Lumpectomy in Dogs
Dr. Cathy Reese
A lump is an abnormal growth or mass that can appear on the skin surface or below the skin. Removal of a lump is medically referred to as a lumpectomy. Physical exam. Your veterinarian will perform a complete physical exam and palpate (feel) the mass to determine its size, degree of invasiveness and consistency. He/she will also determine if it seems painful to your pet and palpate local lymph nodes for enlargement, which could suggest the mass has spread to these lymph nodes. He/she will also listen to your pet's heart and lungs, take her temperature, and palpate your pet's abdomen to be sure there are no other problems.
In addition to appearing anywhere on or in the body, lumps can also be well encapsulated or invasive and attached to underlying structures. Some lumps are benign and other are malignant (likely to spread). If determined to be benign, treatment is usually limited to surgical removal. If determined to be malignant, surgical removal of the lump, as well as additional medical treatment, may be necessary.
In order to determine the cause of the lump, your veterinarian will first ask you many questions to develop a complete history of the progression of the problem. Your veterinarian will need to know your dog's age, when the mass was first noted, if it has changed in color, size or consistency, if it seems to bother your dog, any treatments you have tried and the results. If other veterinarians have done any tests regarding the mass, then you should bring these results to your veterinarian's attention. If you have tried any treatments for this problem, it's helpful to tell your veterinarian about them and whether they had any effect or not.
The following may also be recommended:
Fine needle aspirate and cytology. Your veterinarian may insert a small needle into the mass and suck out some cells with a syringe. These cells can be sprayed on a microscope slide and then interpreted by a pathologist. This is a simple procedure that carries little risk, and may help in the diagnosis. Since only a few cells are acquired via this method, an accurate diagnosis is not always made with this test. A biopsy may be necessary for a more definitive diagnosis. Fine needle aspirate and cytology can also be done on local lymph nodes near the lump to see if it has spread to the lymph nodes.
Biopsy. This refers to sampling the tissue for microscopic analysis. A small piece of the mass can be removed for biopsy ("incisional biopsy") or (if possible) the whole mass can be removed and submitted for biopsy ("excisional biopsy"). The outer margins of the tissue that has been excised should be evaluated microscopically to determine if the entire mass was successfully removed. Biopsies generally are invasive procedures that require general anesthesia. The biopsy results will tell what type of tumor it is and whether it is benign or malignant.
Blood and urine tests. If your pet will be undergoing anesthesia and surgery, blood and urine tests are run to be sure that your pet is not anemic and that he doesn't have any underlying liver or kidney problems that might make anesthesia risky. In addition, one type of tumor, the mast cell tumor, can spread via the blood stream, and may be diagnosed through a blood test called the "Buffy Coat."
Radiographs. Radiographs (x-rays) of the chest may be indicated if the mass is suspected or confirmed to be malignant to see if the mass has spread to the lungs. If the mass is near a bony structure, such as the limb or toe, radiographs may be necessary of the area to determine if the mass invades the bone.
General anesthesia and surgery are required to remove a lump. The lump is removed, including some normal tissue around it to make sure that the whole mass is removed. Some tumors extend microscopically very far beyond the primary mass, making it necessary to remove a large area of tissue around the primary mass.
If the surgery is extensive and leaves a large defect, reconstructive surgery can be done to help close the wound. Some malignant tumors on the limbs and toes require amputation of the affected limb or toe in order to remove the whole tumor.
Depending on the type of tumor and/or the success in removing all of the tumor, additional therapy may be necessary to prevent recurrence or spread of the tumor. This can include chemotherapy and/or radiation therapy.
Optimal treatment for your pet requires a combination of home and professional veterinary care. Follow-up can be critical, especially if your pet does not rapidly improve.
Administer all prescribed medications as directed. Alert your veterinarian if you are experiencing problems treating your pet.
Follow your veterinarian's instructions for incision and/or bandage care. Your pet may need an Elizabethan collar if she chews or licks at her stitches or bandage.
Follow your veterinarian's instructions for exercise restriction. Too much activity can cause the incision to open, which can result in less than optimal results and most likely the need for more surgery.
Depending on the results of the surgery and biopsy, your dog may require further surgery or treatment. A close working relationship with your veterinarian is critical to the success of your pet's treatment. Frequent re-check examinations allow for early detection and treatment of any problems that may arise.