Ductular Mammary Cancer-What to do after multiple surgeries?

Dr. Neely,

Our 14-year old cat had a pea size lump on her mammary tract which was removed immediately after seeing the vet. The lab findings reported that the mass was Mammary Ductular Carcinoma. Three months after the surgery the mass reoccured at the same area so we scheduled another appointment with the vet. We decided on another surgery following results of her blood work and chest x-rays. The vet found another mass during that surgery and it was removed. The lump has returned with additional vigor as it is now greater than 2 CM in size. I took her to a specialist for an additional opinion. We have an added risk which is there may not be sufficient tissue for another surgery without removing her front leg. I am troubled that I did not see your website and had acted more aggressively; seems the clinical protocol is to remove the entire mammary track. She is eating well but also suffers from kidney disease. She is happy and spoiled. Considering your extensive experience, would you proceed with the mammary track procedures now if her lungs and blood work are clear and margins are available for another surgery? You have said that you have had good results with some big and ugly tumors.

I did not see a comparable scenario on your website. Though our options may be narrow for our dear friend, thanks for providing the information to all of us who are looking for help concerning this vicious disease. We should have had the entire mammary track removed upon initial discovery of that small lump. But if there are viable options with what I know today, I'd sure like to know about them. Thank You

Hello,

I am likewise sorry you did not get to me when you found the first lump. In my experience, the best outcome is to remove the entire chain and sometimes even the other side.

At this point, it sounds like you have two options: to try for a cure by doing everything possible or to make her happy and comfortable for as long as possible until the new lump is bothering her or metastasizes to her chest.

Since I cannot see her, I do not know for sure what the area looks like and whether there is enough skin to close the wound if a complete mastectomy is done. Only your vet can determine that.

It is also difficult to give advice in general in a situation like this because it is a very personal choice. However, if this were my cat and everything could still be removed and her blood work and xrays looked fine, I would probably go for it. I know in my heart though that I would not do it for my own cat if it involved removing her leg.

Also, I don't know exactly what her kidney values are. If they are mildly elevated and she receives IV fluids prior to the surgery and during and after, and only gas anesthesia is used, it is quite possible to not affect the kidneys.

These days, 14 years of age isn't as old as it used to be. With a good outcome, she could live several more years. But, of course, nothing is definite.

I have to add that a surgery such as these is definitely given the best prognosis if it is followed up by chemotherapy. Be sure and discuss that with your veterinarian and if you have a veterinary oncologist in your area, that is the best person to take care of all of this.

I wish you and your kitty the very best in whatever you choose. Please let us know how it goes and feel free to write back anytime.

Best,
Dr. Neely