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Singh N, Das P, Singh DK, Zaidi A. Radio-pathological characteristics of primary neuroendocrine breast carcinoma: Series of 4 cases. Radiol Case Rep 2024; 19:5696-5707. [PMID: 39308627 PMCID: PMC11415836 DOI: 10.1016/j.radcr.2024.08.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 08/07/2024] [Accepted: 08/10/2024] [Indexed: 09/25/2024] Open
Abstract
Neuroendocrine breast cancers (NEBCs) are a rare and distinct subtype of breast tumors, characterized by their neuroendocrine differentiation. Despite accounting for less than 1% of all breast cancers, NEBCs present unique diagnostic and therapeutic challenges due to their heterogeneous nature and variable prognosis. Accurate imaging plays a crucial role in the diagnosis, treatment planning, and follow-up of NEBCs, yet remains a complex area due to the rarity of these tumors and overlapping features with more common breast cancers. We present a series of 4 cases of primary NEBC, emphasizing the imaging features and their histopathological correlations. All patients presented with breast lump. Diagnostic Mammography followed by Ultrasound was performed in each case. All 4 cases were categorized as Breast Imaging- Reporting and Data System (BI-RADS)-4. Trucut biopsy was performed and histopathological analysis revealed the diagnosis of NEBC. Patients underwent Surgery followed by Chemotherapy, Hormonal Therapy or Radiation therapy alone or in combination with each other depending upon the histopathological characteristics.
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Affiliation(s)
- Neha Singh
- Department of Radiodiagnosis and Imaging, Dr. Ram Manohar Lohia Institute of Medical sciences, Lucknow, India
| | - Priya Das
- Department of Radiodiagnosis and Imaging, Dr. Ram Manohar Lohia Institute of Medical sciences, Lucknow, India
| | - Deepak K Singh
- Department of Neurosurgery, Dr. Ram Manohar Lohia Institute of Medical sciences, Lucknow, India
| | - Ariba Zaidi
- Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical sciences, Lucknow, India
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Li N, Li JW, Qian Y, Liu YJ, Qi XZ, Chen YL, Gao Y, Chang C. Axillary lymph node metastasis in pure mucinous carcinoma of breast: clinicopathologic and ultrasonographic features. BMC Med Imaging 2024; 24:108. [PMID: 38745134 PMCID: PMC11094983 DOI: 10.1186/s12880-024-01290-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/03/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND The purpose of this research is to study the sonographic and clinicopathologic characteristics that associate with axillary lymph node metastasis (ALNM) for pure mucinous carcinoma of breast (PMBC). METHODS A total of 176 patients diagnosed as PMBC after surgery were included. According to the status of axillary lymph nodes, all patients were classified into ALNM group (n = 15) and non-ALNM group (n = 161). The clinical factors (patient age, tumor size, location), molecular biomarkers (ER, PR, HER2 and Ki-67) and sonographic features (shape, orientation, margin, echo pattern, posterior acoustic pattern and vascularity) between two groups were analyzed to unclose the clinicopathologic and ultrasonographic characteristics in PMBC with ALNM. RESULTS The incidence of axillary lymph node metastasis was 8.5% in this study. Tumors located in the outer side of the breast (upper outer quadrant and lower outer quadrant) were more likely to have lymphatic metastasis, and the difference between the two group was significantly (86.7% vs. 60.3%, P = 0.043). ALNM not associated with age (P = 0.437). Although tumor size not associated with ALNM(P = 0.418), the tumor size in ALNM group (32.3 ± 32.7 mm) was bigger than non-ALNM group (25.2 ± 12.8 mm). All the tumors expressed progesterone receptor (PR) positively, and 90% of all expressed estrogen receptor (ER) positively, human epidermal growth factor receptor 2 (HER2) were positive in two cases of non-ALNM group. Ki-67 high expression was observed in 36 tumors in our study (20.5%), and it was higher in ALNM group than non-ALNM group (33.3% vs. 19.3%), but the difference wasn't significantly (P = 0.338). CONCLUSIONS Tumor location is a significant factor for ALNM in PMBC. Outer side location is more easily for ALNM. With the bigger size and/or Ki-67 higher expression status, the lymphatic metastasis seems more likely to present.
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Affiliation(s)
- Na Li
- Department of Medical Ultrasound, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Jia-Wei Li
- Department of Medical Ultrasound, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Yu Qian
- Department of Medical Ultrasound, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Ya-Jing Liu
- Department of Medical Ultrasound, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Xiu-Zhu Qi
- Department of Medical Ultrasound, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Ya-Ling Chen
- Department of Medical Ultrasound, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Yi Gao
- Department of Medical Ultrasound, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Cai Chang
- Department of Medical Ultrasound, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
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Construction of a Prognostic Nomogram Model for Patients with Mucinous Breast Cancer. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:1230812. [PMID: 35368964 PMCID: PMC8967531 DOI: 10.1155/2022/1230812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/28/2022] [Accepted: 03/02/2022] [Indexed: 12/02/2022]
Abstract
Objective The objective of the study is to develop a nomogram for estimating three- and five-year survival rates in mucinous breast cancer patients. Methods Between 2010 and 2016, the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) were searched as a data source for patients associated with mucinous breast cancer (MBC). A total of 3964 patients were recruited after screening. The multivariate Cox model and the univariate Kaplan-Meier (KM) approach were employed to evaluate the independent prognostic markers, followed by developing a nomogram for estimating three- and five-year survival rates in MBC patients. Consequently, the consistency index (C-index) was employed to assess the predictive accuracy of the generated nomogram. Results Age, race, T stage, M stage, surgery, and radiotherapy were all independent predictive biomarkers for the MBC patients (P < 0.05). The nomogram was finally developed based on the underlined factors. Furthermore, the C-index of 0.803 and reliable calibration curves were obtained in the nomogram's assessment. Conclusions In patients with mucinous breast cancer, the proposed nomogram provides a viable tool for accurate prognostic prediction. In clinical practice, it could serve as a personalized diagnosis tool, estimate prognosis, and help in suggesting treatment plans for patients with MBC.
