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.

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

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.