1
|
Al Marwani M, Alamri N, Allebdi A. Synchronous bilateral breast cancer with different histology. Radiol Case Rep 2023; 18:2491-2497. [PMID: 37214322 PMCID: PMC10196912 DOI: 10.1016/j.radcr.2023.04.006] [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: 01/16/2023] [Revised: 03/24/2023] [Accepted: 04/03/2023] [Indexed: 05/24/2023] Open
Abstract
Synchronous bilateral breast cancer is a rare clinical entity. And due to both an improved prognosis and growing life expectancy on early detection, we have brought interest in case of patient with synchronous breast cancer. This study reports a case of synchronous bilateral breast cancer in an asymptomatic 70-year-old woman with a positive family history of breast cancer. This woman was diagnosed through radiological screenings, including mammograms, ultrasonography, and magnetic resonance imaging (MRI). On histopathologic examination of the core biopsy, the left breast mass was a Nottingham grade I invasive carcinoma of no particular type. The right breast mass was a Nottingham grade I invasive carcinoma with a mucinous component. After lumpectomies ultrasonography of the surgical specimens confirmed a small biopsy-proven invasive ductal cancer hypoechoic mass in the left breast, with an irregular margins and proven mucinous cancer mass in the right breast. The case was finally diagnosed as synchronous bilateral breast cancer of different pathologic types (ductal and mucinous).
Collapse
|
2
|
Wadhwa S, Ashwini RK, Khadri SIS. A Diagnostic Revelation: Case of a Mucinous Carcinoma of the Breast. Indian J Surg Oncol 2023; 14:144-149. [PMID: 36891453 PMCID: PMC9986366 DOI: 10.1007/s13193-022-01638-z] [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: 10/30/2020] [Accepted: 08/23/2022] [Indexed: 10/14/2022] Open
Abstract
Mucinous or colloid cancers are a rare subtype of invasive ductal carcinoma, making up only 2-3% of infiltrating carcinomas. Prevalence of pure mucinous breast cancer(PMBC) among infiltrating duct carcinomas in less than 60 year olds is 2-7%, and in less than 35 year olds, it is 1%. Mucinous carcinoma of the breast is divided into 2 subtypes, the pure type and mixed type. PMBC is characterized by a lower incidence of nodal involvement, favourable histological grade, and higher ER/PR expression. Axillary metastases are rare, though found in 12-14%. It has a better prognosis than infiltrative ductal cancer with 10-year survival being more than 90%. Here is the case of a 70-year-old female who presented with lump in the left breast since 3 years. On examination, we detected a left breast lump occupying the whole breast except lower outer quadrant, measuring 10 × 8 cm with overlying skin stretched with puckering and engorged veins seen, nipple displaced laterally and higher by 1 cm, firm to hard in consistency, and mobile with breast tissue. Sonomammography, mammography, FNAC and biopsy were suggestive of benign phyllodes tumour. Patient was hence posted for simple mastectomy on the left side with removal of attached lymph nodes (near axillary tail). Histopathological examination revealed pure mucinous breast carcinoma with nine lymph nodes, free from tumour and showing reactive hyperplasia. Immunohistochemistry studies demonstrated ER + , PR + , HER-2-NEU-. The patient was started on hormonal therapy. Therefore, mucinous carcinoma of the breast is a rare entity with imaging features sometimes mimicking a benign tumour such as Phyllodes tumour, hence making it important to include it as a differential diagnosis in our daily practice. It is especially important in the subtyping of carcinoma of the breast since it carries a favourable risk profile with less chances of lymph node involvement, higher hormone receptor positivity and good response to endocrine treatment.
Collapse
Affiliation(s)
- Sheena Wadhwa
- Present Address: Department of General Surgery, Karwar Institute of Medical Sciences, Kodibag, Karwar India
- Department of General Surgery, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka India
| | - R. K. Ashwini
- Department of General Surgery, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka India
| | - Syed Iqbalulla Sha Khadri
- Department of General Surgery, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka India
| |
Collapse
|
3
|
Shin GW, Park HY, Park YM. Mucinous Breast Carcinoma Presenting as a Coarse and Densely Calcified Mass on Mammography: A Case Report. TAEHAN YONGSANG UIHAKHOE CHI 2020; 81:1266-1271. [PMID: 36238037 PMCID: PMC9431855 DOI: 10.3348/jksr.2019.0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 11/14/2019] [Accepted: 12/16/2019] [Indexed: 06/16/2023]
Abstract
We report herein a 46-year-old woman who presented with mucinous breast carcinoma that appeared as a coarse and densely calcified mass on mammography. The lesion was a 4.6-cmsized palpable, hyperechoic, calcified mass with posterior shadowing on ultrasonography. This finding is a unique feature of mucinous breast carcinoma and is also observed in unusual breast cancer variants such as metaplastic breast cancer with chondroid differentiation, extraosseous osteosarcoma, and breast chondrosarcoma. The lesion showed a slow-growing pattern throughout the 4-year observation period. Mammography performed 4 years ago revealed faint, grouped microcalcifications; the lesion increased in size over 2 years, presenting as a well-circumscribed, calcified mass, mimicking dystrophic calcification. As several unusual variants of breast cancer, including mucinous carcinoma, may present as coarse and densely calcified masses on mammography, immediate biopsy should be considered when they are observed.
