Mixed mucinous carcinoma of breast – A case report

In females breast carcinoma is the most common cancer worldwide. Globally, 2.3 million women were diagnosed and 685 000 deaths due to breast cancer were reported in year 2020. Even in the era of immunohistochemistry (IHC) and molecular studies, the aggressive nature of the breast cancer can be determined by its histological type, grade, nodal status, and metastasis. Mucinous carcinoma (MC) is a rare variant of invasive breast cancer accounting for 1-7%. It is represented by the presence of large extracellular mucin pools. Based on the mucin content two main subtypes are identified: Pure Mucinous Carcinoma (PMC) and Mixed Mucinous Carcinoma (MMC). Pure Mucinous Carcinoma (PMC) is localized in most of the cases, whereas the mixed forms tend to metastasize to lymph nodes. Hence the mixed forms often require an axillary dissection during surgery. We are presenting a case of 70 year old female who presented with the complaints of lump in the right breast since 2 months and on ultrasound work up a score of BIRADS V was given. She underwent right modified mastectomy with right axillary dissection and was diagnosed as mixed type of mucinous adenocarcinoma breast by histopathological examination. It was confirmed by IHC which showed positivity for ER, PR & Synaptophysin and negativity for Her2neu. Prognostically MC is better compared to other variants of invasive ductal carcinoma as they respond to hormone therapy.

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Spontaneous regression of breast cancer with immune response: a case report

Surgical Case Reports ◽

10.1186/s40792-020-01103-5 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Masahiro Ohara ◽

Yumiko Koi ◽

Tatsunari Sasada ◽

Keiko Kajitani ◽

Seishi Mizuno ◽

...

Keyword(s):

Breast Cancer ◽

Immune Responses ◽

Needle Biopsy ◽

Spontaneous Regression ◽

Ductal Carcinoma ◽

Surgical Stress ◽

Fibrous Tissue ◽

Coagulation Necrosis ◽

Surgical Specimen ◽

The Right

Abstract Background Spontaneous regression (SR) is a rare phenomenon in which a cancer disappears or remits without treatment. We report a case of breast cancer that showed spontaneous tumor regression in the surgical specimen after core needle biopsy. Case presentation A 59-year-old woman came to our hospital complaining of a painful lump in the right breast. In the upper-outer quadrant of the right breast, a tumor with an unclear boundary, 30 mm in diameter, was palpable. In pathological findings from needle biopsy, the tumor was diagnosed as solid-type invasive ductal breast carcinoma. Partial coagulation necrosis was generated in estrogen receptor-negative, HER2-negative, and AE1/AE3-positive ductal carcinoma without infiltration of lymphocytes. Surgery for right breast cancer was then performed. Histological examination of the surgical specimen revealed the tumor was invasive ductal carcinoma with lymphocyte infiltration, coagulation necrosis, and fibrous tissue with hemosiderin. The tumor formed a solid nest, 3 mm in diameter, suggesting the possibility of SR. Conclusions Immune responses, infection, hormones, surgical stress, and ischemia have been reported as mechanisms of SR. The findings in this case strongly suggest that SR of breast cancer is associated with anti-tumor immune responses.

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Uncommon Breast Malignancies: Presentation Pattern, Prognostic Issue and Treatment Outcome in an Italian Single Institution Experience

Tumori Journal ◽

10.1177/030089161309900107 ◽

2013 ◽

Vol 99 (1) ◽

pp. 39-44

Author(s):

Claudia Maria Regina Bareggi ◽

Dario Consonni ◽

Barbara Galassi ◽

Donatella Gambini ◽

Elisa Locatelli ◽

...

