not considered candidates for surgery [ 44 ] . A report by Zhang et al . [ 46 ] described a similar approach in human patients with breast cancer . Radiation therapy was used in conjunction with other treatment options , in this case after incomplete tumour resection by mastectomy .
Chemotherapy treatment for FMT is normally conducted over a period of months , during which time patients are admitted to hospital for the day when each treatment is given [ 43 ] . Protocols can be adapted and altered if required , depending on the patient ' s temperament and toleration of hospitalisation [ 43 ] ; however , the patient ' s demeanour should be considered prior to committing to treatment . Excessive patient stress and duress can become an ethical concern [ 43 ] and consideration should be given to the best possible outcome ; that is , the patient ' s quality of life while undergoing treatment should be weighed against the potential disease-free time . Similarly , a study concerning children ' s cancer therapy and human medical professionals found that staff had ethical concerns regarding their involvement in treatment [ 47 ] . Staff reported moral dilemmas such as breaching patient autonomy and conflicting views [ 47 ] .
Veterinary professionals should always offer all treatment options , including euthanasia , in cases where they feel the pet ' s quality of life has changed and the owner ' s consent may have wavered .
Conclusions
Feline mammary cancer is a debilitating disease . Progression is often fast , requiring rapid diagnosis and treatment from the veterinary team . The exact pathogenesis is still unknown ; however , there are substantial links to sex hormones and their impact in the early stages of a cat ' s life . Owing to the aggressive nature of FMT , prevention is the most successful approach to disease management . Owner education and early neutering have proven to be effective in reducing the risk of FMT .
Feline mammary neoplasia has been used as a research model in the investigation and understanding of breast cancer in humans . Species-specific differences in disease aetiology have enabled progression in both veterinary and human medicine . Further research is required to fully understand FMT and to increase the rates of treatment success in veterinary medicine .
The veterinary team must continue to guide and educate owners on responsible cat ownership , not only to minimise disease risk but also to encourage an ethical and conscientious approach to feline medicine .
Acknowledgements
The author would like to thank the project supervisor , Dr Nick Wheelhouse .
REFERENCES
1 Zappulli V , Rasotto R , Caliari D , Mainenti M , Pena L , Goldschmidt MH , et al . Prognostic evaluation of feline mammary carcinomas : a review of the literature . Veterinary Pathology . 2015 ; 52 ( 1 ): 46 – 60 . Available from : https :// doi . org / 10.1177 / 0300985814528221 .
2 Overley B , Shafer FS , Goldschmidt MH , Sherer D , Sorenmo KU . Association between ovarihysterectomy and feline mammary carcinoma . Journal of Veterinary Internal Medicine . 2005 ; 19 ( 4 ): 560 – 563 . Available from : https :// doi . org / 10.1111 / j . 1939-1676.2005 . tb02727 . x .
3 Cunha S , Corgozinho K , Justen H , Silva K , Leite J , Ferreira AM . Survival and disease-free interval of cats with mammary carcinoma treated with chain mastectomy . Acta Scientiae Veterinariae . 2018 ; 44 ( 1 ): 8 . Available from : https :// doi . org / 10.22456 / 1679-9216.80900 .
4 de Campos CB , Damasceno KA , Gamba CO , Ribeiro AM , Machado CJ , Lavalle GE , et al . Evaluation of prognostic factors and survival rates in malignant feline mammary gland neoplasms . Journal of Feline Medicine and Surgery . 2016 ; 18 ( 12 ): 1003 – 1012 . Available from : https :// doi . org / 10.1177 / 1098612X15610367 .
5 Giménez F , Hecht S , Craig LE , Legendre AM . Early detection , aggressive therapy : optimizing the management of feline mammary masses . Journal of Feline Medicine and Surgery . 2010 ; 12 ( 3 ): 214 – 224 . Available from : https :// doi . org / 10.1016 / j . jfms . 2010.01.004 .
6 Nordin ML , Shaari R , Kadir AA , Osman Y , Arshad MM , Farhan M , et al . Recent overview of mammary cancer in dogs and cats : classification , risk factors and future perspectives for treatment . IOSR Journal of Agriculture and Veterinary Science . 2017 ; 10 ( 8 ): 64 – 69 .
7 Dagher E , Abadie J , Loussouarn D , Campone M , Nguyen F . Feline invasive mammary carcinomas : prognostic value of histological grading . Veterinary Pathology . 2019 ; 56 ( 5 ): 660 – 670 . Available from : https :// doi . org / 10.1177 / 0300985819846870 .
8 Petrucci G , Henriques J , Gregorio H , Vicente G , Prada J , Pires I , et al . Metastatic feline mammary cancer : prognostic factors , outcome and comparison of different treatment modalities – a retrospective multicentre study . Journal of Feline Medicine and Surgery . 2021 ; 23 ( 6 ): 549 – 556 . Available from : https :// doi . org / 10.1177 / 1098612X20964416 .
9 Gower L . Pre-pubertal feline neutering : the role of the veterinary nurse in owner education . Veterinary Nursing Journal . 2017 ; 32 ( 7 ): 194 – 200 . Available from : https :// doi . org / 10.1080 / 17415349.2017.1321331 .
10 Matos AJF , Baptista CS , Gartner MF , Rutteman GR . Prognostic studies of canine and feline mammary tumours : the need for standardized procedures . Veterinary Journal . 2012 ; 193 ( 1 ): 24 – 31 . Available from : https :// doi . org / 10.1016 / j . tvjl . 2011.12.019 .
11 Hughes K , Dobson JM . Prognostic histopathological and molecular markers in feline mammary neoplasia . Veterinary Journal . 2012 ; 194 ( 1 ): 19 – 26 . Available from : https :// doi . org / 10.1016 / j . tvjl . 2012.05.008 .
12 Mills SW , Musil KM , Davies JL , Hendrick S , Duncan C , Jackson ML , et al . Prognostic value of histologic grading for feline mammary carcinoma : a retrospective survival analysis . Veterinary Pathology . 2015 ; 52 ( 2 ): 238 – 249 . Available from : https :// doi . org / 10.1177 / 0300985814543198 .
13 Burrai GP , Mohammed SI , Miller MA , Marras V , Pirino S , Addis MF , et al . Spontaneous feline mammary intraepithelial lesions as a model for human estrogen receptor- and progesterone receptor-negative breast lesions . BMC Cancer . 2010 ; 10 ( 1 ): 156 . Available from : https :// doi . org / 10.1186 / 1471-2407-10-156 .
14 Soares M , Ribeiro R , Najmudin S , Gameiro A , Rodrigues R , Cardoso F , et al . Serum HER2 levels are increased in cats with mammary carcinomas and predict tissue HER2 status . Oncotarget . 2016 ; 7 ( 14 ): 17314 – 17326 . Available from : https :// doi . org / 10.18632 / oncotarget . 7551 .
15 Graf R , Grüntzig K , Boo G , Hässig M , Axhausen KW , Fabrikant S , et al . Swiss Feline Cancer Registry 1965 – 2008 : the influence of sex , breed and age on tumour types and tumour locations . Journal of Comparative Pathology . 2016 ; 154 ( 2 – 3 ): 195 – 210 . Available from : https :// doi . org / 10.1016 / j . jcpa . 2016.01.008 .
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