Dr. Carroll Learns a Little About Breast Cancer

I really wish that in vet school they would offer some sort of comparative medicine course between human and vet med.  It would be nice to know what similarities and differences exist between diseases shared by pets and humans.  I’ve learned a lot over the years, but I’d love to know more.

For example:  Pancreatitis is a serious GI ailment that occurs in humans, dogs and cats.  In humans, my understanding is the number one cause is alcohol abuse.  In dogs it’s over consumption of fat.   I suppose, either way it’s too much of a good thing.   Nobody knows yet what causes it in cats, but as a species we know they definitely consume too many carbs, so maybe that’s it for them too (alcohol being high in carbs for people).

Over the summer at the AVMA convention I took a class on comparative oncology.  There are lots and lots of similarities between animals and humans when it comes to cancer.  Actually, every single kind of cancer that dogs get also occurs in humans except one (Mast cell tumors, and they’re not sure they’re actual tumors). 

So anyways, what I was getting at in a very roundabout way, was I got a lesson in comparative oncology last week.  I saw a Dobie named Sasha for a followup from an Emergency Clinic visit the previous weekend.

She was (uh oh, I’m speaking in past tense…this story has a sad ending by the way) a 10-year-old Dobie.  Very, very good girl.  She, unfortunately was a train wreck.  She had been seen at the EAC for a seizure. 

I saw her, and did an exam.  She had a heart murmur (red flag #1, Dobies are prone to cardiac disease).  She had terrible dental disease.  Her liver looked small on X-ray (red flag #2, Dobies are prone to liver disease too…yah purebred dogs have their problems, but at least then you know what problems to look for…), and she had these sores, nodules and inflammation along her groin and mammary areas on one side (big, giant red flag #3).

Any of the red flags could be responsible for red flag #4, the seizure.  Hence the train wreck. 

So I had to set out trying to unravel this case.  Oh and she’s not eating.  We did blood work which came back ok, just a lowish platelet count (Possibly another Dobie thing, or maybe tick borne disease? Add it to the list of issues).

My biggest concerns were the lesions on her belly/groin.  You see, she had a mammary mass removed in December.  Unfortunately, it wasn’t biopsied so I couldn’t be sure, but I had a strong suspicion that it was a very “hot” malignant tumor that had returned with a vengeance. 

There is a type of mammary cancer (or breast cancer on the human side) called Inflammatory Carcinoma that may be the mother of all breast cancers.  I’ve seen it three times over the last 12 years now in dogs.  Again, in dogs, they seem to start out as regular mammary masses.  Normal procedure is to surgically remove the mass and send it out for biopsy.

This particular type of tumor gets really, really pissed off (that’s a little bit strong language wise, but these tumors are horrible, so strong language is needed) and spread like crazy.  I’ve seen them back by the time the dog is coming in for suture removal.   At this point (and even before the initial removal) in dogs, there really is no effective treatment.  It’s incredibly, incredibly painful, often making the dogs stop eating and they become systemically ill from the cancer invading the lymphatics.  

In our canine patients, we’re really left with no choice but to euthanize the patients.  Ultimately, in Sasha’s case, that’s what we had to do with her. 

After much discussion, between myself and the client, we decided to biopsy the masses to confirm the cancer (maybe it was just a bad infection…we were hoping for the best…but I had a feeling it was the worst).   I sedated Sasha and quickly got my biopsy specimens and woke her up. 

However, a complication occurred.  Despite having enough platelets to clot her blood, and adequate clotting times when tested, she kept bleeding from her biopsy sites.  We tried every type of blood stop surgical systems we had.  She was so sweet, she laid on the treatment table for an hour while the techs  put ice packs on the two incisions.  We had to give her another sedative to lower her blood pressure so that the bleeding would stop. 

However, at home that night it started again.  The bleeding was a functional problem, her capillaries couldn’t constrict to stop the blood flow because of how invasive the cancer was.   She was really brave and tried to rally for her owners, but ultimately we had to put her down. 

The biopsy results came in about an hour after I euthanized her, inflammatory carcinoma. 

I did a little research to see what this was like on the human side.  What I found to be interesting is that this type of cancer in human women does not cause a mass.  I’ve been trained to do self-checks and mammograms and stuff to look for a mass…but this horrible cancer doesn’t work that way.

They don’t even do surgery on these guys right away, they do intensive chemo and radiation first to shrink the cancer, then goto surgery.  The fatality rate for this one is 50% in humans.  Guess it’s 100% in dogs because they just can’t take the chemo. 

So here’s my public service to you fellow females (and occasional males) out there (young and old…apparently it can affect all ages)…Get yourself checked if you experience any of the below.  It could be a simple infection, called mastitis or it could be something much, much worse.  The sooner you catch this the better. 

  • if you have persistent breast pain that’s not associated with your cycle,
  • if you have weird swellings (like suddenly your boob swells a cup size overnight without surgical intervention)
  • you have sudden, horrible, unrelenting itchiness in the breast area
  • there are spots on your boob that are red or discolored and can have kind of an orange-peel texture
  • ridges/thickenings of the skin
  • nipple discharge, flattening, retraction
  • breast hot to the touch
  • a bruise that doesn’t go away

So, even in the worst of cases there is always something to be learned. 

You guys take care…

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