先說明一下， 不一定有隆起塊狀物就一定是腫瘤， 不一定年輕，就可以排除腫瘤的可能性， 不一定在那個部位就是那個部位的腫瘤，有可能是循環系，或是移行的腫瘤。 這必須靠外科手術完全或部分摘取病灶做生檢來決定。通常病灶必須送交具有專業訓練而 有能力利用肉眼或顯微方法進行診斷的病理學者,有經驗的病理學者可以分出此腫瘤是癌 症及惡性的程度並能獲得更進一步的資訊,如此方能明確的診斷出來。 如此，你覺得在這邊問會有結果嗎?? 趕快帶它去看獸醫吧。 但是我還是提供一些關於mammary tumors的資訊給你，希望對你有幫助。 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. 母狗最常見之腫瘤,佔所有腫瘤42%,佔所有母狗生殖器官腫瘤的82%. 2. 平均診斷到腫瘤的年齡約10-11歲,良性比惡性發生的年齡較早些,年輕動物經常呈現發育 不良或發育過度. 3. 公狗得乳房瘤的機率較少. 4. 好發品種包括:貴賓狗,英國獵犬,英國雪達犬,大麥町,獵狐埂,波士頓埂,可卡犬. 5. 早期結紮所呈現的效果,以及荷爾蒙接收器存在於腫瘤組織的發現,故導向乳房瘤的發生 可能是受道賀爾蒙的影響,此荷爾蒙是指內因性Estrogen and progesterone. 6. 50%的惡性乳房瘤,70%的良性乳房瘤組織以及正常乳房組織上可發現Estrogen and progesterone receptors(接受體).沒有接受體的腫脹有較大的侵略行為,而且對荷爾蒙쀊 反應不佳,而且預後較差. 7. 第一次發情前就結紮的狗,發生乳房瘤的風險率約0.5%. 第一次發情後才結紮的狗,發生乳房瘤的風險率約8%. 第二次發情後才結紮的狗,發生乳房瘤的風險率約26%. 從第二次發情之後,結紮去影響降低乳房瘤機率的效果就愈來愈小.但是對降低良性乳房봊 效果仍持續存在. 8. 不管有沒有結紮,兩者發生乳房瘤的高峰年齡是相同的. 9. 為了防止發情而使用長效的Progestins,發現與母狗的良性乳房瘤的發生有關連. 10. 為了中止懷孕(墮胎)而使用Estrogen,會使乳房瘤的發生機率增加. 11. 發情週期的性質,或是生產的次數,目前並沒有發現與乳房瘤的發生有關連. 12. 經常性假懷孕,可能增加腫瘤生成前病症的表現機率. 13. 在年輕時肥胖以及高脂飲食,發現之後得到乳房瘤時,預後比較差,相對也增加乳房瘤的 風險度. *臨床方法 1. 完整記錄---性別,品種,年齡,服用荷爾蒙與發情時機的關係,生產次數,假懷孕發現之日 期,腫瘤生長速度. 2. 所有乳房組織都要仔細觸診,確定腫瘤之大小數量. 3. 5對乳房都有可能發生,但最常見為最後2對. 4. 腋下,鼠蹊淋巴結也要檢查,Fine-needle aspirtion這些淋巴結做細胞檢查,對於是否轉 移會有幫助. 5. 乳房瘤的完整分期,需要做以下檢查: (1).左側,右側,腹背等三角度的胸腔X光 (2).CBC (3).生化 (4).腹部超音波(檢查腹腔淋巴結是否有轉移的現象) 經由上述評估之後,治療以及預後才能跟畜主討論實施. 6. 乳房瘤的臨床分期: (1).第一期:腫瘤直徑小於3公分(T1),淋巴結組織學上無轉移(No),並未發現遠端轉移 (2).第二期:腫瘤直徑3-5公分(T2),No,Mo. (3).第三期:腫瘤直徑大於5公分(T3),No,Mo. (4).第四期:T1-T3任一種,淋巴結組織發現轉移(N1),Mo (5).第五期:T1-T3任一種,No或N1,發現遠端轉移(M1). 7. 用組織學來將乳房瘤分期是不易的,因為表現的多樣性之故,但還是有人試著將其分期. 8. 大約50-60%的狗乳房瘤是良性的,其多為Fibroadenomas,大約40-50%的狗乳房瘤是惡性的 ,其中50%可能轉移. *診斷 1. Fine-needle cytology可能無法區別良性,惡性之乳房瘤,但是可以用來排除分化不良的 惡性瘤以及轉移的疾病. 2. 同一病患身上之乳房瘤,可能有不同之組織學上的型態,所以所有切除下來的腫塊都要做 組織病理評估,而且都要註明是何部位,以便需要再手術擴創切除時區別之用. 3. 假如組織病理發現某組織邊緣有”Dirty”的組織,則建議再手術將此組織的邊緣剩餘之 部位再切除掉. 4. 組織病理的結果應該包括: (1).浸潤的程度 (2).腫瘤分化的程度 (3).有絲分裂指標的程度 (4).淋巴或血管入侵的程度 5. 一般組織病理惡性腫瘤的分期可分成三期,第三期的預後最差 *治療 1. 以手術切除為主,技術包括 (1).Lumpectomy.(塊狀切除) (2).Simple mastectomy.(單顆乳房切除) (3).Unilateral mastectomy.(單側邊乳房切除) (4).Bilateral mastectomy.(雙側邊所有乳房切除) (5).Radical mastectomy. (根本之乳房切除) 2. 目前大部份資料顯示,移除手術的方式對預後的重要性並沒有比獲得顯微處的完整清除來 的重要.如果淋巴結顯示已經有腫瘤細胞,則必須要將淋巴結切除. 3. 近來研究顯示,當施行乳房切除手術時,同時將卵巢切除,對良性或惡性的乳房瘤都有延長 存活時間的效果. 4. 化療只有當有高度轉移的危險時,才會實施. 5. Tamoxifen是一種合成的,.非類固醇的抗動情素相似物,有管制抵抗以及協同情素之作用, 不同動物以及不同組織有不同之效用.某研究,使用Tamoxifen 0.4-0.8 mg/kg/day PO fo 4-8週,來治療乳房瘤.但是此藥有類似動情素之副作用.例如:子宮蓄膿,陰道增生,發情,꜊ 禁,局部掉毛,可能影響在狗的實施應用上. 6. 某些歐洲國家,使用Antiprogestins(例如:Aglepristone)來治療Progesterone receptor-positive的乳房瘤. 7. 因為乳房瘤常同時有假懷孕現象,而使得做手術切除時,腫瘤面積會較大,所以某些研究者 認為,在手術前一週可以使用抗泌乳藥物,例如:Cabergoline 5mg/kg/day PO 1 week,來ꠊ 懷孕現象緩和. *預後 1. 預後因子可以用來預測再發或移轉,無疾病狀態時間期以及整體存活期. 2. 不佳預後因子包括: (1).腫瘤Size很大(超過3公分直徑) (2).侵入淋巴 (3).轉移至區域或遠端的淋巴結 (4).固定在原發組織之下 (5).潰瘍現象 (6).缺乏腫瘤Estrogen receptor的陽性反應 (7).較原始細胞形態的組織病理 (8).腫瘤生長快速 3.惡性乳房瘤的平均存活期約4-17個月.惡性乳房瘤經常在手術後2年之內轉移.(經常在1-9 個月時),轉移部位:肺,腎,腹部淋巴結,心,腎上腺,腎. Reference:http://203.204.6.124/vet/eNews21.asp?num=122 因為文章轉移，有時會漏字，建議你，還是直接點選連結進去看，比較好。 --

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