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Zhou W, Li YZ, Gao LM, Cai DM. Sonographic Features of Pure Mucinous Brelast Carcinoma With Micropapillary Pattern. Front Oncol 2021; 11:644180. [PMID: 34745931 PMCID: PMC8570766 DOI: 10.3389/fonc.2021.644180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 09/29/2021] [Indexed: 02/05/2023] Open
Abstract
Objective Previous studies have mostly discussed the clinical manifestations and prognosis of mucinous breast carcinoma with a micropapillary pattern. The purposes of this study were to investigate the sonographic features of pure mucinous breast carcinoma with micropapillary pattern (MUMPC) and to identify the role of ultrasound in the differential diagnosis between MUMPC and conventional pure mucinous breast carcinoma (cPMBC). Materials and Methods We obtained written informed consent from all patients, and the Ethics Committee of West China Hospital approved this retrospective study. The study was conducted between May and August 2020. We enrolled 133 patients with 133 breast lesions confirmed as mucinous breast carcinoma (MBC) histopathologically between January 2014 and January 2020.We retrospectively assessed sonographic features (margin, shape, internal echogenicity, calcification, posterior acoustic feature, invasive growth, blood flow grade, and rate of missed diagnosis) and clinical characteristics (age, tumor size, tumor texture, initial symptom, and lymph node metastasis). Bivariable analyses were performed using SPSS version 19.0. Results The 133 lesions included 11 MUMPCs, 65 cPMBCs, and 57 mixed MBCs (MMBCs). There were significant differences in margin, shape, calcification, posterior acoustic feature, invasive growth, rate of missed diagnosis, average tumor size, and lymph node metastasis among the three groups (p < 0.05). The subsequent pairwise comparisons showed that there were significant differences in lymph node metastasis, margin, and invasive growth between MUMPC and cPMBC (p < 0.05). In patients aged >45 years, there was a significant difference in tumor size among the three groups (p = 0.045), and paired comparison showed that the average tumor size in the cPMBC group was larger than that in the MMBC group (p = 0.014). Conclusion MUMPC showed a non-circumscribed margin and invasive growth more frequently than cPMBC did. Lymphatic metastasis was more likely to occur in MUMPC than cPMBC. Ultrasound is helpful to distinguish MUMPC from cPMBC.
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Affiliation(s)
- Wu Zhou
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, China
| | - Yong-Zhong Li
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, China
| | - Li-Min Gao
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Di-Ming Cai
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, China
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Chen R, Wang Y, Li T, Lv J, Feng G, Tan N, Wang J, Cheng X. Oncotype DX 21-gene test has a low recurrence score in both pure and mixed mucinous breast carcinoma. Oncol Lett 2021; 22:771. [PMID: 34589150 PMCID: PMC8442227 DOI: 10.3892/ol.2021.13032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/23/2021] [Indexed: 11/23/2022] Open
Abstract
The Oncotype DX 21-gene test can be used to predict chemotherapy efficacy in patients with estrogen receptor (ER)-positive and HER2-negative breast cancer; however, the data on the 21-gene recurrence score (RS) for mucinous breast carcinoma (MBC) are limited. The present study aimed to evaluate the distribution pattern and clinical value of the 21-gene RS in patients with MBC. A total of 38 pure MBC (PMBC) and 11 mixed MBC (MMBC) cases were retrospectively analyzed, and a total of 29 ER-positive and HER2-negative MBCs underwent the Oncotype DX 21-gene test. There were no statistically significant differences between the PMBCs and MMBCs in age, tumor size and molecular subtype; however, patients with MMBC showed a significantly higher incidence rate of nodal metastases compared with that in patients with PMBC (72.7 vs. 16.2%, respectively). Following surgery, 87.8 and 59.2% of the enrolled patients received endocrine therapy and chemotherapy, respectively. With a median follow-up of 65.6 months, the 5-year disease-free survival and overall survival rates were 97.0 and 100.0%, respectively. The 21-gene test revealed that the proportions of patients with MBC categorized into low (RS <18), intermediate (RS ≥18-30) and high (RS ≥30) risk groups were 51.7, 44.8 and 3.5%, respectively, and there was no statistically significant difference between the PMBC and MMBC cases. Notably, among the genes in the 21-gene RS testing, the expression levels of cathepsin V, progesterone receptor (PR) and CD68 were significantly higher in the PMBC group compared with that in the MMBC group. In conclusion, the current study demonstrated that patients with MBC had a favorable prognosis, and both PMBC and MMBC cases had a low- and intermediate-risk RS, which suggests that a considerable proportion of patients may be able to avoid chemotherapy. In addition, the high expression level of PR, based on the 21-gene test in PMBCs, indicated that they may have a more favorable response to endocrine therapy than MMBCs.
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Affiliation(s)
- Rui Chen
- Department of Thyroid and Breast Surgery, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Yun Wang
- Department of Thyroid and Breast Surgery, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Taolang Li
- Department of Thyroid and Breast Surgery, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Junyuan Lv
- Department of Thyroid and Breast Surgery, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Guoli Feng
- Department of Thyroid and Breast Surgery, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Na Tan
- Department of Pathology, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Jinjing Wang
- Department of Pathology, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Xiaoming Cheng
- Department of Thyroid and Breast Surgery, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
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Zhou X, Zheng Z, Li Y, Zhao W, Lin Y, Zhang J, Sun Q. The clinical features and prognosis of patients with mucinous breast carcinoma compared with those with infiltrating ductal carcinoma: a population-based study. BMC Cancer 2021; 21:536. [PMID: 33975551 PMCID: PMC8111957 DOI: 10.1186/s12885-021-08262-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 04/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND At present, the characteristics of mucinous breast carcinoma (MBC) and the factors affecting its prognosis are controversial. We compared the clinical features of MBC with those of infiltrating ductal carcinoma (IDC) and summarized the relevant prognostic factors. METHODS The Surveillance, Epidemiology, and End Results (SEER) database includes information on 10,593 patients diagnosed with MBC between 2004 and 2016. Chi-square tests and analyses were used to analyze differences in variables between the MBC and IDC groups. Univariate and multivariate Cox proportional hazards models were used to assess the relative impacts of risk factors on cancer-specific survival (CSS) in patients. Kaplan-Meier survival curves were constructed to assess cancer-specific mortality and were compared using the log-rank test. RESULTS From 2004 to 2016, 10,593 people were diagnosed with MBC, and 402,797 were diagnosed with IDC. Patients with MBC had significantly higher 5-/10-year CSS rates (96.4%/93.4%) than those with IDC (89%/83.8%). Compared with IDC patients, MBC patients had less lymph node metastasis, an earlier stage, a higher rate of hormone receptor positivity and a lower expression rate of HER2. Univariate and multivariate analyses showed that age ≥ 60 years old (HR = 1.574, 95%CI: 1.238-2.001, P < 0.001), singled status (HR = 1.676, 95%CI: 1.330-2.112, P < 0.001) and advanced TNM/SEER stage were independent prognostic risk factors for MBC. In addition, positive estrogen receptor (HR = 0.577, 95%CI: 0.334-0.997, P = 0.049), positive progesterone receptor (HR = 0.740, 95%CI: 0.552-0.992, P = 0.044), surgical treatment (HR = 0.395, 95%CI: 0.288-0.542, P < 0.001) and radiotherapy (HR = 0.589, 95%CI: 0.459-0.756, P < 0.001) were identified as protective factors. CONCLUSION Compared with IDC, MBC has a better prognosis. For patients with MBC, we identified prognostic factors that can help clinicians better assess patient outcomes and guide individualized treatment.
