Two Lumps Under Skin - Possible Mammary Cancer

[spac]

I just found two tiny lumps under my cat's skin, right beside each other and right beside her nipple. She is 11 years old and was spayed around age 1. The lumps are located in the cranial abdominal glands (second nipple down from the head).

I obviously need to get this checked out ASAP. I've had cats with plenty of other diseases, but never possible mammary cancer. I only ever had one cat with a tumor which was different than this - less invasive. So I'm kinda freaking out here.

Can anyone tell me how these are typically diagnosed? I'm not sure where I should make an appointment. The vet clinic changed their policies and pricing due to inflation, and overall quality has gone downhill - I'm not happy with them. I'm trying to explore my options.

Unfortunately, I cannot afford chemotherapy or radiation and I think that needs to be kept in mind when making decisions.

So. . . How are these diagnosed? Do I have to go to a specialist?

 

[spac]

It looks like the veterinary website I was looking at had an incorrect diagram. Other veterinary websites have that nipple shown as being the caudal thoracic mammary gland.

 

[silent meowlook]

Hi. You would do best with a feline only veterinarian. Diagnosis is done through usually, first cytology (collecting cells from the lump with a needle) and if that comes back as cancer, removal with surgery and biopsy. This is one of those things that need to be seen ASAP. I case it is bad, you want it removed while still small and not as involved. And, if not bad, you need the piece of mind.

 

[spac]

UPDATE:
The vet thinks it's a Feline Mammary Gland Adenocarcinoma. His recommendation is surgical removal. He would first do an xray to confirm it's hasn't spread to the lungs, then do blood work, remove it, and send it to a lab for analysis. He doesn't recommend doing fine-needle aspiration prior to the surgery.

He made some comments that I am puzzled about and I figured I'd do research when I came home, then call if I have more questions. He something about animals don't get cancers that spread the way humans do??? Something about them being localized. But he said that he wanted to do an x-ray to make sure it hadn't metastized to the lungs. So I don't understand what he's saying. It makes no sense.

He never mentioned chemo either. I don't know if chemo is only recommended depending on the results of the biopsy. I can't afford it anyway.

I asked about lifespan and he said she could live for many years.

I am confused. I had to take a Xanax prior to the appointment and as a result, I couldn't remember everything he said. It was my first time going to this clinic and I'm used to going to a clinic that ALWAYS gives me discharge instructions that include what the findings were during the exam.

 

[silent meowlook]

When was your cat spayed?

 

[fionasmom]

I can only speak generally about some of the things that your vet has told you, based upon my own experience with this. The reason that your vet wants to do the x-ray of the lungs is that in dogs and cats metastatic cancer very often moves to the lungs. It is very rare for a cat to develop primary lung cancer.

In a case in which a tumor needs to be removed, it is not uncommon to skip a fine needle aspiration, or another type of biopsy, because the more important issue is to remove the tumor.

if a tumor, including a malignant one, is removed with completely clean margins it is very possible for a human or an animal to continue to live successfully. I cannot address whether you should or should not do chemo or why your vet did not bring it up to you, but that is certainly something that you could ask him. It is possible that if the tumor is removed successfully with clean margins, the chemo would not be needed. This may be why your vet did not bring this up yet.

Your vet might have meant, when he spoke about a localized tumor, that he feels that this may not have spread. In the world of most cancers, there are two kinds of diseases: local and distant. If something is local, it means it is contained at the point of origin for that.

Whatever has been done or discussed about your cat has been documented in a medical record at the hospital. Those records are your property and you have the right to ask for them. If it would help you to have them because it would clarify what was said you should ask them if they can send them to you.

This kind of thing is very upsetting, and we all understand that it was very stressful for you.

 

[silent meowlook]

Mammary Tumors

This is an article on feline mammery adenocarcinoma.
There is chemotherapy and I will link another article that discusses staging and chemo.

Feline Mammary Gland Adenocarcinoma - AVIM&O

 

[spac]

Thanks for the info.
I apologize if this is a repetitive question. I have severe anxiety disorders with ADHD and have trouble processing information sometimes.

My inclination is that these tumors should go ahead and be removed. The doctor said he thinks it's best to just remove these tumors as opposed to doing a full mastectomy. It's hard to tell, but I think they are probably under 2 cm, I think they were caught early enough.

He said the surgery with xrays, and blood work should be around $1100. The biopsy will be around $350, I think. Does all this sound about right to you all? This is the first time using this clinic and the second time using this veterinarian. I took a gamble because I was very unhappy with my regular vet clinic and the one I used prior to that. I can't afford to get a second opinion and don't want to waste time either.

I would like opinions from people who are familiar with this type of cancer. I won't make my decision solely based on the responses I get here. I just want opinions to use as a guideline as I do more research on this issue. Perhaps there is a detail I've overlooked and it helps to gain different perspectives.