Collapse
|
4
|
Zhao X, Yang X, Gao R, Zhai L, Yang L, Yu K. HER2-positive pure mucinous breast carcinoma: A case report and literature review. Medicine (Baltimore) 2020; 99:e20996. [PMID: 32871976 PMCID: PMC7437824 DOI: 10.1097/md.0000000000020996] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Pure mucinous carcinoma is a rare type of breast carcinoma, but it usually has a favorable prognosis. Tumors of pure mucinous carcinoma are typically positive for both estrogen receptor (ER) and progesterone receptor (PR), and they do not commonly overexpress human epidermal growth factor receptor 2 (HER2). However, when tumors have HER2 overexpression and are progesterone receptor negative, the prognosis is worse. PATIENT CONCERNS A 59-year-old female reported a slow growth mass of 3 years, which was radiologically diagnosed as fibroadenoma at another institution. The patient came to our institution for treatment and follow-up. She had no salient past history. DIAGNOSIS Excisional biopsy revealed a pure mucinous breast carcinoma that was ER (100%, moderate-strong intensity), PR(-), 5% Ki-67 (+), and HER2(3+) by immunohistochemistry. The HER2 gene was found to be amplified by fluorescence in situ hybridization (FISH). The clinical staging was T2N0M0, with pathological grade I, subtype luminal B. INTERVENTIONS After a modified radical mastectomy, she received four 21-day cycles of intravenous docetaxel (75 mg/m), intravenous cyclophosphamide (600 mg/m), and intravenous trastuzumab (8 mg/kg) (loading dose) on day 1 followed by 6 mg/kg every 3 weeks to complete a full year of treatment. She then received 2.5 mg of letrozole daily for 5 years. OUTCOMES After following up for 2 years, the patient's outcome was survival without recurrence. Cardiac ultrasounds were performed every 3 months and there was no change in the left ventricular ejection fraction (LEVF). CONCLUSION It is essential to correctly diagnose the ER(+), PR(-) HER2(+) subtype in mucinous carcinoma. This type should be treated with chemotherapy and anti-HER2 therapy, as well as aromatase inhibitor endocrine therapy.
Collapse
Affiliation(s)
| | | | | | - Liqin Zhai
- Department of Pathology, Shanxi People's Hospital, Taiyuan
| | - Lizhu Yang
- Department of Pathology, Shanxi People's Hospital, Taiyuan
| | - Keda Yu
- Department of Mammary Gland, Fudan University Cancer Hospital, Shanghai, China
| |
Collapse
|
5
|
Ginter PS, Tang X, Shin SJ. A review of mucinous lesions of the breast. Breast J 2020; 26:1168-1178. [PMID: 32419267 DOI: 10.1111/tbj.13878] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 11/28/2022]
Abstract
Mucinous lesions of the breast include a variety of benign and malignant epithelial processes that display intracytoplasmic or extracellular mucin, including mucocele-like lesions, mucinous carcinoma, solid papillary carcinoma, and other rare subtypes of mucin-producing carcinoma. The finding of free-floating or stromal mucin accumulations is a diagnostic challenge of which the significance depends on the clinical, radiologic, and pathologic context. This article emphasizes the differential diagnosis between benign and malignant mucin-producing lesions, with a brief consideration of potential mimics, such as biphasic and mesenchymal lesions with associated with mucinous, myxoid, or matrix material.
Collapse
Affiliation(s)
- Paula S Ginter
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Xiaoyu Tang
- Department of Pathology and Laboratory Medicine, Albany Medical College, Albany, NY, USA
| | - Sandra J Shin
- Department of Pathology and Laboratory Medicine, Albany Medical College, Albany, NY, USA
| |
Collapse
|
6
|
Abstract
We report a case of giant mucinous carcinoma of the breast in a 55-year-old female who presented with left breast lump for two years. The patient did not seek any medical attention for two years. On exam, the lump measured 12 x 14 cm. Core needle biopsy showed invasive mucinous adenocarcinoma without ductal component. The patient underwent neo-adjuvant chemotherapy without any response. She underwent left modified radical mastectomy. All lymph nodes were negative. This was followed by adjuvant chemotherapy. Mucinous carcinoma is a rare type of breast cancer that carries a good prognosis compared to other types of breast cancers. In this report, we presented a giant mucinous carcinoma measuring 14 cm.
Collapse
Affiliation(s)
| | - Saqib Saeed
- Surgery, Harlem Hospital Center, New York, USA
| | - Khuram Khan
- Surgery, Harlem Hospital Center, New York, USA
| | | | | |
Collapse
|
7
|
Pure mucinous breast carcinoma in a 25-year-old female, a case report. Int J Surg Case Rep 2018; 53:58-60. [PMID: 30388613 PMCID: PMC6218698 DOI: 10.1016/j.ijscr.2018.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 09/27/2018] [Accepted: 10/06/2018] [Indexed: 11/22/2022] Open
Abstract
Young patient. Mucinous carcinoma. Prognosis. Hormone receptor.
Introduction Mucinous carcinoma is a variant of invasive breast carcinomas representing 2% of them. These tumors frequently develop in postmenopausal females; it is a rare histological variant in young patients. Case presentation A 25-year-old female refers a slow growth mass of 2 years of evolution. Excisional biopsy reveals a pure mucinous carcinoma with positive hormone receptors and negative HER2. She was treated with hormone therapy and surgical resection. Discussion Mucinous carcinoma is a rare variant reported in young patients. Many series report that is frequently found in postmenopausal patients. We present a case of a pure mucinous carcinoma in a 25-year-old female with the importance of being a low-frequency malignancy in young patients. Conclusion Due to its benign course, it is important to know that this lesion can also present in young patients. The importance underlies in the multidisciplinary management at the right time in a proper way.
Collapse
|
8
|
Abstract
Mucinous lesions of the breast include a variety of benign and malignant epithelial processes that display intracytoplasmic or extracellular mucin, including mucocelelike lesions, mucinous carcinoma, solid papillary carcinoma, and other rare subtypes of mucin-producing carcinoma. The most important diagnostic challenge is the finding of free-floating or stromal mucin accumulations for which the significance depends on the clinical, radiologic, and pathologic context. This article emphasizes the differential diagnosis between mucocelelike lesions and mucinous carcinoma, with a brief consideration of potential mimics, such as biphasic and mesenchymal lesions with myxoid stroma ("stromal mucin") and foreign material.