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Affiliation(s)
- Xingtong Zhou
- Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No 41 Damucang Hutong, Xicheng District, Beijing, 100032, China
| | - Zhibo Zheng
- Department of International Medical Services, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yan Li
- Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No 41 Damucang Hutong, Xicheng District, Beijing, 100032, China
| | - Weiwei Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Harbin Medical University, Harbin, China
| | - Yan Lin
- Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No 41 Damucang Hutong, Xicheng District, Beijing, 100032, China
| | - Jieshi Zhang
- Department of International Medical Services, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Qiang Sun
- Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No 41 Damucang Hutong, Xicheng District, Beijing, 100032, China.
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Anwar SL, Dwianingsih EK, Avanti WS, Choridah L, Suwardjo, Aryandono T. Aggressive behavior of Her-2 positive colloid breast carcinoma: A case report in a metastatic breast cancer. Ann Med Surg (Lond) 2020; 52:48-52. [PMID: 32211189 PMCID: PMC7082430 DOI: 10.1016/j.amsu.2020.02.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 02/22/2020] [Accepted: 02/27/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Colloid breast carcinoma is a rare form of invasive ductal cancer characterized by large amount of mucous deposition. It is considered as an indolent cancer that usually affects older women. Colloid breast carcinoma generally expresses estrogen and progesterone receptors but negative for Her-2. Recommended surgery and adjuvant treatment of colloid breast carcinoma is not well-established. PRESENTED CASE A 46 years-old woman presented as an aggressive colloid breast carcinoma showing skin ulceration, enlargement of multiple axillary lymph nodes and a metastasis in the pleura at diagnosis. The primary tumor showed strong positive expression of estrogen, progesterone as well as Her-2 receptors. The patient was treated with 6 cycles of paclitaxel and carboplatin followed by mastectomy, radiotherapy, and hormonal therapy. Patient tolerated the treatment course and showed improvement both in the locoregional control and pleural metastasis. DISCUSSION Colloid breast carcinoma with aggressive clinical course is rarely found. Nodal involvement as a sign of poor prognosis in colloid breast carcinoma ranges only between 12 and 19%. Therefore, axillary node clearance is usually excluded during the surgery of colloid breast carcinomas. However, in the presence of high-risk characteristics, mastectomy involving axillary lymph node dissection is still contentious. In patients with Her-2 overexpression, treatment using anti-Her2 (trastuzumab) is also still disputed in colloid breast carcinoma because of the higher resistance rates. CONCLUSION Although clinically aggressive colloid breast carcinoma is rare, thorough clinical assessment and immediate treatment initiation will be beneficial for patients with high risk of relapse and metastatic spread.
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Affiliation(s)
- Sumadi Lukman Anwar
- Division of Surgical Oncology, Department of Surgery, Dr Sardjito Hospital, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
| | - Ery Kus Dwianingsih
- Department of Anatomical Pathology, Dr Sardjito Hospital, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
| | - Widya Surya Avanti
- Department of Radiology, Dr Sardjito Hospital, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
| | - Lina Choridah
- Department of Radiology, Dr Sardjito Hospital, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
| | - Suwardjo
- Division of Surgical Oncology, Department of Surgery, Dr Sardjito Hospital, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
| | - Teguh Aryandono
- Division of Surgical Oncology, Department of Surgery, Dr Sardjito Hospital, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
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Marrazzo E, Frusone F, Milana F, Sagona A, Gatzemeier W, Barbieri E, Bottini A, Canavese G, Rubino AO, Eboli MG, Rossetti CM, Testori A, Errico V, De Luca A, Tinterri C. Mucinous breast cancer: A narrative review of the literature and a retrospective tertiary single-centre analysis. Breast 2019; 49:87-92. [PMID: 31783314 PMCID: PMC7375663 DOI: 10.1016/j.breast.2019.11.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 10/14/2019] [Accepted: 11/01/2019] [Indexed: 12/15/2022] Open
Abstract
Mucinous carcinoma (MC) is a rare breast cancer characterized by the presence of large extracellular mucin amount. Two main subtypes can be distinguished: pure (PMC) and mixed (MMC). We conducted a retrospective MC analysis in our prospective maintained database, calculating disease-free survival (DFS) and 5-year overall survival (OS). We found a global 92.1% OS (higher in MMC group and statistically significative) and a DFS of 95.3% (higher in MMC group but not statistically significative).
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Affiliation(s)
- Emilia Marrazzo
- Humanitas Research Hospital and Cancer Center, Breast Surgery Dept, Milan, Rozzano, Italy
| | - Federico Frusone
- Sapienza University of Rome, Department of Surgical Sciences, Rome, Italy.
