Finding a lump doesn't necessarily signify a severe health issue, and even if it turns out to be a type of cancer, there could be several treatment approaches available. Let's delve into how we can identify the nature of this lump and explore the potential treatment routes.
Explaining the terminology
The language used to describe such conditions can be perplexing, and you might come across words like lump, mass, growth, tumour, neoplasia or cancer, often used interchangeably. Generally, lump and mass are descriptive terms used when the exact nature of the issue isn't clear yet.
A lump could be a fluid filled cyst, an abscess, a result of inflammation, perhaps around a hair follicle or due to a foreign body such as a thorn, and not necessarily a growth. On the other hand, terms like growth, mass and tumour suggest some form of cancer, which happens when the typical process controlling cell growth, division and repair goes a miss. Nevertheless, this growth, mass or tumour can either be benign, indicating that it's non-aggressive and does not spread elsewhere in the body. Or it could be malignant, meaning that it's likely to spread to other parts of the body or invade nearby structures.
Understanding the situation
To start, the vet will have to evaluate the lump. They may examine the following aspects:
- Is the lump firm or soft?
- Does it cause pain?
- Is it mobile and 'loose' within the skin layer, or is it attached to deeper structures?
- Has there been any hair loss over the lump (if it's located on haired skin), or has it become red, sore or ulcerated?
Though sometimes it might be apparent that the mass is a fatty lump, wart or cystic lesion, other masses could be shrouded in fat or resemble different types of masses. Hence, to confirm the true nature of the lump, it is advisable to have it sampled.
Why is sampling such a crucial step?
The objective of sampling is to understand the nature of the lump, which in turn, informs the vet's strategy for its treatment. When we take a sample, we're trying to answer questions such as:
- Is it inflammation or a growth?
- If it's a tumour, what kind is it and is it benign or malignant?
- What is the best course of action?
Planning - can the lump be excised locally (removal with minimal surrounding normal tissue), or does it need more sophisticated surgical techniques to remove larger amounts of surrounding tissue to avoid recurrence?
How will the vet decide which type of sample to take?
Several factors will influence this decision, including the mass's location, its size, your pet's temperament, the mass's position on the body, feasibility for sedation or anaesthesia, and related costs.
All of these aspects will be discussed with you. If you have any questions or concerns, feel free to reach out to us.
In general, there are two sampling methods. The first is called cytology, performed using a fine needle aspirate (FNA) technique. A small needle, like those used for blood samples, is inserted into the mass, and suction is applied with a syringe. After removing the needle, the contents from the needle hub are transferred onto a microscope slide. This is then analysed in-house or sent to an external lab for a specialist's opinion from a pathologist. This method is minimally invasive and can typically be carried out during your consultation or scheduled for a longer appointment.
Your pet usually doesn't require any sedation/anaesthetic if they are cooperative and the same can be taken safely. It is relatively affordable compared to a biopsy, and results are typically available within a few days. While most of the time the lab can provide an answer, since this method collects only a few cells and not a tissue section, there is always a chance that we may not get a definitive answer and may need to contemplate 'plan b' -a biopsy.
Considering a biopsy
The alternative method is a biopsy, which involves extracting a piece of tissue for laboratory histopathology analysis. In some situations, this will be more appropriate than a fine needle aspirate. This requires a surgical procedure, meaning your pet would need to be admitted for the day to undergo the operation under general anaesthesia. The benefit of this method is that it provides the lab with more tissue to examine, reducing the likelihood of an inconclusive result. However, it does require anaesthetic and is consequently more costly. Typically, a biopsy does not completely remove the lump, implying a potential need for a second surgery.
Why not just remove the mass?
We usually recommend sampling the lump initially. This enables the vet to identify the nature of the lump which helps us to recommend the most effective treatment course and determining the extent of normal tissue removal required. It helps reduce uncertainty and the chances of recurrence and complications. However, in certain situations, some exceptions might be necessary, so we suggest discussing these options with us to devise a personalised treatment plan that caters to you and your pet's needs.
In some instances, if the mass is extremely small and located where there is ample 'extra' skin, a biopsy may lead to complete excision. But as mentioned earlier, if the histopathology results indicate that the mass has infiltrated the surrounding tissues, a repeat surgery may be required to remove additional skin.
Uncertain? Reach out to us
Determining the lump's nature based solely on examination can be challenging due to the vast variety of lump types. Sampling provides us with insight into what the lump is and its likely behaviour, such as its potential to grow or spread. This way, we can decide whether to stop worrying about the lump or whether we need to formulate a treatment plan.
Having pet insurance is crucial for unexpected situations like discovering a lump on your pet. Learn more about pet insurance advice here.
If you discover a lump on your pet, contact City Vets, your local Exeter veterinary practice to schedule an appointment.