Collapse
Affiliation(s)
- Beth T Harrison
- Department of Pathology, Brigham and Women's Hospital, 75 Francis Street, Amory 3, Boston, MA 02115, USA.
| | - Deborah A Dillon
- Department of Pathology, Brigham and Women's Hospital, 75 Francis Street, Amory 3, Boston, MA 02115, USA
| |
Collapse
|
9
|
Slimane M, Ben Hassouna J, Gadria S, Laamouri B, Hamdi N, Gamoudi A, Hechiche M, Rahal K. Pure mucinous carcinoma of breast cancer in 56 Tunisian women. JOURNAL OF CANCER RESEARCH AND PRACTICE 2017. [DOI: 10.1016/j.jcrpr.2017.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
10
|
No Effect of Pretreatment Breast MRI on the Timing of Surgical Treatment of Newly Diagnosed Breast Cancer. J Am Coll Radiol 2017; 14:1310-1315. [PMID: 28807386 DOI: 10.1016/j.jacr.2017.06.032] [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: 03/14/2017] [Revised: 05/29/2017] [Accepted: 06/27/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND Although breast MRI has been shown to be more sensitive in the diagnosis of breast cancer than conventional mammography, one criticism breast MRI has faced in the preoperative treatment planning is that it can delay treatment. METHODS A retrospective analysis was performed of all women diagnosed and treated for breast cancer over three consecutive years at an American university hospital. The subjects were divided into two groups: those who received preoperative breast MRI and those who did not. There were 189 patients included in this study, of whom 109 (57.67%) received pretreatment breast MRI. RESULTS Median time to treatment was not significantly different between pretreatment MRI and no pretreatment MRI groups (32 days versus 34.5 days, P = .950). Adjusting for age, detection method, stage, and histology type did not change this conclusion. CONCLUSIONS At this institution, preoperative breast MRI for patients with newly diagnosed breast cancer seemed to have no significant effect on the timing of surgical treatment in cases of newly diagnosed breast cancer.
Collapse
|
11
|
Saha M, Mukherjee R, Chakraborty C. Computer-aided diagnosis of breast cancer using cytological images: A systematic review. Tissue Cell 2016; 48:461-74. [DOI: 10.1016/j.tice.2016.07.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 06/16/2016] [Accepted: 07/27/2016] [Indexed: 12/13/2022]
|
12
|
Abstract
We report a case of primary breast lymphoma in a 75-year-old woman who noticed a lump in her right breast after trauma. Mammographic, ultrasonographic, and pathologic correlations are provided. The typical appearance of primary breast lymphoma on mammography is a solitary, uncalcified, circumscribed, or indistinctly marginated mass with adjacent lymphadenopathy. On ultrasound, primary breast lymphoma is usually hypoechoic with circumscribed or microlobulated margins demonstrating increased vascularity. The differential diagnosis for a mass with this appearance is discussed in detail and includes hematoma, abscess, primary breast lymphoma, invasive ductal carcinoma, phyllodes tumor, and metastatic disease.
Collapse
|
13
|
Mucocele-Like Lesions in the Breast Diagnosed With Percutaneous Biopsy: Is Surgical Excision Necessary? AJR Am J Roentgenol 2015; 204:204-10. [DOI: 10.2214/ajr.13.11988] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
14
|
Abstract
Mucinous carcinoma of the breast is one of the rarer forms of intramammary cancer, often presenting as a lobulated, fairly well circumscribed mass on mammography, sonography, and gadolinium-enhanced magnetic resonance imaging. It accounts for 1% to 7% of all breast cancers and generally carries a better prognosis than other types of malignant breast cancers. Metastatic disease occurs at a lower frequency than in other types of invasive carcinoma. We present an atypical case of mucinous carcinoma in a woman who presented with a palpable intramammary lymph node metastasis from an unknown breast primary. Subsequent magnetic resonance imaging and percutaneous biopsy demonstrated histologic findings consistent with a mixed mucinous neoplasm with a micropapillary pattern.
Collapse
Affiliation(s)
- Kelli Y Ha
- Department of Radiology, Baylor University Medical Center at Dallas
| | | | | |
Collapse
|
15
|
Tan JZY, Waugh J, Kumar B, Evans J. Mucinous carcinomas of the breast: Imaging features and potential for misdiagnosis. J Med Imaging Radiat Oncol 2012; 57:25-31. [DOI: 10.1111/1754-9485.12006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2012] [Accepted: 07/06/2012] [Indexed: 12/16/2022]
Affiliation(s)
| | - John Waugh
- BreastScreen Victoria; Monash Medical Centre (Moorabbin)
| | - Beena Kumar
- Southern Cross Pathology Australia; Melbourne; Victoria; Australia
| | - Jill Evans
- BreastScreen Victoria; Monash Medical Centre (Moorabbin)
| |
Collapse
|
16
|
Yoder MC, Bannon JP, Mitchell EP, Morris GJ. Mucinous Colloid Carcinoma of the Colon Metastatic to the Breast. Semin Oncol 2012; 39:e1-7. [DOI: 10.1053/j.seminoncol.2012.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
17
|
Bode MK, Rissanen T. Imaging findings and accuracy of core needle biopsy in mucinous carcinoma of the breast. Acta Radiol 2011; 52:128-33. [PMID: 21498339 DOI: 10.1258/ar.2010.100239] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Diagnosis of mucinous carcinoma can be difficult due to its benign appearance on mammograms and ultrasonographic (US) images. In the light of the rather scarce literature, core needle biopsy (CNB) has proved useful in diagnosing mucinous lesions. PURPOSE To assess mammographic, US, and CNB findings of mucinous breast tumors and to correlate them with final histology obtained in therapeutic surgery. MATERIAL AND METHODS From 2000-2006, 25 mucinous carcinomas detected with CNB were surgically removed. The mammography, US, and CNB results were analyzed and correlated with final histology. RESULTS Ninety-six percent of the mucinous carcinomas (24/25) were visible with US. All except two of the 24 tumors were solid masses. All the mixed-type lesions (group 2) were hypoechoic and had irregular or lobulated margins and heterogeous internal echotexture. The US features were more variable among the 14 pure mucinous carcinomas (group 1) and the six US visible mucinous carcinomas with cancerous cells outside the tumor (group 3). Fifty-seven percent of group 1 and 50% of group 3 tumors had clearly lobulated or irregular margins. Fifty-seven percent of group 1 and 67% of group 3 cancers were hypoechoic. A vast majority of these tumors had heterogenous echotexture. Seventy-one percent (17/24) of the lesions visible with US had posterior acoustic enhancement. Eighty percent (20/25) of the mucinous carcinomas were classified as BI-RADS 4 lesions in US. All the lesions with images available were visible on mammograms, where most of the tumors were seen as a high-density circumscribed lesion and classified as BI-RADS 4 lesions, while none were classified as BI-RADS 1, 2 or 5. The sensitivity and positive predictive value of CNB regarding mucinous carcinoma was 100%. CONCLUSION CNB was found to be a highly reliable diagnostic tool for diagnosing mucinous carcinoma in this selected material. US findings of pure mucinous carcinoma were variable, however, all reached BI-RADS 4 category. The presence of posterior acoustic enhancement beneath a solid breast lesion should raise suspicion of mucinous carcinoma. Most of the tumors appeared as BI-RADS 4 lesions in US and in mammography thus making both a useful tool for raising a suspicion of malignancy in mucinous cancers.