Keyword(s):

Breast Cancer ◽

Treatment Outcome ◽

Invasive Ductal Carcinoma ◽

Ductal Carcinoma ◽

Early Stage ◽

Medullary Carcinoma ◽

Mucinous Carcinoma ◽

Lymph Node Involvement ◽

Tubular Carcinoma ◽

Breast Malignancies

Aims and background Often neglected by large clinical trials, patients with uncommon breast malignancies have been rarely analyzed in large series. Patients and methods Of 2,052 patients diagnosed with breast cancer and followed in our Institution from January 1985 to December 2009, we retrospectively collected data on those with uncommon histotypes, with the aim of investigating their presentation characteristics and treatment outcome. Results Rare histotypes were identified in 146 patients (7.1% of our total breast cancer population), being classified as follows: tubular carcinoma in 75 (51.4%), mucinous carcinoma in 36 (24.7%), medullary carcinoma in 25 (17.1%) and papillary carcinoma in 10 patients (6.8%). Whereas age at diagnosis was not significantly different among the diverse diagnostic groups, patients with medullary and papillary subtypes had a higher rate of lymph node involvement, similar to that of invasive ductal carcinoma. Early stage diagnosis was frequent, except for medullary carcinoma. Overall, in comparison with our invasive ductal carcinoma patients, those with rare histotypes showed a significantly lower risk of recurrence, with a hazard ratio of 0.28 (95% CI, 0.12–0.62; P = 0.002). Conclusions According to our analysis, patients with uncommon breast malignancies are often diagnosed at an early stage, resulting in a good prognosis with standard treatment.

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Postirradiation Multiple Minute Digitate Porokeratosis

Journal of Cutaneous Medicine and Surgery ◽

10.1177/120347540100500205 ◽

2001 ◽

Vol 5 (2) ◽

pp. 126-130 ◽

Cited By ~ 1

Author(s):

Ramon M. Pujol ◽

Eugenia Perez–Losada ◽

Xavier Matias–Guiu ◽

Josefina Fuentes ◽

Carmen M. Alonso ◽

...

Keyword(s):

Granular Layer ◽

Ductal Carcinoma ◽

Histopathological Examination ◽

Infiltrating Ductal Carcinoma ◽

Anterior Aspect ◽

Irradiation Therapy ◽

Irradiation Field ◽

Cornoid Lamella ◽

Radiation Induced ◽

The Right

Background: Development of multiple minute digitate hyperkeratoses (MMDH) after irradiation has been reported previously. The keratotic lesions in these cases were confined within the irradiation field, and histopathological examination disclosed a focal column of parakeratosis (cornoid lamella) arising from an epidermis devoid of granular layer. Objective: We describe a 78-year-old woman who developed multiple, discrete, tiny, filiform, keratotic papules on the anterior aspect of the right chest wall, 13 months after postmastectomy cobalt irradiation therapy for mammary infiltrating ductal carcinoma. Conclusion: Postirradiation MMDH represents a peculiar radiation-induced disorder that we believe should be distinguished from other cases of MMDH and included within the spectrum of porokeratosis.

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Difficulty Diagnosing a Brain Tumor during Clinical Maintenance of a Complete Response to anti-HER2 Treatments for Metastatic Breast Cancer: A Case Report

Case Reports in Oncology ◽

10.1159/000511051 ◽

2020 ◽

Vol 13 (3) ◽

pp. 1311-1316

Author(s):

Ryoko Semba ◽

Yoshiya Horimoto ◽

Atsushi Arakawa ◽

Yoko Edahiro ◽

Tomoiku Takaku ◽

...

Keyword(s):

