SMALL PINK LUMP PUG

My 7 year old pug has had this small pink lump on his chest for a few months now.  It has not changed in size and doesn’t seem to bother him at all even when I touch it.   I mentioned this to the vet the other day when I was in about something else and she took a look at it for what felt like 30 seconds and immediately said she would remove it. I was a bit taken aback as she never indicated what it could be and didn’t offer to do any further tests. i reluctantly booked him in to have it removed but have since cancelled as my gut was telling me it was unnecessary to put him through surgery when I don’t know for sure if the lump is even cancerous.   I have booked another appointment with my vet and I was planning on requesting they take a sample of the lump using a needle in the hope that this will establish if it’s cancerous or not. I just feel a bit lost and alone in all of this as my vet hasn’t really provided me with any advice other than a very expensive invasive removal.   I was wondering if anyone has pets with similar lumps and could offer advice?   thanks!

Hello!  Very often when they go to the vets, people want clear, direct, simple guidance and this is what your vet has given.  It sounds like you're the type of owner who'd like to hear a few more of the pros and cons - thats ok, you can ask them!   Here is my best guess.... imagine there is a lego model.  You dont know what the model is of.  You can put a needle into a lump - that's the equivalent of being handed a few random bricks (cells) to look at, out of context of the other peices.  But if you take a few bricks and they're all red, you can't conclude 'there are only red bricks in this model.'   You might have just blindly taken your red bricks from the zig-zaggy bit on the back of a green dragon's tail.  Similarly, you dont know how those red bricks are related to each other - what pattern they were built in.  Are they a dragon, or a dog, or a horse?  Nor do you know how those cells were arranged.  So although you might happen to get an obvious cancer cell, you can't necessarily say with much conviction that it isn't a cancer. You might not be able to identify it.  I once, as a very junior vet 20 years ago, put a needle into a swollen lumph node and got back many, many mast cells.  This suggests a mast cell tumour and thats what I diagnosed.  But we now know that you can also get lots of mast cells for other reasons, such as a certain type of reaction to a foreign body, and this is what had happened in this case.  To my pleasure but also embarrassment, the atient got better. Gradually, with combined experiences of this type, it was realised that a very few cells arent as useful as taking a small peice of tissue, which shows how the cells relate to each other - and that even this isnt as useful as taking the whole lump (with a wide margin if we are concerned about sideways spread).  These days, we therefore weigh up what we're looking for - if we're looking just a type of cell, then FNAs are the best.  But if we need to know the structure of those cells (are they clustered around a foreign body, or are they coming out of the lymphatic drainage system?) then a larger sample will give more context.  This is for the individual vet to decide in the individual patient.

Another great image is if you take a busy crowd scene and pull out four people.  Those people might represent what is going on in the crowd scene, but you might just get 4 passer-by characters who were walking past and miss the fact that 80% of the crowd are a marching band.  Part of the vets' job is to weigh up how useful each different type of sample will be, vs how much the patient is likely to be compromised in taking each kind of sample (anaesthetic needed vs not, age, difference it will make, etc).  A fine needle aspirate can be expensive to procss, so if it's not likely to change the outcome, vets might decide just to go for removal.  Biopsy is ueful, but vets often have to operate again if they find something, so taking the whole lump can often be the most appropriate.  Always ask your vet lots of questions, however, if you have concerns.  'What can you do to make the anesthetic safer?' And 'Do you think that the risks outweigh the potential benefits' are both great questions.

Furthermore, have a look through the articles in our blog.  'Lump' and 'tumour' are good words to put into the search bar.