| | - Flavio Milana
- Humanitas Research Hospital and Cancer Center, Breast Surgery Dept, Milan, Rozzano, Italy
| | - Andrea Sagona
- Humanitas Research Hospital and Cancer Center, Breast Surgery Dept, Milan, Rozzano, Italy
| | - Wolfgang Gatzemeier
- Humanitas Research Hospital and Cancer Center, Breast Surgery Dept, Milan, Rozzano, Italy
| | - Erika Barbieri
- Humanitas Research Hospital and Cancer Center, Breast Surgery Dept, Milan, Rozzano, Italy
| | - Alberto Bottini
- Humanitas Research Hospital and Cancer Center, Breast Surgery Dept, Milan, Rozzano, Italy
| | - Giuseppe Canavese
- Humanitas Research Hospital and Cancer Center, Breast Surgery Dept, Milan, Rozzano, Italy
| | - Arianna Olga Rubino
- Humanitas Research Hospital and Cancer Center, Breast Surgery Dept, Milan, Rozzano, Italy
| | - Marco Gaetano Eboli
- Humanitas Research Hospital and Cancer Center, Breast Surgery Dept, Milan, Rozzano, Italy
| | - Carlo Marco Rossetti
- Humanitas Research Hospital and Cancer Center, Breast Surgery Dept, Milan, Rozzano, Italy
| | - Alberto Testori
- Humanitas Research Hospital and Cancer Center, Thoracic Surgery Dept, Milan, Rozzano, Italy
| | - Valentina Errico
- Humanitas Research Hospital and Cancer Center, Thoracic Surgery Dept, Milan, Rozzano, Italy
| | - Alessandro De Luca
- Sapienza University of Rome, Department of Surgical Sciences, Rome, Italy
| | - Corrado Tinterri
- Humanitas Research Hospital and Cancer Center, Breast Surgery Dept, Milan, Rozzano, Italy
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Gök M, Topal U, Öz B, Akgün H, Akcan AC, Sözüer EM. Comparison of Clinical Features and Treatment Results of Mix Mucinous Carcinomas and Other Atypical Carcinomas of the Breast. Eur J Breast Health 2019; 15:222-228. [PMID: 31620680 PMCID: PMC6776130 DOI: 10.5152/ejbh.2019.5032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 07/30/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE There are multiple subtypes of breast cancer with different biological and pathological features and accordingly exhibit different clinical behaviors. The aim of this study was to compare the treatment modalities, clinical features and prognostic characteristics of Mix Mucinous Carcinomas (MMBC) and other rare tumors of the breast. MATERIALS AND METHOD A total of 2152 patients who were operated on for breast cancer in our clinic between 2010-2019, with pathological diagnoses of tubular, pure mucinous, mix mucinous or papillary carcinoma were enrolled in the study. Patients were divided into two groups as mix mucinous patients (Group1) and other rare tumors (Group2). The demographic, clinical and prognostic characteristics and treatment approaches were compared between Groups, and additionally between the subtypes of Group 2. RESULTS 42 patients participated in our study. Group 1 consisted of 7 patients, and Group2 consisted of 35 patients. The subtypes in Group2 were papillary (n=21), pure mucinous (n=10) and tubular (n=4). Progesterone Receptor Positivity was found to be significantly higher in Group 2 patients than in Group1 patients (p=0.005, p<0.05). Multicentricity rates in the tumors of the patients in Group1 were found to be statistically significantly higher than the patients in Group 2 (p=0.024, p<0.05). In subtype analysis in Group2, there were no statistically significant differences parameters in the subgroups (p>0.05). Mean survival was 19.5+5.6 (8.5-30.5) months in Group 1 and 46.3+5.2 (36.1-56.6) months, in Group2 when evaluated separately (p:0.002). CONCLUSION The prognosis of pure mucinosis (PMBC) and other atypical cancers of the breast compared to the (MMBC) is quite good. Rare pathological types of breast cancer can have favorable outcomes when treated with necessary oncological principles.
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Affiliation(s)
- Mustafa Gök
- Department of General Surgery, Erciyes University School of Medicine, Kayseri, Turkey
| | - Uğur Topal
- Department of General Surgery, Erciyes University School of Medicine, Kayseri, Turkey
- Department of Surgical Oncology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Bahadır Öz
- Department of Pathology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Hülya Akgün
- Department of Surgical Oncology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Alper Celal Akcan
- Department of Pathology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Erdoğan Mütevelli Sözüer
- Department of General Surgery, Erciyes University School of Medicine, Kayseri, Turkey
- Department of Surgical Oncology, Erciyes University School of Medicine, Kayseri, Turkey
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Asano Y, Kashiwagi S, Nagamori M, Tanaka S, Kuwae Y, Amano R, Takashima T, Ohsawa M, Hirakawa K, Ohira M. Pure Mucinous Breast Carcinoma with Micropapillary Pattern (MUMPC): A Case Report. Case Rep Oncol 2019; 12:554-559. [PMID: 31427951 PMCID: PMC6696764 DOI: 10.1159/000501766] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 06/25/2019] [Indexed: 01/01/2023] Open
Abstract
Pure mucinous breast carcinoma with micropapillary pattern (MUMPC) was proposed as a new histopathological variant of pure mucinous carcinoma (PMC) with tumor cells forming a micropapillary architecture. The Classification of Tumours of the Breast by the World Health Organization, however, does not differentiate MUMPC as a distinct subtype. There is currently no consensus whether tumors that exhibit these features are classified as PMC or invasive micropapillary carcinoma (IMPC) with associated mucin production. A 45-year-old woman was examined for a tumor in her left breast. Upon physical examination, an elastic hard mass of around 5 cm along with accompanying skin flare and ulceration was palpated in the upper outer quadrant of the left breast. Mammary ultrasonography revealed a clearly marginated hypoechoic tumor of 55.0 × 46.9 × 37.0 mm in size in the upper outer quadrant of the left breast. A vacuum-assisted biopsy (VAB) was performed in the same site and histopathological diagnosis of PMC was made. Contrast-enhanced magnetic resonance imaging (MRI) showed a T1W1 low-intensity signal and a T2W1 high-intensity signal at the primary focus, ring enhancement of the tumor margin, and stranding enhancement inside the tumor. A preoperative diagnosis of left breast cancer (PMC), cT4bN1M0, stage IIIB, luminal B-like was made. We performed a simple mastectomy with axillary lymph node dissection. A 55.0 × 48.1 × 37.1 mm tumor with the gelatinous cut surface was excised. Histopathological examination of the excised specimen revealed mucin lake formation in the tumor containing clusters of atypical cells. The atypical cells showed swollen, irregular nuclei and a papillary growth pattern that lead to the diagnosis of MUMPC.