Collapse
Affiliation(s)
- MK Bode
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - T Rissanen
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| |
Collapse
|
18
|
Yoo JL, Woo OH, Kim YK, Cho KR, Yong HS, Seo BK, Kim A, Kang EY. Can MR Imaging Contribute in Characterizing Well-circumscribed Breast Carcinomas? Radiographics 2010; 30:1689-702. [DOI: 10.1148/rg.306105511] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
19
|
Kertmen N, Dogan E, Altundag K. Pure Mucinous Breast Carcinoma with Lung Metastasis in a Young Male Patient. Am Surg 2010. [DOI: 10.1177/000313481007600819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Neyran Kertmen
- Department of Medical Oncology Hacettepe University Faculty of Medicine Ankara, Turkey
| | - Erkan Dogan
- Department of Medical Oncology Hacettepe University Faculty of Medicine Ankara, Turkey
| | - Kadri Altundag
- Department of Medical Oncology Hacettepe University Faculty of Medicine Ankara, Turkey
| |
Collapse
|
20
|
Liu H, Tan H, Cheng Y, Zhang X, Gu Y, Peng W. Imaging findings in mucinous breast carcinoma and correlating factors. Eur J Radiol 2010; 80:706-12. [PMID: 20615642 DOI: 10.1016/j.ejrad.2010.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Revised: 06/05/2010] [Accepted: 06/09/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To investigate the factors influencing mammographic and sonographic features of mucinous breast carcinoma. MATERIALS AND METHODS Forty-six patients diagnosed as mucinous breast carcinoma between March 2005 and April 2009 were studied. Mammographies of all patients and sonographies of 41 patients were analyzed retrospectively. Microscopic slides were re-evaluated by a pathologist in order to estimate the volume of extracellular mucus which was classified as: (+), less than 50% of mucus; (++), 50-80% of mucus; and (+++), more than 80% of mucus. RESULTS Thirty-one (61.3%) cases of pure mucinous type and 2 (33.3%) of mixed mucinous carcinoma presented as masses had well-defined margins on mammography. No correlation was found between margin characteristics and histological type as well as extracellular mucus rates. Denser breasts and young age group had significantly higher ratios of tumors presented with ill-defined masses than its counterpart. Sonographically, 100% lesions showed a hypoechoic lesion, 76.5% lesions in pure type and 71.4% lesions in mixed type showed a heterogeneous internal echo. No correlation was found between sonographic findings and histological type as well as extracellular mucus rates. Lesions with >40 positivity PCNA had higher ratio presented as ill-defined margins than those of ≤40% positivity PCNA. CONCLUSIONS The most common appearance of mucinous breast carcinoma is a mass on mammography and a hypoechoic lesion with heterogeneous internal echo on sonography. Mammographic margins and sonographic findings have no relation with histological type and extracellular mucus rate. Mammographic margin features are correlated with breast density and age and PCNA.
Collapse
Affiliation(s)
- Haiquan Liu
- Department of Radiology, Cancer Hospital, and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, PR China.
