Sonographic Features of Pure Mucinous Brelast Carcinoma With Micropapillary Pattern

ObjectivePrevious 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 MethodsWe 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.ResultsThe 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).ConclusionMUMPC 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.

Role of multi-parametric MRI in the differentiation between mucinous breast carcinoma and fibroadenoma

Background The purpose of this study was to evaluate diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and functional MRI (diffusion and MR spectroscopy) using the latest MRI breast imaging reporting and data system (MRI-BIRADS) descriptors and non-BIRADS items for differentiation of mucinous breast carcinomas from fibroadenomas. Methods We included 19 cases of mucinous breast carcinoma and 37 cases of fibroadenoma. DCE-MRI, Diffusion-weighted MR imaging (DWI) and multi-voxel MR spectroscopy (MRS) were done, MRI-BIRADS (5th edition) analysis of the lesions was performed, and histopathological examination of all cases was done. Results According to univariate analysis, mucinous carcinoma was frequently detected in older age-group (COR = 1.4, 95% CI = 1.1–1.7 and p value < 0.001) and had more frequent irregular borders and non-circumscribed margins than fibroadenoma (COR = 11.6, 95% CI = 2–66.4 and p value = 0.002). All mucinous carcinoma had high T2 signal. Fibroadenomas had more frequent homogenous enhancement than mucinous carcinoma; none of the fibroadenomas had rim enhancement nor enhancing internal septations; mucinous carcinoma had more frequent rim enhancement and (n = 6, p value < 0.001) and enhancing internal septations (n = 7, p value < 0.001). Fibroadenoma had frequent dark non-enhancing internal septations than mucinous carcinoma (p value < 0.001). On multivariate analysis, mucinous carcinoma had significant combination of being common in older age, larger in size, with irregular shape, and non-circumscribed margins. On ADC map and MRS, mucinous carcinoma had higher ADC values and higher CHO.SNR than fibroadenoma. The mean ADC value of mucinous carcinoma was 1.3 ± 0.1 × 10−3mm2/s, which was significantly higher than that of fibroadenoma (1.1 ± 0.1 × 10−3mm2/s), with p = 0.002. Also, the mean CHO.SNR was significantly higher in mucinous carcinoma (3.1 ± 0.8) than fibroadenoma (0.8 ± 0.5) with p value < 0.001. According to our results, the presence of type 3 (washout curve), dark internal septations, non-circumscribed margins and irregular shape of the lesion showed the highest sensitivity and accuracy for differentiation of mucinous carcinomas and fibroadenomas (100, 78.6%), (89.4, 82%), (86.5, 80.3%) and (81, 71.4%), respectively. Conclusion The combined use of DCE-MRI, DW-MRI and MRS with breast MRI-BIRADS descriptors and non-BIRADS items increases the diagnostic accuracy for differentiation of mucinous carcinomas from fibroadenomas.

The clinical features and prognosis of patients with mucinous breast carcinoma compared with those with infiltrating ductal carcinoma: a population-based study

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.

Is Invasive Mucinous Breast Carcinoma A Rare Variant With Neuroendocrine Differentiation?

We want to bring your attention towards the rare variant of breast cancer hence promoting its early detection and screening. The main advantage of early diagnosis is reduced tumor size without distant dissemination at the initial treatment.

Retraction: Periodic acid-Schiff and alcian blue immunohistochemistry to detect mucin in mucinous breast carcinoma

[This retracts the article DOI: 10.13181/mji.oa.192768]

A Rare Case of Metastatic Mucinous Breast Carcinoma as a First Presentation of Colon Cancer in a Male Patient: Case Report and Review of the Literature

The majority of breast tumors are primary; however metastatic tumor to the breast from extramammary sites has an incidence of 0.5 to 3% and can be misinterpreted clinically as a primary breast tumor. We report a case of metastatic mucinous breast carcinoma as a first presentation from colon cancer in a male patient who hasn’t had any bowel symptoms. The immunohistochemical study helped in suspecting the diagnosis, which was then confirmed by CT scan abdomen and pelvis and endoscopic biopsy of the colonic lesion. Management of such patients usually by palliative chemotherapy due to the aggressive nature of the disease however, surgical intervention may be indicated in symptomatic patient or risk of tumor ulceration as in our patient.