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Affiliation(s)
- Yuka Asano
- Department of Breast and Endocrine Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Shinichiro Kashiwagi
- Department of Breast and Endocrine Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Mizuki Nagamori
- Department of Breast and Endocrine Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Sayaka Tanaka
- Department of Diagnostic Pathology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yuko Kuwae
- Department of Diagnostic Pathology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Ryosuke Amano
- Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Tsutomu Takashima
- Department of Breast and Endocrine Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Masahiko Ohsawa
- Department of Diagnostic Pathology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kosei Hirakawa
- Department of Breast and Endocrine Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Masaichi Ohira
- Department of Breast and Endocrine Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
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11
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Wang PL, Zheng FY, Lu Q, Xia HS, Huang BJ, Liu LM, Wang WP. Imaging features of pure mucinous breast carcinoma: correlation with extracellular mucus content. Clin Radiol 2019; 74:569.e9-569.e17. [PMID: 30967244 DOI: 10.1016/j.crad.2019.01.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 01/24/2019] [Indexed: 12/21/2022]
Abstract
AIM To analyse the correlation between imaging features using multiple techniques and extracellular mucus content in pure mucinous breast carcinoma (PMBC). MATERIALS AND METHODS A retrospective review of available images from 25 patients with 25 PMBC tumours was conducted, with ultrasonography (US), ultrasonic elastography (USE), mammography, and breast-specific gamma imaging (BSGI) available for 25, 15, 11, and eight patients, respectively. Microscopic slides from each tumour were evaluated for extracellular mucus content. The correlation between imaging features and mucus content was analysed using linear-by-linear association chi-square tests or Spearman's rank correlation analyses. RESULTS On US images, a significant correlation was found between mucus content and echo pattern (p=0.042) and colour Doppler blood flow (p=0.032), with a trend that the lower mucus content present in tumours, the more likely they were detected with isoechoic echo and high blood flow. On USE images, a moderate negative correlation (r=-0.60, p=0.029) was observed between mucus content and tumour stiffness. On BSGI images, a strong negative correlation (r=-0.92, p=0.001) was shown between mucus content and lesion to non-lesion ratio (L/N) values of radioactivity counts. No significant correlation was found between mucus content and mammography imaging features (all p>0.05). CONCLUSION Imaging features at US, USE, and BSGI correlated with extracellular mucus content in PMBC tumours, among which the L/N value using BSGI imaging is the most relevant feature.
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Affiliation(s)
- P-L Wang
- Department of Ultrasound, Zhongshan Hospital Fudan University, 180 Fenglin Rd, Xuhui District, Shanghai 200032, China; Shanghai Institute of Medical Imaging, Shanghai 200032, PR China
| | - F-Y Zheng
- Department of Ultrasound, Zhongshan Hospital Fudan University, 180 Fenglin Rd, Xuhui District, Shanghai 200032, China; Shanghai Institute of Medical Imaging, Shanghai 200032, PR China
| | - Q Lu
- Department of Ultrasound, Zhongshan Hospital Fudan University, 180 Fenglin Rd, Xuhui District, Shanghai 200032, China; Shanghai Institute of Medical Imaging, Shanghai 200032, PR China
| | - H-S Xia
- Department of Ultrasound, Zhongshan Hospital Fudan University, 180 Fenglin Rd, Xuhui District, Shanghai 200032, China
| | - B-J Huang
- Department of Ultrasound, Zhongshan Hospital Fudan University, 180 Fenglin Rd, Xuhui District, Shanghai 200032, China; Shanghai Institute of Medical Imaging, Shanghai 200032, PR China.
| | - L-M Liu
- Department of Ultrasound, Zhongshan Hospital Fudan University, 180 Fenglin Rd, Xuhui District, Shanghai 200032, China
| | - W-P Wang
- Department of Ultrasound, Zhongshan Hospital Fudan University, 180 Fenglin Rd, Xuhui District, Shanghai 200032, China; Shanghai Institute of Medical Imaging, Shanghai 200032, PR China
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12
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The feasibility of using 18F-FDG-PET/CT in patients with mucinous breast carcinoma. Nucl Med Commun 2018; 39:1033-1038. [DOI: 10.1097/mnm.0000000000000910] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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13
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Wang W, Chen X, Lin L, Fei X, Garfield DH, Hong J, Gao W, Zhu S, Wu J, Huang O, He J, Li Y, Zhu L, Chen W, Shen K. Distribution and Clinical Utility of the 21-gene Recurrence Score in Pure Mucinous Breast Cancer Patients: a case-control study. J Cancer 2018; 9:3216-3224. [PMID: 30271480 PMCID: PMC6160674 DOI: 10.7150/jca.27291] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 07/06/2018] [Indexed: 12/29/2022] Open
Abstract
The 21-gene recurrence score (RS) is increasingly being used for patients with early stage, hormone receptor-positive, Her-2-negative breast cancer. However, these results are largely from populations with infiltrating ductal carcinoma (IDC). The clinical value of RS testing in mucinous carcinoma has not been well investigated. Pure mucinous breast cancer (PMBC) and paired pure IDC patients who underwent 21-gene RS were retrospectively reviewed and matched with tumor stage and molecular subtype. Clinic-pathological factors, treatment strategies, and RS distribution were compared between the PMBC and IDC patients. A total of 35 PMBC and 70 IDC patients were included. We found that RS was lower in the PMBC as compared with the IDC group: 21.26 vs. 24.40 (P=0.037). Regarding RS categories, PMBC patients had a relatively lower percentage of high RS patients than the IDC group: 8.57% vs. 22.86% (P = 0.048). Multivariate analysis showed that histologic type was an independent factor predicting RS distribution: IDC patients were associated with a higher RS as compared with PMBC patients (OR: 1.27, 95% CI: 1.03-2.13; P=0.014). Among genes in 21-gene RS testing, HER2, STMY3, STK15, and BAG1 were significantly different between the PMBC and IDC groups (P < 0.05). Two patients (5.71%) in the PMBC group, both with high RS, were recommended to receive adjuvant chemotherapy, much lower than patients with IDC (57.14%, P < 0.001). In multivariate analysis, histologic type of IDC was an independent factor for chemotherapy recommendation (OR = 22.00, 95% CI: 4.89-98.97, P<0.001). With a medium follow-up time of 24 months, one IDC patient had ipsilateral axillary lymph nodes recurrence and one PMBC patient had contralateral breast cancer. In conclusion, PMBC patients, mostly classified with low or intermediate RS category, were associated with lower RS as compared with IDC patients. PMBC and IDC had different genes expression patterns. Patients with high RS in the PMBC group might be recommended to receive adjuvant chemotherapy, which deserves further clinical evaluation.