Breast Cancer ◽

Brain Tumor ◽

Ductal Carcinoma ◽

Metastatic Breast ◽

Stage Iv ◽

B Cell Lymphoma ◽

High Dose ◽

Her2 Positive ◽

Stage Iv Breast Cancer ◽

The Right

A 46-year-old woman with erythema of the right breast presented to our hospital and was diagnosed with stage IV breast cancer (HER2-positive invasive ductal carcinoma). She received 4 courses of anthracycline-based regimens and 4 courses of trastuzumab + pertuzumab + docetaxel (Tmab + Pmab + DTX). Since she responded well to these therapies, only Tmab + Pmab was continued thereafter. Twenty-three months after starting treatment, she developed a headache. A tumor was identified in the right temporal lobe. Craniotomy was performed for definitive diagnosis. Intraoperative pathological assessment suggested the tumor to be brain metastasis of breast cancer. However, the final pathological diagnosis was diffuse large B-cell lymphoma of central nervous system (DLBCL-CNS) based on re-assessment with immunohistochemical examinations. Therefore, the Tmab + Pmab was discontinued, and 6 courses of high-dose methotrexate therapy were administered. This case highlights the importance of considering rare entities, such as DLBCL, when diagnosing a solitary brain tumor in a patient with a primary cancer, based on imaging and pathological findings.

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Expressing Status and Correlation of ARID1A and Histone H2B on Breast Cancer

BioMed Research International ◽

10.1155/2016/7593787 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Yan Wu ◽

Yan Gu ◽

Shanyu Guo ◽

Qiancheng Dai ◽

Wei Zhang

Keyword(s):

Breast Cancer ◽

Ductal Carcinoma ◽

Expression Profiles ◽

Gene Expression Profiles ◽

Mucinous Carcinoma ◽

Cancer Gene ◽

Breast Cancers ◽

Histone H2b ◽

Oncomine Database ◽

Breast Cancer Gene

ARID1A is one of the important cancer-related genes and regulates transcription of certain genes by altering chromatin structure. Inactivated mutations and decreased expression of ARID1A gene have been reported in several kinds of cancer. Histone H2B is a major component of chromatin and encoded by HIST1H2BE. The goal of the study is to evaluate expressing status of ARID1A and H2B as well as their correlation on breast cancer. Gene expression profiles of ARID1A and H2B on Oncomine database are analyzed. Tissue microarray of breast cancer was used for examination of ARID1A and H2B expression by immunohistochemistry. As a result, the disagreement of ARID1A expression was found, while HIST1H2BE expression is elevated in 4 out of 5 datasets on Oncomine database. There were 15 cases (20%) of breast cancers that were positive for ARID1A. Fifty-eight out of 75 cases of breast cancer (77.3%) were highly expressed for H2B protein and 17 cases (22.7%) were low expressed for H2B protein. All cases with ARID1A expression are overlapped with H2B high expression. Among 15 cases with ARID1A and H2B coexpression, 13 are invasive ductal carcinoma and 2 are mucinous carcinoma. Our results indicate that ARID1A gene may be involved in carcinogenesis of some subtypes of breast cancer.

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Successful Local Control With High-dose Palliative Radiation Therapy for Local Advanced Breast Cancer of Mucinous Carcinoma With Malignant Wound.

10.21203/rs.3.rs-1024514/v1 ◽

2021 ◽

Author(s):

Yojiro Ishikawa ◽

Rei Umezawa ◽

Takaya Yamamoto ◽

Noriyoshi Takahashi ◽

Kazuya Takeda ◽

...

Keyword(s):

