼或显微方法进行诊断的病理学者,有经验的病理学者可以分出此肿瘤是癌 症及恶性的程度并能获得更进一步的资讯,如此方能明确的诊断出来。 如此，你觉得在这边问会有结果吗?? 赶快带它去看兽医吧。 但是我还是提供一些关於mammary tumors的资讯给你，希望对你有帮助。 Mammary Cancer Race Foster, DVM Holly Nash, DVM, MS Drs. Foster & Smith, Inc. Mammary tumors are the most common tumors in female dogs who have not been spayed. Mammary tumors can be small, simple nodules or large, aggressive, metastatic growths. With early detection and prompt treatment, even some of the more serious tumors can be successfully treated. Cats also suffer from mammary tumors and they have their own unique set of problems that are discussed in a separate article. Which dogs are at risk for developing mammary tumors? Mammary tumors are more common in unspayed, middle-aged female dogs (those between 5 and 10 years of age), although they can, on rare occasions, be found in dogs as young as 2 years. These tumors are rare in dogs that were spayed under 2 years of age. Occasionally, mammary tumors will develop in male dogs and these are usually very aggressive and have a poor prognosis. The risk of breast cancer is almost eliminated in dogs that are spayed before their first heat. Spaying greatly reduces the chances of a female dog developing this condition. In those females spayed prior to their first heat cycle, breast cancer is very, very rare. The risk of malignant mammary tumors in dogs spayed prior to their first heat is 0.05%. It is 8% for dog spayed after one heat, and 26% in dogs spayed after their second heat.It is believed that the elimination or reduction of certain hormonal factors causes the lowering of incidence of the disease in dogs that have been spayed. These factors would probably be estrogen, progesterone, a similar hormone or possibly a combination of two or more of these. What are the types of mammary tumors in dogs? There are multiple types of mammary tumors in dogs. Approximately one-half of all mammary tumors in dogs are benign, and half are malignant. All mammary tumors should be identified through a biopsy and histopathology (microscopic examination of the tissue) to help in the treatment of that particular type of tumor. The most common benign form of canine mammary tumors is actually a mixture of several different types of cells. For a single tumor to possess more than one kind of cancerous cell is actually rare in many species. This combination cancer in the dog is called a 'benign mixed mammary tumor' and contains glandular and connective tissue. Other benign tumors include complex adenomas, fibroadenomas, duct papillomas, and simple adenomas. The malignant mammary tumors include: tubular adenocarcinomas, papillary adenocarcinomas, papillary cystic adenocarcinomas, solid carcinomas, anaplastic carcinomas, osteosarcomas, fibrosarcomas, and malignant mixed tumors. What are the symptoms of mammary tumors? Mammary tumors present as a solid mass or as multiple swellings. When tumors do arise in the mammary tissue, they are usually easy to detect by gently palpating the mammary glands. When tumors first appear they will feel like small pieces of pea gravel just under the skin. They are very hard and are difficult to move around under the skin. They can grow rapidly in a short period of time, doubling their size every month or so. The dog normally has five mammary glands, each with its own nipple, on both the right and left side of its lower abdomen. Although breast cancer can and does occur in all of the glands, it usually occurs most frequently in the 4th and 5th. In half of the cases, more than one growth is observed. Benign growths are often smooth, small and slow growing. Signs of malignant tumors include rapid growth, irregular shape, firm attachment to the skin or underlying tissue, bleeding, and ulceration. Occasionally tumors that have been small for a long period of time may suddenly grow