When was your cat spayed?

She was a stray. So I was not able to get her spayed until she was around 1 y/o. I think she may have been 11 months. She was actually pregnant at the time we took her to get spayed. She is 11 now.

 

[fionasmom]

The links above which S silent meowlook provided discuss tumor size and prognosis. 2 cm is considered to have a good outcome and I definitely believe that the tumors should be removed. The only difference that I am seeing with your vet from the usual recommendation is that they want to do a lumpectomy whereas a mastectomy is usually recommended. However, I am not trying to throw anyone on the defensive. Your vet may have good reasons for proceeding that way based on their own experience and success rate.

Personally, I consider the quote to be reasonable, but I don't know the going rate for this procedure in your area.

Feline Mammary Tumors | OSU Veterinary Medical Center
Mammary Tumors in Cats | VCA Animal Hospitals
These articles may give you a little more information.

You helped this cat when she was a stray and you got her spayed when you could. In your case, just ignore anyone (vets included) if they are saying that she should have been spayed sooner.

 

[spac]

Thanks. I might be misunderstanding still. I believe he said he didn't want or think a (radical) chain mastectomy was needed. I think he was saying that he was just going to do the one mammary gland that was affected as opposed to all eight. I'll ask more about this when they call me for scheduling.

I've considered calling my regular vet clinic to see if they would give me an estimate and talk to me about it without coming in for an office visit, but I don't know if they would. I would be interested in what they normally do for these types of cancers.

Honestly, I have not been able to read the articles in full. I skimmed over them a bit, but I can't concentrate right now.

 

[silent meowlook]

The only reason I asked about when she was spayed is because this type of cancer is hormone related. Not judging anyone or anything. My own cat I didn't have spayed until she was around a year old due to many reasons, I don't judge anyone. We all do the best we can with the knowledge we have.

It's overwhelming, I know.

If your vet isn't comfortable doing a full chain mammary chain removal he should not. It is a big surgery and I personally feel it should really only be done by a surgical specialist; The recovery is a bit of work as well.

I get not having the funds to get multiple opinions and do advanced testing.

What I would do if this was my cat, and I was in your situation. I would have the masses removed by this vet if I felt I could trust him. I would skip the blood work and I would skip the biopsy, but have them save the samples so you can have them biopsied at a later date, if need be,

So, I would just get those removed because you don't want them remaining, because the bigger they get the worse it is. This is of course if they are what the vet mentioned and most likely they are, but it's not definitely for sure that they are. The fact that she was spayed at a year and not two years decreases the odds,

I say skip the blood work because the most important thing you can do is get the growths off. I would skip the radiographs, because if it has spread to the lungs, what would you do different? And the biopsy? Why? So, you know what it is. That doesn't matter because you aren't going to do chemotherapy. I wouldn't do that kind of chemotherapy for my cat. It is only the injectable kind and that would involve weekly blood tests and injections. For me, that wouldn't be right to do to my cat, not to mention that it is expensive.

Personally, if this was my cat, I would get the things removed. Making sure they provide adequate pain medication. Enjoy every day you have with your cat and be aware of any signs of decline in health, but don't let it take over all of your time spent with your cat.

I hope this helps.

 

[spac]

UPDATE:
Because I'm forgetful due to extreme anxiety, I ALWAYS record any conversation I have with a veterinary clinic and that's perfectly legal in this state.

I was finally able to listen to the recording and the following are some highlights of what the doctor said:

The tumor is in the mammary chain, the other chains feel good

The tumors feel like little follicles

Would make a wide incision and take those off

In animals tumors tend to be locally aggressive, they don't spread, but in a human, they're gonna spread

It is cancer - it could spread

The most agressive action would be to go in and surgically remove them

It's a slow growing tumor (My Note: he said it's an adenocarcinoma)

30-45 minute surgery

There's 9 other nipples it could spread to because it's a tumor that moves along the milk vein (My Note: Don't cats have 8 mammary glands and dogs have 10?)

In some cases they do what's called a radical mastectomy - they take all 5 nipples off at one time, then they bring the animals back and do another side, but I don't do that unless I've got multiple nipples involved.
-----------

I'm wondering if he's confusing a cat and a dog. Aren't these tumors/cancers more serious in cats than dogs? I thought I read that the radical mastectomy is more suited for a cat as opposed to a dog.

I apologize if I'm being annoying. I still don't know what to do. Am I crazy or are there contradictory statements made here? I thought that since he worked in an ER for many years that he would be more knowledgeable. Maybe I'm just misunderstanding or he misspoke.

 

[maggie101]

UPDATE:
Because I'm forgetful due to extreme anxiety, I ALWAYS record any conversation I have with a veterinary clinic and that's perfectly legal in this state.