Breast Cancer ◽

Advanced Breast Cancer ◽

Standard Treatment ◽

Mucinous Carcinoma ◽

Advanced Breast ◽

High Dose ◽

The Right ◽

To Receive ◽

Local Advanced ◽

Local Advanced Breast Cancer

Abstract Background: Patients with breast cancer who refuse standard treatment often suffer from malignant wounds due to the growth of local tumors. However, treatment strategies for patients with unresectable locally advanced breast cancer who have refused standard treatment have been unclear.Case presentation: A 44-year-old female was diagnosed with breast cancer of mucinous carcinoma in the right breast. She refused standard treatment for her breast cancer for six years. She suddenly visited the emergency department because of acute bleeding from the right breast cancer with malignant wounds. Macroscopically, the tumor in the right breast measured over 20 cm in diameter. The tumor was exudative, exhibited ulceration and slight bleeding, and gave off an odor. Imaging findings showed multiple lymph node and bone metastases, and the final diagnosis was breast cancer of stage IV (cT4bN1M1). Although the surgeon recommended chemotherapy for the breast cancer, the patient refused to receive chemotherapy or other therapy due to concerns about complications during treatment. Considering the symptoms of advanced breast cancer with malignant wounds, she finally agreed to receive radiation therapy (RT). We performed RT of 70 Gy in 35 fractions over a period of 7 weeks. The tumor-associated symptoms were disappeared after RT. At three months after RT, the tumor had almost disappeared. We administered luteinizing hormone-releasing hormone agonists after RT. At two years after RT, she died due to multiple liver metastases and appearance of ascites; however, there was no disease progression in the right breast.Conclusions: High-dose RT for local advanced breast cancer of MC with malignant wounds is therefore considered to be an effective therapeutic option.

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EP.TH.515A Case of mucinous adenocarcinoma of the breast in a young male patient presenting with a subcutaneous axillary lump

British Journal of Surgery ◽

10.1093/bjs/znab309.058 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Amna Suliman ◽

Ahmed Latif ◽

Anna Metafa ◽

Michal Uhercik

Keyword(s):

Breast Cancer ◽

Mucinous Adenocarcinoma ◽

Breast Tissue ◽

Ductal Carcinoma ◽

Progesterone Receptors ◽

Young Male ◽

Mucinous Carcinoma ◽

Lymph Node Biopsy ◽

Axillary Node ◽

Axillary Mass

Abstract Aims Mucinous adenocarcinoma of the breast is rarely encountered clinically, and makes up only 0.01% of Breast cancer (BC) cases and < 1% of male breast cancer (MBC). We describe an extremely rare case of mucinous carcinoma in accessory axillary breast tissue in a male. Case details A 48-year old male presented with a subcutaneous lump in his left axilla. Ultrasound described a 30mm hypoechoic mass and core biopsy confirmed mucinous adenocarcinoma, strongly positive for oestrogen and progesterone receptors, HER2 negative. A solitary enlarged axillary node in was sampled (C2) and mammogram reported a 32mm spiculate mass (M4) on the left. PET scan showed uptake only in the known axillary mass. Management Wide Local Excision and Sentinel Lymph Node Biopsy (SLNB) was completed. Histology showed a 27 mm grade 2 mucinous carcinoma, and the patient completed adjuvant radiotherapy and was commenced on tamoxifen. Conclusions MBC is rare, and accounts for only 1% of all BC. Men tend to be diagnosed at an older age (mean is 67 years) and usually have genetic/hormonal risk factors. Histologically, invasive ductal carcinoma makes up 95% of MBC. In every regard therefore, our case breaks the mold since, he was young, had no genetic/family history and no background of gynaecomastia (present in 6-38%). Literature review suggests that this is only the second case of its kind and from it we can learn to be vigilant for MBC in accessory axillary breast tissue as well as the more typical presentations.

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Invasive Cancer Confined to the Nipple of the Conserved Breast: A Case Report

Case Reports in Oncology ◽

10.1159/000510309 ◽

2020 ◽

Vol 13 (3) ◽

pp. 1125-1130

Author(s):

Miyuki Kitahara ◽

Yasuo Hozumi ◽

Naoto Takeuchi ◽

Satoko Ichinohe ◽

Mitsuki Machinaga ◽

...