quickly and aggressively, but this is the exception not the rule. It is very difficult to determine the type of tumor based on physical inspection. A biopsy or tumor removal and analysis are almost always needed to determine if the tumor is benign or malignant, and to identify what type it is. Tumors, which are more aggressive may metastasize and spread to the surrounding lymph nodes or to the lungs. A chest x-ray and physical inspection of the lymph nodes will often help in confirming this. Mammary cancer spreads to the rest of the body through the release of individual cancer cells from the various tumors into the lymphatics. The lymphatic system includes special vessels and lymph nodes. There are regional lymph nodes on both the right and left sides of the body under the front and rear legs. They are called the 'axillary' and 'inguinal' lymph nodes, respectively. Mammary glands 1, 2, and 3 drain and spread their tumor cells forward to axillary lymph nodes, while cells from 3, 4, and 5 spread to the inguinal ones. New tumors form at these sites and then release more cells that go to other organs such as the lungs, liver, or kidneys. What is the treatment? Surgical Removal: Upon finding any mass within the breast of a dog, surgical removal is recommended unless the patient is very old. If a surgery is done early in the course of this disease, the cancer can be totally eliminated in over 50% of the cases having a malignant form of cancer. The area excised depends on the judgment and preference of the practitioner. Some will only remove the mass itself. Others, taking into consideration how the cancer spreads, will remove the mass and the rest of the mammary tissue and lymph nodes that drain with the gland. For example, if a growth were detected in the number 2 gland on the left side, we would therefore remove glands, 1, 2, and 3 and the axillary lymph node on that side. If it were found in the number 4 gland on the right side, then glands 3, 4, 5, and the inguinal lymph node on that side would be completely removed. With some tumor types, especially sarcomas, complete removal is very difficult and many of these cases will have tumor regrowth at the site of the previously removed tumor. Owners may confuse a surgical removal of a mammary gland in the dog with a radical mastectomy in humans, with all of the associated problems. In humans, this type of surgery would affect the underlying muscle tissue which complicates the recovery. In the dog, however, all of the breast tissue and the related lymphatics are outside of the muscle layer, so we only need to cut through the skin and the mammary tissue. This makes the surgery much easier and recovery much faster. A radical mastectomy in a dog means all the breasts, the skin covering them, and the four lymph nodes are all removed at the same time. Although this is truly major surgery, suture removal usually occurs in 10 to 14 days with normal activity resuming at that point. Many veterinarians will spay a dog having a mastectomy (unless she is very old). The value of this in decreasing the recurrence of tumors is still controversial. Chemotherapy and Radiation Therapy: Chemotherapy has not been a very successful nor widely used treatment for mammary tumors in dogs. However, with the constantly changing and improving drugs available, a veterinary oncologist should be consulted to find out if there is an effective drug available for your dog's particular type of mammary cancer. The effectiveness of radiation therapy has not been thoroughly researched. Some anti-hormonal drug regimens are being tested in dogs. At this point in time, surgical removal of the tumors is the treatment of choice. How can I prevent mammary cancer in my dog? There are few cancers that are as easily prevented as mammary cancer in dogs. There is a