| | | | | | | | | | | |
Collapse
|
21
|
Dragoumis DM, Assimaki AS, Tsiftsoglou AP. Pure mucinous carcinoma with axillary lymph node metastasis in a male breast. Breast Cancer 2009; 19:365-8. [DOI: 10.1007/s12282-009-0163-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2008] [Accepted: 07/20/2009] [Indexed: 11/28/2022]
|
22
|
Cho JS, Ryu HS, Ro HW, Lim HS, Park MH, Lee JS, Yoon JH, Jegal YJ. A Mucocele-Like Tumor of the Breast Associated with Ductal Carcinoma In Situ and Mucinous Carcinoma: A Case Report. J Breast Cancer 2009. [DOI: 10.4048/jbc.2009.12.2.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Jin Seong Cho
- Department of Surgery, College of Medicine, Chonnam National University, Gwangju, Korea
| | - Hee Seon Ryu
- Department of Surgery, College of Medicine, Chonnam National University, Gwangju, Korea
| | - Hye Won Ro
- Department of Surgery, College of Medicine, Chonnam National University, Gwangju, Korea
| | - Hyo Soon Lim
- Department of Radiology, College of Medicine, Chonnam National University, Gwangju, Korea
| | - Min Ho Park
- Department of Surgery, College of Medicine, Chonnam National University, Gwangju, Korea
| | - Ji Shin Lee
- Department of Pathology, College of Medicine, Chonnam National University, Gwangju, Korea
| | - Jung Han Yoon
- Department of Surgery, College of Medicine, Chonnam National University, Gwangju, Korea
| | - Young Jong Jegal
- Department of Surgery, College of Medicine, Chonnam National University, Gwangju, Korea
| |
Collapse
|
23
|
Chang YW, Kwon KH, Lee DW. Synchronous bilateral mucinous carcinoma of the breast: case report. Clin Imaging 2009; 33:62-6. [DOI: 10.1016/j.clinimag.2008.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2008] [Accepted: 05/02/2008] [Indexed: 11/28/2022]
|
24
|
Di Saverio S, Gutierrez J, Avisar E. A retrospective review with long term follow up of 11,400 cases of pure mucinous breast carcinoma. Breast Cancer Res Treat 2008; 111:541-7. [PMID: 18026874 DOI: 10.1007/s10549-007-9809-z] [Citation(s) in RCA: 160] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2007] [Accepted: 10/30/2007] [Indexed: 11/26/2022]
Abstract
BACKGROUND Pure mucinous breast carcinoma (PMBC) is a rare histologic type of mammary neoplasm. It has been associated with a better short-term prognosis than infiltrating ductal carcinoma (IDC) but identical long-term survival curves have been reported. The value of tumor size for TNM staging has been challenged because of the mucin content of the lesions. This study presents a large PMBC series with 20 years follow up as compared to IDC. The relative significance of a variety of common prognostic factors is calculated for this uncommon histology. MATERIALS AND METHODS A retrospective analysis of all PMBC cases reported in the SEER database between 1973 and 2002 was conducted. Overall survival (OS) and disease specific survival (DSS) were calculated at 5, 10, 15 and 20 years of follow up. Those curves were compared with all the IDC cases reported into the database during the same period. The prognostic significance of gender, race, laterality, age at diagnosis, T and N status, estrogen and progesterone receptors and administration of radiation therapy was calculated by univariate and multivariate analysis. RESULTS There were 11,422 PMBC patients reported. The median age at diagnosis was 71 years (Range 25-85). Fifty three percent of the tumors were well differentiated, 38% were moderately differentiated and the remaining 9% were poorly differentiated or anaplastic. The majority of the tumors were located in the upper outer quadrant (44%) the other 56% were roughly evenly divided between the upper inner, lower inner, lower outer and central quadrants. Eighty six percent of the patients had only localized disease at the time of surgery without nodal or distant disease while 12% had regional nodal involvement and 2% had distant metastases. The PMBC cases showed a better differentiation with lesions of lesser grade and more frequent ER/PR expression, smaller size and lesser nodal involvement when compared to the IDC cases of the same period. Kaplan Meier survival curves revealed a 5 years. breast cancer specific survival rate of 94%. Although slowly decreasing with time, 10, 15 and 20 years survival were 89%, 85% and 81% respectively compared to 82% (5 year), 72% (10 year), 66% (15 year) and 62% (20 year) for IDC. There were no significant differences in overall survival. Multivariate analysis by Cox regression revealed the nodal status (N) to be the most significant prognostic factor followed by age, tumor size (T), progesterone receptors and nuclear grade. Disease specific survival curves stratified for nodal status revealed a highly significant difference between node negative and node positive patients. The addition of radiation therapy after surgery did not significantly improve overall survival. CONCLUSIONS This large retrospective comparative analysis confirms the less aggressive behavior of PMBC compared to IDC. This favorable outcome is maintained after 20 years. This tumor presents typically in older patients and is rarely associated with nodal disease. Positive nodal status appears to be the most significant predictor of worse prognosis.
Collapse
MESH Headings
- Adenocarcinoma, Mucinous/epidemiology
- Adenocarcinoma, Mucinous/mortality
- Adenocarcinoma, Mucinous/pathology
- Adenocarcinoma, Mucinous/therapy
- Adult
- Aged
- Aged, 80 and over
- Breast Neoplasms/epidemiology
- Breast Neoplasms/mortality
- Breast Neoplasms/pathology
- Breast Neoplasms/therapy
- Carcinoma, Ductal, Breast/epidemiology
- Carcinoma, Ductal, Breast/mortality
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/therapy
- Disease-Free Survival
- Female
- Follow-Up Studies
- Humans
- Kaplan-Meier Estimate
- Middle Aged
- Proportional Hazards Models
- Retrospective Studies
- Risk Assessment
- Risk Factors
- SEER Program
- Time Factors
- Treatment Outcome
- United States/epidemiology
Collapse
Affiliation(s)
- Salomone Di Saverio
- Department of Surgery, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
| | | | | |
Collapse
|
25
|
Imaging differences in metaplastic and invasive ductal carcinomas of the breast. AJR Am J Roentgenol 2007; 189:1288-93. [PMID: 18029860 DOI: 10.2214/ajr.07.2056] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to compare the imaging features of metaplastic breast carcinoma with those of invasive ductal carcinoma. MATERIALS AND METHODS Women diagnosed on preoperative mammography or sonography with metaplastic breast carcinoma and T-stage matched invasive ductal carcinoma of the breast from a single pathology database were included in the study. Clinical and pathologic information on all metaplastic cancers was documented. Mammography and sonography variables were recorded using the BI-RADS lexicon. Groups were compared using Fisher's exact test, the chi-square test, or Wilcoxon's rank sum test, as appropriate. RESULTS Forty-three patients diagnosed with metaplastic carcinoma were matched to 43 patients with ductal carcinoma by tumor T stage. Patients with metaplastic carcinoma were younger (median, 46 vs 53 years, p = 0.048) than those with ductal carcinoma. Mammographically, metaplastic carcinomas were less frequently irregular in shape (16% vs 74%, p < 0.0001) and less frequently showed microlobulated or spiculated margins (19% vs 56%, p = 0.0008) and calcifications (25% vs 51%, p = 0.02) when compared with ductal carcinomas. Sonographically, metaplastic carcinomas were less frequently irregular in shape (27% vs 69%, p = 0.001) and less frequently showed angular margins (9% vs 49%) and posterior acoustic shadowing (9% vs 49%, p < 0.0001). CONCLUSION Characteristic malignant imaging features, including irregular shape, spiculated margins, segmentally distributed pleomorphic calcifications, and posterior acoustic shadowing, are uncommon in metaplastic carcinomas. These carcinomas tend to show more benign imaging features, such as round or oval shape with circumscribed margins, when compared with ductal carcinomas.
