All canine diagnoses

Your dog was diagnosed with Mast Cell Tumour — Low Grade. Most common skin tumour in dogs, accounting for ~17.8% of all canine cutaneous neoplasms. Kiupel low-grade represents approximately 85% of Patnaik Grade II tumours. Compare 6 treatment options for dogs including Wide Surgical Excision, Stelfonta (Tigilanol Tiglate), Palladia (Toceranib Phosphate) — with survival times, costs, and what to expect during treatment.

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Mast Cell Tumour — Low Grade

BreedsBoxerPugLabrador RetrieverGolden RetrieverFrench BulldogAmerican Staffordshire Terrier
canine

Round Cell

About This Cancer

Mast cell tumours arise from mast cells, a type of immune cell found in connective tissues throughout the body that normally plays a role in allergic and inflammatory responses. These cells contain granules filled with histamine and other inflammatory chemicals, which can be released by the tumour, occasionally causing redness, swelling, or gastrointestinal upset. Mast cell tumours are the most common skin cancer in dogs and typically present as a lump in or under the skin. Low-grade tumours, as classified by the Kiupel grading system, generally behave in a relatively benign fashion — they grow slowly, are less likely to spread, and carry an excellent prognosis when completely removed surgically. Certain breeds, including Boxers, Pugs, Labrador Retrievers, and French Bulldogs, are predisposed. Even with a low-grade classification, complete surgical removal with adequate margins is important to prevent local recurrence.

Kiupel 2-Tier Histologic Grading System

Two-tier system (low-grade vs high-grade) replacing the older Patnaik 3-tier system. Reduces interobserver variability and provides clearer prognostic separation.

Stage Low GradeFewer than 7 mitotic figures per 10 HPF, no multinucleated cells, no bizarre nuclei, no karyomegaly. 1-year survival 94%.
Stage High Grade7 or more mitotic figures per 10 HPF, OR presence of multinucleated cells (3+), bizarre nuclei, or karyomegaly. Poor prognosis.
Prognostic Factors(5)
c-KIT mutation statusExon 11 internal tandem duplications (ITDs) found in 20-30% of cutaneous MCTs. Associated with higher metastatic risk, shorter DFI/OS. Predicts response to TKI therapy (toceranib/masitinib).(PMC9501132)
KIT staining patternAberrant patterns (perinuclear/cytoplasmic Pattern II-III) associated with higher proliferation, higher grade, and worse prognosis. Normal membrane Pattern I is favourable.(Webster et al., 2007)
Lymph node status (Weishaar classification)HN0/HN1 (nonmetastatic): MST 1824 days. HN2/HN3 (metastatic): MST 804 days. Sentinel lymph node assessment is more accurate than regional lymph node alone.(Rassnick et al., 2014)
Surgical marginsComplete excision with clean margins: 10% local recurrence. Incomplete margins: 35% recurrence.
Anatomical locationPerineal, inguinal, digital, and mucosal locations carry worse prognosis than trunk/limb locations.
Minimum Workup(7 steps)
1Fine-needle aspirate cytology (usually diagnostic for MCT)
2Histopathology with Kiupel 2-tier grading (preferred over Patnaik)
3Regional lymph node aspirate cytology (sentinel lymph node preferred)
4Abdominal ultrasound with hepatic and splenic aspirates if grade uncertain
5CBC and buffy coat smear
6c-KIT mutation testing (exon 8 and 11) if considering TKI therapy
7KIT immunohistochemistry staining pattern

Median Survival Time Comparison

How long the average patient survives with each treatment

Bar opacity reflects evidence strength
Wide Surgical Excision
See notes
Stelfonta (Tigilanol Tiglate)
See notes
Palladia (Toceranib Phosphate)
See notes
Active Monitoring (Post-Complete Excision)
See notes
Definitive Radiation Therapy (Non-Resectable)
See notes
Definitive Radiation Therapy (Non-Resectable)
See notes
Reading this page: MST (Median Survival Time) is how long the average patient survives with a given treatment. ORR (Overall Response Rate) is the percentage of patients whose tumour shrank or disappeared. CR = Complete Response (tumour gone); PR = Partial Response (tumour shrank). Hover over any abbreviation for a quick explanation.
Strength of Evidence

Each treatment is rated by how much published research supports its use. Solid bars indicate stronger evidence; dashed bars mean less certainty.

StrongLarge published studies with strong agreement among veterinary oncologists.
ModerateWidely used in clinical practice, but supported by smaller or retrospective studies.
IndirectEvidence comes from a different tumour type or species and has been applied here.
LimitedVery little published data is available for this specific treatment.

Please note: All treatment data is sourced from published peer-reviewed literature. Survival times and cost figures are approximate guides. Your pet's individual factors — including tumour grade, stage, and overall health — will influence outcomes and should guide all treatment decisions. The strength-of-evidence rating reflects how much research exists, not how strongly a treatment is recommended. This tool is designed to help you have informed conversations with your veterinary oncologist, not to replace them. Costs shown are US referral centre estimates and may vary significantly by region.