direct and well-documented link between the early spaying of female dogs and the reduction in the incidence in mammary cancer. Dogs spayed before coming into their first heat have an extremely small chance of ever developing mammary cancer. Dogs spayed after their first heat but before 2.5 years are at more risk, but less risk than that of dogs who were never spayed, or spayed later in life. We all know the huge benefits of spaying females at an early age, but every day, veterinarians still deal with this easily preventable disease. Early spaying is still one of the best things pet owners can do to improve the health and ensure a long life for their dogs. Conclusion Mammary cancer is a very common cancer and can often be successfully treated, if caught early. If all non-breeding dogs and cats were spayed before their first heat this disease could be almost completely eliminated. If you find a growth or lump in the mammary tissue of your dog, you should inform your veterinarian immediately and not take a "wait and see" attitude. Reference:http://www.peteducation.com/article.cfm?cls=2&cat=1638&articleid=460 另一篇 *前言 1. 母狗最常见之肿瘤,占所有肿瘤42%,占所有母狗生殖器官肿瘤的82%. 2. 平均诊断到肿瘤的年龄约10-11岁,良性比恶性发生的年龄较早些,年轻动物经常呈现发育 不良或发育过度. 3. 公狗得乳房瘤的机率较少. 4. 好发品种包括:贵宾狗,英国猎犬,英国雪达犬,大麦町,猎狐埂,波士顿埂,可卡犬. 5. 早期结紮所呈现的效果,以及荷尔蒙接收器存在於肿瘤组织的发现,故导向乳房瘤的发生 可能是受道贺尔蒙的影响,此荷尔蒙是指内因性Estrogen and progesterone. 6. 50%的恶性乳房瘤,70%的良性乳房瘤组织以及正常乳房组织上可发现Estrogen and progesterone receptors(接受体).没有接受体的肿胀有较大的侵略行为,而且对荷尔蒙쀊 反应不佳,而且预後较差. 7. 第一次发情前就结紮的狗,发生乳房瘤的风险率约0.5%. 第一次发情後才结紮的狗,发生乳房瘤的风险率约8%. 第二次发情後才结紮的狗,发生乳房瘤的风险率约26%. 从第二次发情之後,结紮去影响降低乳房瘤机率的效果就愈来愈小.但是对降低良性乳房봊 效果仍持续存在. 8. 不管有没有结紮,两者发生乳房瘤的高峰年龄是相同的. 9. 为了防止发情而使用长效的Progestins,发现与母狗的良性乳房瘤的发生有关连. 10. 为了中止怀孕(堕胎)而使用Estrogen,会使乳房瘤的发生机率增加. 11. 发情周期的性质,或是生产的次数,目前并没有发现与乳房瘤的发生有关连. 12. 经常性假怀孕,可能增加肿瘤生成前病症的表现机率. 13. 在年轻时肥胖以及高脂饮食,发现之後得到乳房瘤时,预後比较差,相对也增加乳房瘤的 风险度. *临床方法 1. 完整记录---性别,品种,年龄,服用荷尔蒙与发情时机的关系,生产次数,假怀孕发现之日 期,肿瘤生长速度. 2. 所有乳房组织都要仔细触诊,确定肿瘤之大小数量. 3. 5对乳房都有可能发生,但最常见为最後2对. 4. 腋下,鼠蹊淋巴结也要检查,Fine-needle aspirtion这些淋巴结做细胞检查,对於是否转 移会有帮助. 5. 乳房瘤的完整分期,需要做以下检查: (1).左侧,右侧,腹背等三角度的胸腔X光 (2).CBC (3).生化 (4).腹部超音波(检查腹腔淋巴结是否有转移的现象) 经由上述评估之後,治疗以及预後才能跟畜主讨论实施. 6. 乳房瘤的临床分期: (1).第一期:肿瘤直径小於3公分(T1),淋巴结组织学上无转移(No),并未发现远端转移 (2).第二期:肿瘤直径3-5公分(T2),No,Mo. (3).第三期:肿瘤直径大於5公分(T3),No,Mo. (4).第四期:T1-T3任一种,淋巴结组织发现转移(N1),Mo (5).第五期:T1-T3任一种,No或N1,发现远端转移(M1). 7. 用组织学来将乳房瘤分期是不易的,因为表现的多样性之故,但还是有人试着将其分期. 8. 大约50-60%的狗乳房瘤是良性的,其多为Fibroadenomas,大约40-50%的狗乳房瘤是恶性的 ,其中50%可能转移. *诊断 1. Fine-needle cytology可能无法区别良性,恶性之乳房瘤,但是可以用来排除分化不良的 恶性瘤以及转移的疾病. 2. 同一病患身上之乳房瘤,可能有不同之组织学上的型态,所以所有切除下来的肿块都要做 组织病理评估,而且都要注明是何部位,以便需要再手术扩创切除时区别之用. 3. 假如组织病理发现某组织边缘有”Dirty”的组织,则建议再手术将此组织的边缘剩余之 部位再切除掉. 4. 组织病理的结果应该包括: (1).浸润的程度 (2).肿瘤分化的程度 (3).有丝分裂指标的程度 (4).淋巴或血管入侵的程度 5. 一般组织病理恶性肿瘤的分期可分成三期,第三期的预後最差 *治疗 1. 以手术切除为主,技术包括 (1).Lumpectomy.(块状切除) (2).Simple mastectomy.(单颗乳房切除) (3).Unilateral mastectomy.(单侧边乳房切除) (4).Bilateral mastectomy.(双侧边所有乳房切除) (5).Radical mastectomy. (根本之乳房切除) 2. 目前大部份资料显示,移除手术的方式对预後的重要性并没有比获得显微处的完整清除来 的重要.如果淋巴结显示已经有肿瘤细胞,则必须要将淋巴结切除. 3. 近来研究显示,当施行乳房切除手术时,同时将卵巢切除,对良性或恶性的乳房瘤都有延长 存活时间的效果. 4. 化疗只有当有高度转移的危险时,才会实施. 5. Tamoxifen是一种合成的,.非类固醇的抗动情素相似物,有管制抵抗以及协同情素之作用, 不同动物以及不同组织有不同之效用.某研究,使用Tamoxifen 0.4-0.8 mg/kg/day PO fo 4-8周,来治疗乳房瘤.但是此药有类似动情素之副作用.例如:子宫蓄脓,阴道增生,发情,꜊ 禁,局部掉毛,可能影响在狗的实施应用上. 6. 某些欧洲国家,使用Antiprogestins(例如:Aglepristone)来治疗Progesterone receptor-positive的乳房瘤. 7. 因为乳房瘤常同时有假怀孕现象,而使得做手术切除时,肿瘤面积会较大,所以某些研究者 认为,在手术前一周可以使用抗泌乳药物,例如:Cabergoline 5mg/kg/day PO 1 week,来ꠊ 怀孕现象缓和. *预後 1. 预後因子可以用来预测再发或移转,无疾病状态时间期以及整体存活期. 2. 不佳预後因子包括: (1).肿瘤Size很大(超过3公分直径) (2).侵入淋巴 (3).转移至区域或远端的淋巴结 (4).固定在原发组织之下 (5).溃疡现象 (6).缺乏肿瘤Estrogen receptor的阳性反应 (7).较原始细胞形态的组织病理 (8).肿瘤生长快速 3.恶性乳房瘤的平均存活期约4-17个月.恶性乳房瘤经常在手术後2年之内转移.(经常在1-9 个月时),转移部位:肺,肾,腹部淋巴结,心,肾上腺,肾. Reference:http://203.204.6.124/vet/eNews21.asp?num=122 因为文章转移，有时会漏字，建议你，还是直接点选连结进去看，比较好。 --

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