I was finally able to listen to the recording and the following are some highlights of what the doctor said:

The tumor is in the mammary chain, the other chains feel good

The tumors feel like little follicles

Would make a wide incision and take those off

In animals tumors tend to be locally aggressive, they don't spread, but in a human, they're gonna spread

It is cancer - it could spread

The most agressive action would be to go in and surgically remove them

It's a slow growing tumor (My Note: he said it's an adenocarcinoma)

30-45 minute surgery

There's 9 other nipples it could spread to because it's a tumor that moves along the milk vein (My Note: Don't cats have 8 mammary glands and dogs have 10?)

In some cases they do what's called a radical mastectomy - they take all 5 nipples off at one time, then they bring the animals back and do another side, but I don't do that unless I've got multiple nipples involved.


I'm wondering if he's confusing a cat and a dog. Aren't these tumors/cancers more serious in cats than dogs? I thought I read that the radical mastectomy is more suited for a cat as opposed to a dog.

I apologize if I'm being annoying. I still don't know what to do. Am I crazy or are there contradictory statements made here? I thought that since he worked in an ER for many years that he would be more knowledgeable. Maybe I'm just misunderstanding or he misspoke.

Just a suggestion
I always have someone come with me to doctors appointments. It helps if the doctor emails me with everything written down. Hope your cat feels better! Is she able to eat?

 

[heatherwillard0614]

Hello S spac I would call the vet and have them email everything from the appointment. I do this for my cat so I can have a copy of all of her medical records. I also print hers out I have an electronic copy I keep on my computer and a physical copy I keep in a filing cabinet.

So if I were you I would first get everything from the visit emailed to you.
Also when you call you can ask all unanswered questions you have and have them have the vet answer any questions in the email (I have done this when getting my cats files emailed)

What I would do if this was my cat, and I was in your situation. I would have the masses removed by this vet if I felt I could trust him. I would skip the blood work and I would skip the biopsy, but have them save the samples so you can have them biopsied at a later date, if need be,

So, I would just get those removed because you don't want them remaining, because the bigger they get the worse it is. This is of course if they are what the vet mentioned and most likely they are, but it's not definitely for sure that they are. The fact that she was spayed at a year and not two years decreases the odds,

I say skip the blood work because the most important thing you can do is get the growths off. I would skip the radiographs, because if it has spread to the lungs, what would you do different? And the biopsy? Why? So, you know what it is. That doesn't matter because you aren't going to do chemotherapy. I wouldn't do that kind of chemotherapy for my cat. It is only the injectable kind and that would involve weekly blood tests and injections. For me, that wouldn't be right to do to my cat, not to mention that it is expensive.

Personally, if this was my cat, I would get the things removed. Making sure they provide adequate pain medication. Enjoy every day you have with your cat and be aware of any signs of decline in health, but don't let it take over all of your time spent with your cat.

I would have to agree with this if it were my cat this would be the route I would take.

So first go ahead and call the vet tell them you have questions for the vet that you need answered. They will write down your questions for the vet.
Then tell them you also need everything from the appointment emailed to you. You can ask that the questions be answered and emailed with the medical notes from the visit.
This will get more answers for questions you might still have from the vet himself.

Please keep us posted.

 

[fionasmom]

Cats normally have 8, but I have read that there can be more or less. How often this happens I don't know or even how correct that information is.

An adenocarcinoma is cancerous. It is found in skin or tissues of the organs.

Your questions are good ones and you are not being annoying...not to us and I certainly hope not to the doctor to whom you are entrusting your cat's care and to whom you are paying a lot of money.

I agree that you should call back and say that you have more questions and ask for everything to be sent to you in writing. That way you can compare what he said with what was determined upon examination.

 

[silent meowlook]

Your questions are valid.

I have worked in animal ER’sand Specialty hospitals, surgery and internal medicine. I have also worked at feline only hospitals, and in GP vet hospitals.
The following is only my opinion.
ER vets are great for emergency’s. Usually dog emergency medicine. Snake bite, hit by car, burns, shock, near death, these vets are terrific for keeping critical patients alive until they can be transferred to their regular vet. In my opinion based on my experiences, they usually ( at least the ones I have worked with) not to knowledgeable with internal medicine cases, oncology, and sadly cats.

Internal medicine veterinarians are good at just that, internal medicine, oncology, figuring out what is going on with a patient, and more advanced diagnostics. They suck ( for lack of a better word) in surgery or emergencies. Some are more knowledgeable than others in cats.
Most general practice veterinarians are good with uncomplicated basics in preventive care in dogs. Some may have more knowledge than others in cats, but most focus their studies on dogs.
Surgeons are good at surgery. I have found a tendency also for their knowledge to be more dog related.
Feline only hospital veterinarians are usually very well rounded in cats. After all, that is the only species they see. All of their mandatory CE is done in cats and they usually are much better than the other types of veterinarians in being compassionate and empathetic towards cats. Of course there are exceptions.