Collapse
|
26
|
Okafuji T, Yabuuchi H, Sakai S, Soeda H, Matsuo Y, Inoue T, Hatakenaka M, Takahashi N, Kuroki S, Tokunaga E, Honda H. MR imaging features of pure mucinous carcinoma of the breast. Eur J Radiol 2006; 60:405-13. [PMID: 16963218 DOI: 10.1016/j.ejrad.2006.08.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2006] [Revised: 07/24/2006] [Accepted: 08/03/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To characterize MR imaging features of pure mucinous carcinoma of the breast. MATERIALS AND METHODS MR images obtained from 16 women (age range, 29-81; mean age, 57 years) with pure mucinous carcinoma of the breast determined at surgery were reviewed. The MR findings used were shape, margin, internal mass enhancement, kinetic curve pattern on dynamic study, signal intensity on short time inversion recovery (STIR) T2-weighted images, and non-mass-like enhancement around the main tumor. Non-mass-like enhancement was compared with the presence of extensive intraductal component (EIC) on histopathological findings. RESULTS Eleven tumors (69%) had lobular contour, and nine tumors (56%) had smooth margin. Eight tumors (50%) showed rim enhancement and six tumors (38%) showed heterogeneous enhancement. Fourteen tumors (88%) showed a persistent enhancing pattern on kinetic curve. Fifteen tumors exhibited homogenous strongly high signal intensity on STIR T2-weighted images. In six cases with EIC, five cases had non-mass-like enhancement around the main mass. CONCLUSIONS MR findings such as lobular shape, rim or heterogeneous enhancement, persistent pattern on kinetic curve, and homogeneous strongly high signal intensity on STIR T2-weighted images may be useful in diagnosing pure mucinous carcinoma. Moreover, linear-ductal enhancement around main mass may indicate presence of EIC.
Collapse
Affiliation(s)
- Takashi Okafuji
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Dhillon R, Depree P, Metcalf C, Wylie E. Screen-detected mucinous breast carcinoma: potential for delayed diagnosis. Clin Radiol 2006; 61:423-30. [PMID: 16679116 DOI: 10.1016/j.crad.2005.10.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2005] [Revised: 10/05/2005] [Accepted: 10/07/2005] [Indexed: 10/24/2022]
Abstract
AIM To describe the imaging features of 34 screen-detected mucinous carcinomas lesions. MATERIALS AND METHODS The BreastScreen Western Australia (WA) database between January 1991 and December 2003 was searched. During this period, 214,507 women were screened and 2745 cases of invasive carcinoma and 45 cases of mucinous carcinoma were recorded. Case notes, radiology films and pathology reports of patients with mucinous carcinoma were reviewed. Thirty-four radiologically detected pure mucinous carcinomas are described. RESULTS Of the pure mucinous carcinomas, the average age at diagnosis was 65 years (range 48-82 years), which was higher than that of other women with breast cancer (average age 60 years) screened at BreastScreen WA. Characteristic mammographic features of mucinous carcinoma are well-circumscribed masses with lobulated margins (26/34). Only 39% (11/28) of tumours were detected at ultrasound, as the smaller lesions less than 15mm in diameter were often isoechoic with normal fat. Where histological grade was reported at excision, most (25/26) were low to medium-grade tumours (Bloom, Richardson and Elston grade I and II). A significant number of lesions (13/34) were evident on the previous screening examination where they were misinterpreted as benign lesions. However, none of these cases had positive axillary lymph nodes at final diagnosis. CONCLUSION Although mammographically benign appearances of mucinous carcinoma caused a delay in diagnosis in 38% of the present cases, mucinous breast carcinomas have a favourable prognosis, as they are often low-grade tumours and rarely metastasize. Delay in diagnosis for these tumours in a screening programme may not lead to a significant adverse outcome for most women.
Collapse
Affiliation(s)
- R Dhillon
- Department of Diagnostic and Interventional Imaging, Royal Perth Hospital, WA, Australia.
| | | | | | | |
Collapse
|
28
|
Lam WWM, Chu WCW, Tse GMK, Ma TKF, Tang APY. Role of fine needle aspiration and tru cut biopsy in diagnosis of mucinous carcinoma of breast—from a radiologist's perspective. Clin Imaging 2006; 30:6-10. [PMID: 16377477 DOI: 10.1016/j.clinimag.2005.06.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2005] [Revised: 05/10/2005] [Indexed: 11/22/2022]
Abstract
This study was to assess whether fine needle aspiration (FNA) or core biopsy would allow diagnosis of mucinous carcinoma of breast. In 37 mucinous carcinoma in 34 patients, 20 lesions had FNA and 24 lesions with core biopsy. FNA achieved a sensitivity of 66.7% in diagnosis of malignant lesions and 56% sensitivity in diagnosis of mucinous carcinoma. Core biopsy achieved 100% sensitivity and accuracy in the diagnosis of malignant lesions and mucinous carcinoma.
Collapse
Affiliation(s)
- Wynnie Wai-man Lam
- Department of Diagnostic Radiology and Organ Imaging, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong 852.
| | | | | | | | | |
Collapse
|
29
|
Kim JY, Han BK, Choe YH, Ko YH. Benign and Malignant Mucocele-Like Tumors of the Breast: Mammographic and Sonographic Appearances. AJR Am J Roentgenol 2005; 185:1310-6. [PMID: 16247155 DOI: 10.2214/ajr.04.0925] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to analyze and compare the mammographic and sonographic appearances of benign and malignant mucocele-like tumors. CONCLUSION The mammographic appearance of mucocele-like tumor of the breast is characterized as pleomorphic calcifications, often increasing in number. Microcalcifications in malignant mucocele-like tumors extended over a wider area than those in benign mucocele-like tumors. Sonography often shows cysts with calcified or noncalcified mural nodules.
