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Mammary gland tumors are common in the dog, and surgery to remove
cancerous mammary glands, called a mastectomy, is a routinely done procedure
in veterinary medicine. Male dogs almost never get mammary
tumors; as well, female dogs that have
been
spayed before their first heat cycle rarely acquire breast cancer.
Statistics demonstrate that if a female dog is spayed after her first heat
cycle but before her second cycle, her potential to develop mammary tumors
is slightly greater than the dog that was spayed prior to a heat cycle.
If two cycles occur, then the spay procedure, an even higher incidence of
breast cancer is demonstrated. And spaying after three heat cycles has
no effect on diminishing the potential to develop mammary tumors. In
short, the sooner a dog is spayed the less the chances for mammary tumors to
develop in the future; but after three or four heat cycles, spaying has
almost no effect on protection against tumor development. Keep in mind
that spaying any dog at any time (as long as the patient is healthy) may be
advisable to prevent a very serious uterine infection called
PYOMETRA.
Also see images of the SPAY
(technically called an Ovariohysterectomy) surgery procedure.
Visual inspection and a physical exam probably will not be helpful in
determining whether or not a growth is benign or malignant. A biopsy
can be done on these growths to determine the cell types, which are highly
variable in canine mammary tumors, and to establish the degree of
malignancy. Malignancy means that they have the tendency to spread
invasively into surrounding tissues and also to be spread by the lymph
system to other parts of the body. Most veterinarians will
suggest a chest X-ray prior to any mammary gland surgery to see if there is
any evidence of metastasis (new tumors as a result of "seeding" from a
distant, primary tumor). If there is evidence of tumor spread to other
areas, the decision to do a mastectomy may not be advisable because
metastasis of mammary gland tumor to the lungs or other body tissues almost
always signals a very poor prognosis for recovery in the dog.
Chemotherapy for mammary gland cancer, and/or radiation treatment, can be
done but the main effort of treatment is surgical excision of any suspicious
mass.
The
case shown below is of an eight year old dog that had been spayed and that
had small masses in the right third, fourth and fifth mammary glands for a
number of months. All of a sudden a rapidly growing tumor near the
right fourth nipple attracted the owner's attention and surgery was
performed. There was no evidence of metastasis in this patient and
removal of the third, fourth and fifth mammary glands was done. Since
there was no evidence of tumors in the first and second gland, those were
left intact but careful vigilance will be needed to ensure that if any
evidence of tumors show up, further surgery may need to be done.
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Mammary Gland
Surgery In The Dog |
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This view is of
the patient just prior to preoperative preparation of the surgical
area for surgery. The large mass between the fourth and fifth
nipple is evident. |
The surgeon,
employing sterile technique, begins the incision near the masses in
the glands, being careful not to incise any tumor tissue. |
Hemostasis
(controlling bleeding) can be challenging in these surgeries due to
the mass of tissue to be removed as well as the vigorous blood supply
to the area. |
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One side of the
three mammary glands is dissected down to the abdominal wall; then the
opposite side is dissected. |
Care is employed
to remove all the mammary gland tissue but also to leave enough normal
tissue that closing the incision will not create excessive tension
along the surgical closure. |
Blood vessels are
tied off and the row of three mammary glands is lifted away from the
patient. Some veterinarians will remove all five glands even if
no evidence of tumor in other glands is present. |
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A major artery and
vein to and from the area is the Caudal Superficial Epigastric
vessels. Lymph channels drain from the last three mammary glands
through this small channel through the abdominal wall. |
After removal of
the mammary glands (along with the tumor tissue) the incision is
closed in layers from deep to superficial. The goal is to
comfortably close the incision with no tension being placed on the
skin. |
In this case the
skin is closed via two simple continuous sutures to decrease surgical
and anesthetic time. The patient is placed on pain control
medication for a few days and sutures are removed in 12 days. |
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