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Affiliation(s)
- Wei Wang
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin Second Road, Shanghai 200025, P.R. China
| | - Xiaosong Chen
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin Second Road, Shanghai 200025, P.R. China
| | - Lin Lin
- Department of clinical laboratory, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - Xiaochun Fei
- Pathology Department, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin Second Road, Shanghai 200025, P.R. China
| | - David H Garfield
- University of Colorado Comprehensive Cancer Center, Aurora, CO 80045, USA
| | - Jin Hong
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin Second Road, Shanghai 200025, P.R. China
| | - Weiqi Gao
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin Second Road, Shanghai 200025, P.R. China
| | - Siji Zhu
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin Second Road, Shanghai 200025, P.R. China
| | - Jiayi Wu
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin Second Road, Shanghai 200025, P.R. China
| | - Ou Huang
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin Second Road, Shanghai 200025, P.R. China
| | - Jianrong He
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin Second Road, Shanghai 200025, P.R. China
| | - Yafen Li
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin Second Road, Shanghai 200025, P.R. China
| | - Li Zhu
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin Second Road, Shanghai 200025, P.R. China
| | - Weiguo Chen
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin Second Road, Shanghai 200025, P.R. China
| | - Kunwei Shen
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin Second Road, Shanghai 200025, P.R. China
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Collins K, Ricci A. Micropapillary variant of mucinous breast carcinoma: A distinct subtype. Breast J 2017; 24:339-342. [PMID: 29063656 DOI: 10.1111/tbj.12935] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 03/23/2017] [Accepted: 04/18/2017] [Indexed: 02/05/2023]
Abstract
Invasive micropapillary carcinoma of the breast is a subtype with high malignant potential characterized by lymphovascular invasion (LVI) and a predilection for axillary lymph node (AXLN) metastases. In contrast, pure mucinous breast carcinoma (MBC) is relatively indolent with low metastatic potential. Recent studies have described a histologic variant of breast cancer that displays combined mucinous and micropapillary patterns, ie, micropapillary variant of mucinous carcinoma (MpVMBC). This underrecognized variant is, as yet, incompletely characterized clinicopathologically. Extant reports suggest a more aggressive lesion than pure MBC with greater propensity for both LVI and AXLN metastases. Here we present our institution's experience with MpVMBCs including clinicopathologic and immunohistochemical (IHC) analyses. Greater awareness and recognition of this variant could positively contribute to patient care by (1) avoiding underestimation of malignant potential for individuals whose tumors may have been diagnosed as simply "MBC, not otherwise specified", and (2) recommending a postsurgical adjuvant approach emphasizing the hormone receptor targets, even perhaps in younger women presenting with AXLN positive disease.
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Affiliation(s)
- Katrina Collins
- Department of Pathology, Hartford Hospital, Hartford, CT, USA
| | - Andrew Ricci
- Department of Pathology, Hartford Hospital, Hartford, CT, USA
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15
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Wang Q, Sun L, Yan J, Wang S, Zhang J, Zheng X. Expression of vascular endothelial growth factor and caspase-3 in mucinous breast carcinoma and infiltrating ductal carcinoma-not otherwise specified, and the correlation with disease-free survival. Oncol Lett 2017; 14:4890-4896. [PMID: 29085497 DOI: 10.3892/ol.2017.6744] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 06/02/2017] [Indexed: 12/17/2022] Open
Abstract
Mucinous breast carcinoma (MBC) is a rare type of breast cancer, but it has been infrequently studied due to its associated good prognosis. Vascular endothelial growth factor (VEGF) and caspase-3 have been identified to be prognostic factors of infiltrating ductal carcinoma-not otherwise specified (IDC-NOS), but their expression in MBC has not been reported. In the present study, the expression of caspase-3 and VEGF in MBC and IDC-NOS were assessed by immunohistochemistry. Scoring was conducted based on staining intensity and percentage of positive cells. Based on the scores of caspase-3 and VEGF expression, all patient samples were divided into two groups: Low expression (score of 0-5) or high expression (score of 6-12). In total, 42.59% of MBC patients exhibited a high VEGF score compared with 61.67% of the IDC-NOS group (P<0.05). Furthermore, 57.41% of MBC patients exhibited high caspase-3 expression compared with only 33.33% of IDC-NOS patients (P<0.05). VEGF expression in MBC was associated with age, nodal status and tumor-node-metastasis (TNM) stage. Cox univariate analysis showed that higher VEGF expression, positive nodal status and higher TNM stage were associated with shorter disease-free survival (DFS). The Kaplan-Meier method showed that higher VEGF expression in MBC was associated with worse DFS times, while Cox multivariate analysis showed that only TNM stage was significantly associated with DFS. VEGF and caspase-3 expression varied in the MBC and IDC-NOS samples, but neither was directly correlated with DFS in the MBC patients.
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Affiliation(s)
- Qiuli Wang
- Department of Breast Surgery, First Affiliated Hospital, China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Lisha Sun
- Department of Breast Surgery, First Affiliated Hospital, China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Jici Yan
- Department of Breast Surgery, First Affiliated Hospital, China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Shuo Wang
- Department of Breast Surgery, First Affiliated Hospital, China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Juncheng Zhang
- Department of Breast Surgery, First Affiliated Hospital, China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Xinyu Zheng
- Department of Breast Surgery, First Affiliated Hospital, China Medical University, Shenyang, Liaoning 110001, P.R. China.,Laboratory 1, Cancer Institute, First Affiliated Hospital, China Medical University, Shenyang, Liaoning 110001, P.R. China
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16
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Luna-Abanto J, Mendoza Tisoc G. Mucinous carcinoma of the breast: a case report and review of the literature. Medwave 2017; 17:e7003. [PMID: 28753591 DOI: 10.5867/medwave.2017.06.7003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 07/08/2017] [Indexed: 11/27/2022] Open
Abstract
Mucinous carcinoma of the breast is a rare histological type, which represents between 1 and 4% of breast cancers. Treatment does not differ from other histological types, and it occurs more frequently in older adult women. Prognosis is good. We report the case of a 72-year-old patient with a 1-year disease course characterized by the appearance of a slow-growing tumor in the left upper quadrant of the left breast, in which the core biopsy showed mucinous breast carcinoma of a low nuclear grade. The patient underwent quadrantectomy plus a sentinel node biopsy, which confirmed the initial diagnosis.