Keyword(s):

Breast Cancer ◽

Local Recurrence ◽

Ductal Carcinoma ◽

Breast Conserving Surgery ◽

Lymph Node Biopsy ◽

Invasive Cancer ◽

Breast Cancer Patients ◽

Skin Changes ◽

True Recurrence ◽

The Right

Invasive breast cancer deriving from the milk duct and lobule that develops in the nipple is extremely rare, except in Paget’s disease and skin cancer. This is the second reported case of the development of invasive cancer confined to the nipple after breast-conserving surgery. A 69-year-old woman visited our department due to redness, swelling, and bloody discharge of the right nipple in the last month. A needle biopsy was suggestive of invasive ductal carcinoma; we performed a removal surgery of the right residual breast tissue and a second sentinel lymph node biopsy. She underwent these procedures 10 years previously as well. Thus, we diagnosed the present lesion as a local recurrence, but it was unknown whether the lesion was a true recurrence or second cancer, namely, metachronal ipsilateral breast cancer. The present case helps promote awareness that invasive cancer rarely develops in the nipple after conserving surgery. Patients should be encouraged to visit a medical facility if experiencing skin changes and swelling of the nipple. Additionally, breast cancer patients must be carefully selected for breast-conserving surgery; failure to do so may later result in nipple-specific local recurrence.

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A Clinical Case Study of Synchronous Breast Cancer

Medicina Moderna - Modern Medicine ◽

10.31689/rmm.2021.28.3.329 ◽

2021 ◽

Vol 28 (3) ◽

pp. 329-332

Author(s):

Mihai MEHEDINTU-IONESCU ◽

◽

Stefan-Andrei COMAN ◽

Horia-Alexandru TOADER ◽

◽

...

Keyword(s):

Breast Cancer ◽

Carcinoma In Situ ◽

Clinical Case ◽

Ductal Carcinoma ◽

Lobular Carcinoma ◽

Clinical Case Study ◽

The Right ◽

Synchronous Breast Cancer

The following article represents a clinical case study of a synchronous breast cancer in a 47 year old woman with no prior significant comorbidities.Up to 10% of all breast cancers can be synchronous (usually found with the help of breast MRI). The occurrence of bilaterally is considerable with invasive lobular carcinoma. The patient observed after self-palpating her breast a nodule in the infero-external quadrant of the right breast. During almost 4 months the patient underwent punch biopsy of the right breast, lumpectomy and finally double mastectomy with immediate reconstruction using Mentor implants and AMD. The histopathological result showed ductal carcinoma in situ in the right breast and lobular carcinoma in situ in both breasts. Postoperatively the patient is free of cancer, but under clinical and imagistic surveillance.

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Primary Cutaneous Mucinous Carcinoma Presenting as an Unusually Large Lesion - A Rare Case Report

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/599 ◽

2021 ◽

Vol 10 (34) ◽

pp. 2939-2941

Author(s):

Jiby Soosen Ninan ◽

Ajithakumari K. ◽

Tony Mathew

Keyword(s):

Case Report ◽

Histopathological Examination ◽

Mucinous Carcinoma ◽

Malignant Tumour ◽

Large Size ◽

Rare Case Report ◽

Eccrine Carcinoma ◽

One Year ◽

The Right ◽

Adnexal Tumour

Primary cutaneous mucinous carcinoma (PCMC) also known as primary mucinous carcinoma of the skin (PMCS) or primary mucinous eccrine carcinoma (PMEC) is a rare malignant adnexal tumour of eccrine origin. Many visceral mucinous carcinomas especially of the breast and gastrointestinal tract can metastasize to the skin mimicking PCMC. Hence it is very important to rule out metastatic mucinous carcinomas before making a diagnosis of PCMC. Usually, PCMC presents as a slowgrowing tumour of considerably smaller size compared to our case. The large size and shorter duration are the key features of this case report. Here we report an unusually large-sized rare malignant tumour of skin appendage. Our patient was a 54-year-old lady who presented with progressive swelling of one year duration in the right frontoparietal area. Ultrasonography showed an ill-defined lesion in the subcutaneous plane with multiple cystic spaces within it. No bone involvement was noted. The excised lesion measured 13 x 7 x 2 cms and was diagnosed as primary cutaneous mucinous carcinoma on histopathological examination. The possibility of cutaneous secondaries from elsewhere was ruled out by detailed clinical and radiological investigations. The case is reported considering the unusually bigger size and shorter duration of this rare entity.

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