Mast cell tumors are tricky buggers. This excellent blog post by Dr. Dressler shares important information about staging and treating them:

How to Use the Mitotic Index to Make Decisions About Mast Cell Tumors

There is a lot of uncertainty in canine cancer, and mast cell tumors are the tumor type that proves it. Mast cell tumors are tricksters, with seemingly benign tumors sometimes turning out to be very aggressive … and often enough to be confusing, vice versa. When we’re talking mast cell tumors, we are definitely in what I call “the gray zone.” Determining just how aggressive the tumor is up front is important when it comes to making treatment decisions, which is why Dr. Ettinger, my oncologist co-author, suggests looking at the mitotic index for mast cell tumor assessment.

The most common instance of confusion in mast cell tumor diagnosis is for the grade 2 mast cell tumor. As you may already know, the “grade” is a measure of how aggressive a cancer is. When we say a cancer is a “high grade malignancy” we mean it is hard to cure. A “low grade” growth is easier to cure as a generality (but not always), usually by surgical removal.

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