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Affiliation(s)
- Jorge Luna-Abanto
- Departamento de Cirugía Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú; Escuela de Posgrado, Universidad Peruana Cayetano Heredia, Lima, Perú. Address: Avenida Angamos Este 2520, Surquillo, Lima, Perú.
| | - Grivette Mendoza Tisoc
- Departamento de Patología Quirúrgica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú; Escuela de Posgrado, Universidad Nacional Mayor de San Marcos, Lima, Perú
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17
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Guo Y, Kong QC, Zhu YQ, Liu ZZ, Peng LR, Tang WJ, Yang RM, Xie JJ, Liu CL. Whole-lesion histogram analysis of the apparent diffusion coefficient: Evaluation of the correlation with subtypes of mucinous breast carcinoma. J Magn Reson Imaging 2017. [PMID: 28640538 DOI: 10.1002/jmri.25794] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
PURPOSE To evaluate the utility of the whole-lesion histogram apparent diffusion coefficient (ADC) for characterizing the heterogeneity of mucinous breast carcinoma (MBC) and to determine which ADC metrics may help to best differentiate subtypes of MBC. MATERIALS AND METHODS This retrospective study involved 52 MBC patients, including 37 pure MBC (PMBC) and 15 mixed MBC (MMBC). The PMBC patients were subtyped into PMBC-A (20 cases) and PMBC-B (17 cases) groups. All patients underwent preoperative diffusion-weighted imaging (DWI) at 1.5T and the whole-lesion ADC assessments were generated. Histogram-derived ADC parameters were compared between PMBC vs. MMBC and PMBC-A vs. PMBC-B, and receiver operating characteristic (ROC) curve analysis was used to determine optimal histogram parameters for differentiating these groups. RESULTS The PMBC group exhibited significantly higher ADC values for the mean (P = 0.004), 25th (P = 0.004), 50th (P = 0.004), 75th (P = 0.006), and 90th percentiles (P = 0.013) and skewness (P = 0.021) than did the MMBC group. The 25th percentile of ADC values achieved the highest area under the curve (AUC) (0.792), with a cutoff value of 1.345 × 10-3 mm2 /s, in distinguishing PMBC and MMBC. The PMBC-A group showed significantly higher ADC values for the mean (P = 0.049), 25th (P = 0.015), and 50th (P = 0.026) percentiles and skewness (P = 0.004) than did the PMBC-B group. The 25th percentile of the ADC cutoff value (1.476 × 10-3 mm2 /s) demonstrated the best AUC (0.837) among the ADC values for distinguishing PMBC-A and PMBC-B. CONCLUSION Whole-lesion ADC histogram analysis enables comprehensive evaluation of an MBC in its entirety and differentiating subtypes of MBC. Thus, it may be a helpful and supportive tool for conventional MRI. LEVEL OF EVIDENCE 4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:391-400.
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Affiliation(s)
- Yuan Guo
- Department of Radiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Qing-Cong Kong
- Department of Radiology, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Ye-Qing Zhu
- Department of Radiology, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Zhen-Zhen Liu
- Department of Radiology, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Ling-Rong Peng
- Department of Radiology, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Wen-Jie Tang
- Department of Radiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Rui-Meng Yang
- Department of Radiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Jia-Jun Xie
- Department of Radiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Chun-Ling Liu
- Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, Guangzhou, China
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18
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Skotnicki P, Sas-Korczynska B, Strzepek L, Jakubowicz J, Blecharz P, Reinfuss M, Walasek T. Pure and Mixed Mucinous Carcinoma of the Breast: A Comparison of Clinical Outcomes and Treatment Results. Breast J 2016; 22:529-34. [DOI: 10.1111/tbj.12621] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Piotr Skotnicki
- Department of Surgical Oncology; Maria Sklodowska-Curie; Memorial Cancer Centre and Institute of Oncology; Krakow Poland
| | - Beata Sas-Korczynska
- Department of Clinical Oncology; Maria Sklodowska-Curie; Memorial Cancer Centre and Institute of Oncology; Krakow Poland
| | - Lukasz Strzepek
- Department of Surgical Oncology; Maria Sklodowska-Curie; Memorial Cancer Centre and Institute of Oncology; Krakow Poland
| | - Jerzy Jakubowicz
- Department of Clinical Oncology; Maria Sklodowska-Curie; Memorial Cancer Centre and Institute of Oncology; Krakow Poland
| | - Pawel Blecharz
- Department of Gynaecological Oncology; Maria Sklodowska-Curie; Memorial Cancer Centre and Institute of Oncology; Krakow Poland
| | - Marian Reinfuss
- Department of Radiotherapy; Maria Sklodowska-Curie; Memorial Cancer Centre and Institute of Oncology; Krakow Poland
| | - Tomasz Walasek
- Department of Radiotherapy; Maria Sklodowska-Curie; Memorial Cancer Centre and Institute of Oncology; Krakow Poland
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19
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Lei L, Yu X, Chen B, Chen Z, Wang X. Clinicopathological Characteristics of Mucinous Breast Cancer: A Retrospective Analysis of a 10-Year Study. PLoS One 2016; 11:e0155132. [PMID: 27232881 PMCID: PMC4883756 DOI: 10.1371/journal.pone.0155132] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 04/25/2016] [Indexed: 12/16/2022] Open
Abstract
Background Mucinous breast carcinoma (MC) is a special type of breast cancer that presents with a large amount of extracellular mucin. MC comprises approximately 4% of all invasive breast cancers. This type of tumor has a better prognosis and higher incidence in peri- and post-menopausal patients. Pathologically, there are two main subtypes of MC: pure and mixed. In this study, we describe 10 years of experience with MC at the Zhejiang Cancer Hospital in China, specifically, clinical data, histological findings and immunohistochemical features. Methods We identified MC patients who were diagnosed as operable and completed clinical treatment from January 2001 to January 2011. The clinicopathological data included the age at diagnosis, tumor size, TNM stage, presence and number of lymph node (LN) metastases, estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER2) status and p53 expression. If the tumor was defined as mixed mucinous carcinoma (MMC), IHC was performed on a non-mucinous part, such as invasive ductal and lobular cancer. We evaluated the clinical characteristics of all MC patients using chi-square, one-way ANOVA and LSD tests. We also studied the correlations between all of the clinical parameters and LN metastasis in a binary logistic regression analysis. We used ten consecutive years of data that were collected at Zhejiang Cancer Hospital. Results We identified 48 cases of pure mucinous carcinoma (PMC) and 77 cases of MMC. The 48 PMC cases consisted of 38 PMC-A and 10 PMC-B subtypes. The MMCs were divided into two groups, those with partial mixed mucinous breast carcinoma (pMMC, 58 cases) and those with main mixed mucinous breast carcinoma (mMMC, 19 cases). pMMC was defined by tumors with less than 50% mucinous components, while mMMC was defined by tumors where the mucinous component accounted for 50% to 90% of the tumor. No significant differences in the clinicopathological characteristics were noted between the patients with PMC-A and those with PMC-B. The tumor size was larger in the mMMC than PMC cases (44.84 mm vs. 30.06 mm, p = 0.021). The number of positive LN metastases was greater in pMMC than PMC patients (p = 0.024). The clinical stages were significantly different among the three groups, with the pMMC group having more stage III-IV patients than the other two groups (p = 0.005). The incidence of LN metastasis was also higher in the pMMC cases (pMMC vs. mMMC and PMC, 50% vs. 31.58% and 18.75%, p = 0.003). The PMC patients had much lower p53 expression than the other two groups (PMC vs. pMMC and mMMC, 27.08% vs. 55.17% and 57.89%, p = 0.007). The tumor size (>30mm), p53 expression and less proportion of the mucinous component are associated with risk of LN metastasis. Conclusion Based on the results of this study, we conclude that the tumor size, status of LN metastasis, clinical stage, and p53 mutation rate may differ between MMC and PMC patients. The tumor size (>30mm), p53 mutation and less proportion of the mucinous component should be considered risk factors of LN metastasis in MC patients.