From my understanding, and I am not a vet and have No license. The most common mammary tumor in cats is an adenocarcinoma. It does spread, that is why it needs to be removed, and the gold standard is to remove the entire chain.

I will say this again though, if your vet does not offer to do that surgery, it may be because they f do ont feel comfortable doing it and that means you don’t want that vet to do it. It is a big surgery and very vascular. Many things could go wrong if not done properly. The recovery is also difficult, but doable.

I know it is allot to process. I am sorry you and your cat are going through this.

 

[spac]

Thanks S silent meowlook , that's great info. It certainly explains why I always feel like cats are second class citizens in veterinary medicine.

Another Update:
The clinic has not been able to give me a proper estimate or schedule surgery because the person that does that has been out with Covid. (This also means I was exposed). I called today to ask to speak to the doctor about the surgery, but he hasn't called back yet.

I called another clinic about a second opinion and got an appointment for early next week (week of the 10th). They gave me a basic quick estimate for a full chain mastectomy minus x-rays and the price is pretty good compared to the lumpectomy.

I looked again at going to a cat only clinic and it's just not gonna work - too far away and too expensive. I would have to get someone to drive me every time we go. The traffic in that area is crazy and I can't drive there at all due to panic attacks. Vet clinics in the bigger cities are too expensive. The one clinic that was closest actually closed up in 2021.

 

[fionasmom]

You have taken a big step forward in getting more information and help for your cat. Nothing about this condition will get worse within a couple of days, so gather up a list of questions from your previous visit with the other vet and from the advice given here. It is a good sign in one respect that they did have a price list ready to go. Ask if there would be any expectation of additional fees.

 

[spac]

MAJOR UPDATE:

Finally got a second opinion. The second vet also recommends lumpectomy, but at least she explained why. She said that there are 2-3 lumps, but they are VERY tiny. She was actually surprised and impressed that I found them when they were this small. She said it's very rare for pet owners to find them at this early stage. So in this case, a mastecomy of any kind would be overkill due to their small size and being caught early enough. Most owners find these types of lumps when they're much bigger and at a more advanced stage which is why mastecomy is recommended in those cases.

The important thing I learned here is to routinely check my cats for lumps, especially the females.

I already got an estimate from the second vet and even though it's a bit more expensive, I think I'm going with them. The first vet clinic has not contacted me about anything even though I called three times in the last week. I am still waiting on an estimate. I am still waiting to talk to the doctor about why he recommended a lumpectomy. The lack of communication speaks volumes, IMO.

Now the only question that remains is this: how am I supposed to keep this little devil from jumping on things after the surgery? I was told she really shouldn't do any jumping for a week. All the rooms have furniture like beds or chairs. I also forgot to ask if she can use regular clumping litter or if I need pellet litter (paper or pine). If anyone know the answer to these two questions, please let me know. I'll ask the vet clinic when I schedule the surgery, I don't want to bother them until then.

 

[heatherwillard0614]

MAJOR UPDATE:

Finally got a second opinion. The second vet also recommends lumpectomy, but at least she explained why. She said that there are 2-3 lumps, but they are VERY tiny. She was actually surprised and impressed that I found them when they were this small. She said it's very rare for pet owners to find them at this early stage. So in this case, a mastecomy of any kind would be overkill due to their small size and being caught early enough. Most owners find these types of lumps when they're much bigger and at a more advanced stage which is why mastecomy is recommended in those cases.

The important thing I learned here is to routinely check my cats for lumps, especially the females.

I already got an estimate from the second vet and even though it's a bit more expensive, I think I'm going with them. The first vet clinic has not contacted me about anything even though I called three times in the last week. I am still waiting on an estimate. I am still waiting to talk to the doctor about why he recommended a lumpectomy. The lack of communication speaks volumes, IMO.

Now the only question that remains is this: how am I supposed to keep this little devil from jumping on things after the surgery? I was told she really shouldn't do any jumping for a week. All the rooms have furniture like beds or chairs. I also forgot to ask if she can use regular clumping litter or if I need pellet litter (paper or pine). If anyone know the answer to these two questions, please let me know. I'll ask the vet clinic when I schedule the surgery, I don't want to bother them until then.

Is there anyway you can either get a large dog crate/pet play pen, or clear the furniture (beds and anything else she can jump on) out of one of the spare rooms just until she heals?
Here are a couple ideas for the play pen

Amazon.com

Amazon.com

Also my opinion I would do the paper pellets just as you would for a spay.. I think this is best for any surgery done on the underside of kitty so the clay stuff doesn't get near the surgical site.