Collapse
Affiliation(s)
- Ji-Young Kim
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, South Korea
| | | | | | | |
Collapse
|
30
|
Cherel P, Becette V, Hagay C. Stellate images: anatomic and radiologic correlations. Eur J Radiol 2005; 54:37-54. [PMID: 15797292 DOI: 10.1016/j.ejrad.2004.11.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2004] [Revised: 11/26/2004] [Accepted: 11/29/2004] [Indexed: 11/23/2022]
Abstract
The stellate images are the most well-known and most typical finding in the diagnosis of breast cancer. Its positive predictive value is very high. However, in some cases, the stellate images can correspond to benign lesions. Stellate images require high quality mammograms, precise analysis, and as always in senology, confirmation by clinical examination, ultrasound if necessary, and in the case of palpable lesions, cytology. In this work, we will study malignant and benign stellate images mammographic-pathologic correlation as well as the importance of stellate images in the detection of non-palpable lesions. The typical stellate finding is correlated with the phenomena of fibrosis and elastosis and it is impossible to distinguish benign spicules from malignant spicules on mammography. We will present guidelines in the face of stellate image. Stellate images are for the most part suggestive of malignant lesions, and their discovery should lead to suspicion of cancer until the contrary is proven.
Collapse
Affiliation(s)
- P Cherel
- Department of Radiology, René Huguenin Center, St. Cloud, France.
| | | | | |
Collapse
|
31
|
Lam WWM, Chu WCW, Tse GM, Ma TK. Sonographic Appearance of Mucinous Carcinoma of the Breast. AJR Am J Roentgenol 2004; 182:1069-74. [PMID: 15039190 DOI: 10.2214/ajr.182.4.1821069] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the sonographic and mammographic features of mucinous carcinoma and to correlate the imaging features with two histologic classifications. MATERIALS AND METHODS Two radiologists analyzed the mammographic and sonographic features of 33 mucinous carcinomas. Mammographic features according to the Breast Imaging Reporting and Data System (BI-RADS) and sonographic features were recorded and analyzed. The imaging features of the mass were correlated with the nuclear grade and mucin content of these 33 mucinous carcinomas. The incidence of axillary lymph nodes metastasis in different histologic grades and their detection by imaging were also assessed. RESULTS As many as 21.2% (7/33) of mucinous carcinomas could not be detected mammographically. When they were detected mammographically, more than 92% of the tumors presented as a mass, either oval or lobular. Microlobulations were present in 38.5% of these lesions. The margin of the lesion as seen on mammography can be used to predict the histologic grade. A circumscribed margin was associated with a favorable histologic grade (p = 0.01), whereas an indistinct margin was more commonly associated with the mixed type of lesion (p = 0.05). Sonographically, mixed cystic and solid components, distal enhancement, and microlobulated margins were commonly found in mucinous carcinomas, with an incidence of 37.5%, 43.8%, and 56.3%, respectively. Homogeneity on sonography was associated with the pure type of mucinous carcinoma and hence a better prognosis. Sonography showed a sensitivity of 50%, specificity of 89%, positive predictive value of 60%, negative predictive value of 84%, and accuracy of 79.2% in the detection of axillary lymph node metastasis. CONCLUSION Both sonographic and mammographic assessments are important in the correct diagnosis of mucinous carcinoma, the prediction of histologic grade, and the prognosis of the tumors.
Collapse
Affiliation(s)
- W W M Lam
- Department of Diagnostic Radiology and Organ Imaging, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Ngan Shing St., Shatin, New Territories, Hong Kong
| | | | | | | |
Collapse
|
32
|
Ortega R, Gómez de Travecedo I, Rubí M. Adenocarcinoma mucinoso de la mama. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2003. [DOI: 10.1016/s0210-573x(03)77244-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
33
|
Lannigan AK, Going JJ, Weiler-Mithoff E, Cooke TG. Mucinous breast carcinoma. Breast 2002; 11:359-61. [PMID: 14965697 DOI: 10.1054/brst.2002.0417] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2001] [Revised: 12/14/2001] [Accepted: 01/15/2002] [Indexed: 11/18/2022] Open
Abstract
A case of mucinous breast carcinoma is discussed in which several unusual features in presentation and difficulties in management are addressed.
Collapse
Affiliation(s)
- A K Lannigan
- Department of Surgery, Glasgow Royal Infirmary, UK
| | | | | | | |
Collapse
|
34
|
Kawashima M, Tamaki Y, Nonaka T, Higuchi K, Kimura M, Koida T, Yanagita Y, Sugihara S. MR imaging of mucinous carcinoma of the breast. AJR Am J Roentgenol 2002; 179:179-83. [PMID: 12076930 DOI: 10.2214/ajr.179.1.1790179] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We examined retrospectively the MR imaging findings in eight patients with mucinous carcinoma of the breast to better describe the imaging characteristics of this disease. CONCLUSION The MR imaging findings in mucinous carcinomas include dynamic curves of the gradually enhancing type and a very high signal intensity on T2-weighted images compared with other histologic types of invasive ductal carcinoma. These findings appear to be useful for diagnosis.