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Affiliation(s)
- Lei Lei
- Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province, P. R. China
| | - Xingfei Yu
- Department of Breast Tumor Surgery, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province, P. R. China
| | - Bo Chen
- Department of Pathology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province, P. R. China
| | - Zhanhong Chen
- Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province, P. R. China
| | - Xiaojia Wang
- Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province, P. R. China
- * E-mail:
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20
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Saha M, Arun I, Basak B, Agarwal S, Ahmed R, Chatterjee S, Bhargava R, Chakraborty C. Quantitative microscopic evaluation of mucin areas and its percentage in mucinous carcinoma of the breast using tissue histological images. Tissue Cell 2016; 48:265-73. [PMID: 26971129 DOI: 10.1016/j.tice.2016.02.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Revised: 01/30/2016] [Accepted: 02/23/2016] [Indexed: 11/16/2022]
Abstract
Mucinous carcinoma (MC) of the breast is very rare (∼1-7% of all breast cancers), invasive ductal carcinoma. Presence of pools of extracellular mucin is one of the most important histological features for MC. This paper aims at developing a quantitative computer-aided methodology for automated identification of mucin areas and its percentage using tissue histological images. The proposed method includes pre-processing (i.e., colour space transformation and colour normalization), mucin regions segmentation, post-processing, and performance evaluation. The proposed algorithm achieved 97.74% segmentation accuracy in comparison to ground truths. In addition, the percentage of mucin present in the tissue regions is calculated by the mucin index (MI) for grading MC (pure, moderately, minimally mucinous).
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Affiliation(s)
- Monjoy Saha
- School of Medical Science and Technology, IIT Kharagpur, 721 302, India
| | - Indu Arun
- Tata Medical Center, New Town, Rajarhat, Kolkata 700 156, India
| | - Bijan Basak
- Tata Medical Center, New Town, Rajarhat, Kolkata 700 156, India
| | - Sanjit Agarwal
- Tata Medical Center, New Town, Rajarhat, Kolkata 700 156, India
| | - Rosina Ahmed
- Tata Medical Center, New Town, Rajarhat, Kolkata 700 156, India
| | | | - Rohit Bhargava
- Department of Bioengineering, University of Illinois at Urbana-Champaign, United States
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21
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MRI Features of Mucinous Cancer of the Breast: Correlation With Pathologic Findings and Other Imaging Methods. AJR Am J Roentgenol 2016; 206:238-46. [DOI: 10.2214/ajr.15.14851] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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22
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Gupta K, Sharma S, Kudva R, Kumar S. Mixed Mucinous and Infiltrating Carcinoma Occurring in Male Breast- Study of Clinico-Pathological Features: A Rare Case Report. J Clin Diagn Res 2015; 9:ED07-8. [PMID: 26266132 DOI: 10.7860/jcdr/2015/12209.6090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 04/28/2015] [Indexed: 11/24/2022]
Abstract
Mucinous carcinoma is a less common histologic variant of breast cancer. Cases of mucinous carcinomas in male breast are extremely rare. Here, we describe a case of mixed mucinous carcinoma i.e. mucinous carcinoma with infiltrating ductal carcinoma component and showing apocrine differentiation in a 73-year-old man. This uncommon tumour entity has dismal prognosis and treatment depends largely on the tumour type, size, lymph node involvement and hormonal status.
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Affiliation(s)
- Kavita Gupta
- Post Graduate, Department of Pathology, Kasturba Medical College, Manipal University , Manipal, Karnataka, India
| | - Swati Sharma
- Associate Professor, Department of Pathology, Kasturba Medical College, Manipal University , Manipal, Karnataka, India
| | - Ranjini Kudva
- Professor and Head, Department of Pathology, Kasturba Medical College, Manipal University , Manipal, Karnataka, India
| | - Sandeep Kumar
- Assistant Professor, Department of Radiodiagnosis and Imaging, Kasturba Medical College, Manipal University , Manipal, Karnataka, India
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Varadharajan E, Priya S, Prakash G, Mugundan A, Easwaramurthi P. Mucinous Carcinoma of the Breast with Neuroendocrine Differentiation. IRANIAN JOURNAL OF PATHOLOGY 2015; 10:231-236. [PMID: 26351490 PMCID: PMC4539775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 05/31/2014] [Indexed: 06/05/2023]
Abstract
Mucinous carcinoma of the breast is a well-differentiated type of adenocarcinoma accounting for 2-5% of all breast cancers. Pure mucinous carcinoma of the breast has a favorable prognosis, usually seen in post-menopausal women. Neuroendocrine differentiation has been described in both in-situ and infiltrating breast cancers .Mucinous carcinomas of the breast appear to have the greatest association with neuroendocrine differentiation. Chromogranin A and synaptophysin are specific immunohistochemical markers of neuroendocrine differentiation. We report a case of mucinous carcinoma of the breast with neuroendocrine differentiation in a 67-year-old female who was treated surgically in a classical manner.
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Affiliation(s)
- Eswari Varadharajan
- Dept. of Pathology, Meenakshi Medical College Hospital & Research Institute, Enathur, Near Kanchipuram, Tamil Nadu
| | - Shanmuga Priya
- Dept. of Pathology, Meenakshi Medical College Hospital & Research Institute, Enathur, Near Kanchipuram, Tamil Nadu
| | - Geetha Prakash
- Dept. of Pathology, Meenakshi Medical College Hospital & Research Institute, Enathur, Near Kanchipuram, Tamil Nadu
| | - Archana Mugundan
- Dept. of Pathology, Meenakshi Medical College Hospital & Research Institute, Enathur, Near Kanchipuram, Tamil Nadu
| | - Praveen Easwaramurthi
- Dept. of Pathology, Meenakshi Medical College Hospital & Research Institute, Enathur, Near Kanchipuram, Tamil Nadu
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