Collapse
Affiliation(s)
- Miho Kawashima
- Department of Radiology, Gunma Cancer Center, 617-1 Takabayashi-nishi-cho, Ota-shi, Gunma 373-8550, Japan
| | | | | | | | | | | | | | | |
Collapse
|
35
|
Elorz M, Pina L, Bastarrika G, Bergaz F. Presentación atípica de un tumor mucinoso de mama como microcalcificaciones agrupadas. RADIOLOGIA 2001. [DOI: 10.1016/s0033-8338(01)77025-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
36
|
Memis A, Ozdemir N, Parildar M, Ustun EE, Erhan Y. Mucinous (colloid) breast cancer: mammographic and US features with histologic correlation. Eur J Radiol 2000; 35:39-43. [PMID: 10930764 DOI: 10.1016/s0720-048x(99)00124-2] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Mucinous carcinoma of the breast presents with different survival rates in pure and mixed types. The purpose of this study was to correlate the mammographic and ultrasonographic findings of mucinous carcinoma with histologic features in different types and mucin rates. MATERIAL AND METHODS Thirty-four patients (2.3%) had mucinous cancer after retrospective review of the 1439 breast cancers diagnosed between 1990 and 1996. Twenty-seven patients, 19 pure and eight mixed type of mucinous carcinomas of the breast, were included in this study to evaluate the imaging findings. In 22 of these, the microscopic slides were available and re-evaluated to estimate the volume of extracellular mucin. The volume of the extracellular mucin was classified histologically as: (+), less than 50% of mucin; (++), 50-80% of mucin; and ( ), more than 80% of mucin. Mammographic features with emphasis on margin characteristics and sonographic echo pattern of tumors were correlated with histologic findings. RESULTS Ten cases (53%) of pure mucinous type carcinomas had a circumscribed mass lesion on the mammograms. The well-defined, lobulated margins of the masses were well correlated with pure histologic type (P<0.01; chi(2) analysis) Two-thirds of these tumors had high volume extracellular mucin. All mixed type mucinous carcinomas demonstrated poorly defined or spiculated margins with no relation to the mucin rates (P<0.01). The sonographic appearances of the tumors showed correlation with histologic types. Most of the pure type carcinomas (53%) were seen with isoechogenic echo texture relative to that of subcutaneous fat, while all of the mixed type carcinomas were hypoechogenic (P<0.01). CONCLUSION The mammographic and sonographic features of mucinous breast carcinoma show differences in pure and mixed types of the tumor. The most common mammographic appearance of pure mucinous carcinomas with high percentages of mucin is a mass lesion having well-defined margins, which is isoechogenic relative to fat on the sonographic examination. Pure type of carcinomas with small percentages of mucin and mixed type carcinomas have more aggressive imaging characteristics.
Collapse
Affiliation(s)
- A Memis
- Department of Radiology, Medical School of Ege University, Bornova, 35100, Izmir, Turkey. www.ay_memis.medscape.com
| | | | | | | | | |
Collapse
|
37
|
Chopra S, Evans AJ, Pinder SE, Yeoman LJ, Ellis IO, Elston CW, Wilson AR. Pure mucinous breast cancer-mammographic and ultrasound findings. Clin Radiol 1996; 51:421-4. [PMID: 8654008 DOI: 10.1016/s0009-9260(96)80162-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
UNLABELLED Aim to describe the mammographic and ultrasonographic features of pure mucinous breast cancer. PATIENTS AND METHODS The mammographic features of 15 patients and ultrasonographic features of seven patients with pure mucinous breast cancer were reviewed retrospectively by three experienced breast radiologists. RESULTS The commonest mammographic appearance was of a poorly defined (86%) lobulated (71%) mass which could contain calcification (14%). A well defined mass (14%) and suspicious calcifications without a mass (7%) were also seen. Ultrasound showed a mass lesion in all seven cases which was either hypoechoic (86%) or mixed echogenicity (14%); 86% had a heterogeneous internal echo pattern; 71% showed distal enhancement while none showed distal attenuation. CONCLUSION The imaging features of pure mucinous cancer are different from more common types of breast carcinoma. It is possible to misinterpret the appearances of this slow growing tumour as a benign lesion due to rarity of speculation on mammography and distal attenuation on ultrasonography. Most cases do, however, show other features suggesting malignancy.
Collapse
Affiliation(s)
- S Chopra
- Nottingham Breast Screening Unit, City Hospital NHS Trust, UK
| | | | | | | | | | | | | |
Collapse
|
38
|
|
39
|
Abstract
BACKGROUND Breast cancer is the most common cancer and the second leading cause of cancer death among women in the United States; annual breast cancer deaths are exceeded only by those for lung cancer. METHODS Data from the Surveillance, Epidemiology, and End Results (SEER) program registry of the National Cancer Institute comprising 158,621 invasive and 10,639 in situ cases of microscopically confirmed breast carcinomas registered for the years 1973-1987 have been analyzed. Relative frequencies, incidence rates, and 5-year relative survival rates were examined by selected variables of interest. Invasive and in situ breast carcinomas and sarcomas were analyzed separately. RESULTS Infiltrating duct carcinoma was the largest group of female breast cancer, constituting 67.9% of the total with a 5-year relative survival of 79%. All other invasive carcinomas were compared with this group. Lobular carcinoma was the second largest group, only 6.3%, and a 5-year relative survival of 84%. Medullary carcinoma was the third most common with 2.8% and a 5-year relative survival of 82%. Other types included mucinous (colloid) adenocarcinoma, 2.2%, 5-year relative survival of 95%; comedocarcinoma, 1.4%, 5-year relative survival of 87%; Paget's disease (nipple and other breast), 1.1%, 5-year relative survival of 79%; papillary carcinoma, 0.9%, 5-year relative survival of 95%; tubular adenocarcinoma, 0.7%, 5-year relative survival of 96% and inflammatory carcinoma, 0.5%, 5-year relative survival of 18%. Carcinoma in situ was registered as intraductal, lobular, combined ductal and lobular, papillary, and carcinoma in situ, not otherwise specified. The relative survival for all forms of carcinomas in situ was approximately 100%. Sarcomas and malignant tumors not further classified are also considered. CONCLUSIONS The various histologic types of breast cancer exhibit differences in regard to relative frequency, site pattern within the breast, and patient survival. The SEER program data base of breast cancer is the largest single population-based reference source for breast cancer in the United States. This program is a valuable resource for information on frequency, percentage, and incidence rates by histologic type as well as survival rates of patients with breast cancer.
Collapse
Affiliation(s)
- J W Berg
- Department of Pathology and Preventive Medicine, University of Colorado, Boulder
| | | |
Collapse
|
40
|
Breast Cancer Treatment LiteratureWatch. J Womens Health (Larchmt) 1994. [DOI: 10.1089/jwh.1994.3.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|